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Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana

INTRODUCTION: adolescent pregnancy in Ghana, like in most low and middle income countries, is an issue of immense public health importance. Pregnant adolescents are faced with the stronger dilemma of either terminating the unwanted pregnancy or keeping it. This discourse which is based on findings f...

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Autor principal: Bain, Luchuo Engelbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571928/
https://www.ncbi.nlm.nih.gov/pubmed/34795815
http://dx.doi.org/10.11604/pamj.2021.40.34.29220
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author Bain, Luchuo Engelbert
author_facet Bain, Luchuo Engelbert
author_sort Bain, Luchuo Engelbert
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description INTRODUCTION: adolescent pregnancy in Ghana, like in most low and middle income countries, is an issue of immense public health importance. Pregnant adolescents are faced with the stronger dilemma of either terminating the unwanted pregnancy or keeping it. This discourse which is based on findings from empirical research in Accra Ghana aims at contributing to the usefulness of understanding the meaning and scope of autonomy when it comes to providing ethically grounded, and adolescent friendly, reproductive health care services to pregnant adolescents. The aim of this work was to document the meaning and determinants of autonomous decision making among pregnant adolescents in the James Town area of Accra, Ghana. METHODS: thirty (30) semi-structured in depth interviews were conducted among adolescents who had been pregnant at least once, 23 in depth interviews among purposively selected stakeholders (parents, teachers, NGO staff working in reproductive health, community volunteers), and 8 focus group discussions among parents, teachers, adolescent students who had not been pregnant before, and adolescents who had at least one pregnancy in the past. Data were transcribed verbatim and analyzed thematically. RESULTS: most adolescents reported that the final decision to continue a pregnancy to term or go in for an abortion was taken by them. The partner´s willingness to take responsibility of the pregnant adolescent and baby, as well as financial considerations, were main players in deciding upon the pregnancy outcomes. Cultural desirability for children and health care provider/father paternalism (power dynamics) in the decision-making process were central considerations in the decision-making process. Unaffordable and unfriendly safe abortion services pushed adolescents to either continue pregnancies to term against their will, or opt to visit unsafe abortion care providers. CONCLUSION: adolescents stand to make truly autonomous decisions if they are provided with the right information, at the right time, at the right place, by the right persons, and in the right way. Health system, economic, and cultural factors play significant roles in rendering pregnant adolescent autonomy meaningful when deciding upon their pregnancy outcomes. Continuing pregnancies to term against one´s will or being forced to go in for an abortion are ethically unjustified. Further research is required to examine the long-term consequences of forced pregnancy terminations or births.
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spelling pubmed-85719282021-11-17 Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana Bain, Luchuo Engelbert Pan Afr Med J Research INTRODUCTION: adolescent pregnancy in Ghana, like in most low and middle income countries, is an issue of immense public health importance. Pregnant adolescents are faced with the stronger dilemma of either terminating the unwanted pregnancy or keeping it. This discourse which is based on findings from empirical research in Accra Ghana aims at contributing to the usefulness of understanding the meaning and scope of autonomy when it comes to providing ethically grounded, and adolescent friendly, reproductive health care services to pregnant adolescents. The aim of this work was to document the meaning and determinants of autonomous decision making among pregnant adolescents in the James Town area of Accra, Ghana. METHODS: thirty (30) semi-structured in depth interviews were conducted among adolescents who had been pregnant at least once, 23 in depth interviews among purposively selected stakeholders (parents, teachers, NGO staff working in reproductive health, community volunteers), and 8 focus group discussions among parents, teachers, adolescent students who had not been pregnant before, and adolescents who had at least one pregnancy in the past. Data were transcribed verbatim and analyzed thematically. RESULTS: most adolescents reported that the final decision to continue a pregnancy to term or go in for an abortion was taken by them. The partner´s willingness to take responsibility of the pregnant adolescent and baby, as well as financial considerations, were main players in deciding upon the pregnancy outcomes. Cultural desirability for children and health care provider/father paternalism (power dynamics) in the decision-making process were central considerations in the decision-making process. Unaffordable and unfriendly safe abortion services pushed adolescents to either continue pregnancies to term against their will, or opt to visit unsafe abortion care providers. CONCLUSION: adolescents stand to make truly autonomous decisions if they are provided with the right information, at the right time, at the right place, by the right persons, and in the right way. Health system, economic, and cultural factors play significant roles in rendering pregnant adolescent autonomy meaningful when deciding upon their pregnancy outcomes. Continuing pregnancies to term against one´s will or being forced to go in for an abortion are ethically unjustified. Further research is required to examine the long-term consequences of forced pregnancy terminations or births. The African Field Epidemiology Network 2021-09-13 /pmc/articles/PMC8571928/ /pubmed/34795815 http://dx.doi.org/10.11604/pamj.2021.40.34.29220 Text en Copyright: Luchuo Engelbert Bain et al. https://creativecommons.org/licenses/by/4.0/The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Bain, Luchuo Engelbert
Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana
title Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana
title_full Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana
title_fullStr Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana
title_full_unstemmed Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana
title_short Understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from Ghana
title_sort understanding the meaning of autonomy in adolescent pregnancy decision-making: lessons from ghana
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571928/
https://www.ncbi.nlm.nih.gov/pubmed/34795815
http://dx.doi.org/10.11604/pamj.2021.40.34.29220
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