Teen pregnancy decision-making and resolultion Becaming pregnant is not a deliberate choice in many adolescents.

As mentioned by Binyam age (adolescents age) is one of the factors for unwanted pregnancy. Under this sub-section/section the decision unmarried pregnant adolesecnts make regarding the resolution of their unintended pregnancies will be discussed. After having sexual intercourse with out contraception or contraceptive failute that lead to unintended pregnancy, a women and often her partner and significant others, face essentially three options: to terminate the pregnancy, to deliver the pregnancy and to place the child for adoption or to parent the child (HB). This is better illustrated in the depicted figure 1 adopted from (HB). The major factors that influence adolescents pregnancy resolution decisions are: personal attitues and socialization about abortion, parenting and adoption (Custer,1993; Donnelly and Voydonoff, 1991; Fox et al., 1987) cited in HB: the influence or pressure of significant others such as parents and partners (D.)and access to and utilization of pregnancy and adoption, counseling, abortion and prenatal services (Bachrach,1986; Eisen and Zellman,1983) cited in HB; the partner desire to have the baby, fear of the abortion procedure, equating aboriotn with loss of a part of self, getting married were also mentioned as factors for adolescents decision to keep their babies. (Patrick) The decision to have an abortion or give birth Abortion might be chosen by some adolescents because of wishing to keep secret the fact that they are sexually, active or that they become pregnant (HB). A lack of economic resources is often cited, as well as concerns about how children would disrupt or interfere with the parents school, work or other life plans. Relationship difficulties or instability may also be reasons to have an abortion, and many adolescents feel unprepared to assume parental responsibilities at this stage in their lives (Donovan 1995 cited in HB) In the studies made on others influence in pregnancy decision making among Puerto Rican teens Ortiz and Nuttall (1987); (HB) reported that mothers have the most influence among teens, whereas sisters were most influential for those who decided to have on abortion. Fathers were the least influential regardless of whether daughters choose to terminate their pregnancy of give birth. Related findings from a sample of African American adolescents also indicated that mothers were the most influential in their daughters pregnancy experiences and outcomes even more so than daughters male partners or girlfriends (Murry, 1995; HB) Murry (1995); (HB) reported that being older, having higher education income and access to health care clinics were related to African American teens decisions to have an abortion. African Americans who reported a specific religious affiliation were more likely to have an

abortion, in contrast with Stevans, Register and Sessions (1992) report that religious affiliation had no effect on how adolescents resolved their pregnancies. Among Latino adolescent females, being younger at the time of conception and having never used or inconsistency used contraception, were factors that contributed to the decision to have an abortion. Informing adolescents mothers of the pregnancy, and having well-educated mothers, were two family factors associated with choosing to have an abortion. The decision to parent or relinquish for adoption HB, race education and income level, future career and educational aspirations and the influences of significant others (i.e, the mothers and birth fathers) historically were associated with unwed mothers choosing adoption see p429 first paragraph for citation The adoption figures among black teenagers in the USA are much lower than those for whites, Although it is not clear racial differences exist in other societies. But decline in adoption relinquishment in recent decades has been observed due to white-women becoming more like women of other races (HB). This could be better explained by teenagers who in the past would have favored adoption are now able to have legalized abortions (Patrcik). Findings about raltionship between mothers age and the decision to relinquish a baby for adoption are inconsistent. A summary of the relevant research literatures suggests three factors influence a teenagers decision to place her baby for adoption (Sobol and Daly, 1992) (Patrick): these are individual, social and organizational factors. Individual factors include the desire to complete school, the young mothers emotional preparedness and lack of financial relationships. Social factors include peer influences as well as the mother of the pregnant adolescent. Finally, there are several organizational factors influencing the decision not to place, such as the availability of abortion and social welfare benefit (Patrcik) Miller (1995); (HB) summarized previous research showing that female adolescents with high educational and vocational goals were more likely to postpone sexual activity, to use birth control to prevent unwanted pregnancies and to place infants for adoption, than were adolescents with lesser educational goals. Low, Moely and Willis (1989) and Donnelly and Voydanoff (1991); cited in HB found that pregnant teens were more likely to place infants for adoption if they had chosen careers that require longer preparation time. Young women who have personal experiences with adoption (e.g. Knowing someone who was adopted or being adopted themselves) and those who live in maternity residences, are more likely than other young women to choose adoption (Namerow, Kalmuss and Cushman, 1993: HB). The role of significant others particularly mthers and boyfriends preference for adoption rather than parenting are more likely to reliniquish infants for adoption, whereas young woment who

choose to parent are more likely to report that their mothers and boyfriends preferred parenting (HB). In addition another predictor factor for relinquishing the infant for adoption or not is the role of expectancies and values (Namerow and Colleagues (1993); cited in Patrick) i.e. if women believed that by keeping their baby their goals would be attained, they are then more likely to do so, and those who believe that the future outcomes they desire are more likely to occur if they placed for adoption are more like to place. Adoption related attitudes are different among pregnant young women who intend to place for adoption and those who intend to parent (Kalmuss, Namerow, and Kushman, 1991; HB). Those who intend to place have the most favorable attitudes about adoption, whereas those who never consider adoption are the east positive. Men who fathered /Fathers of teenage mothers children In reviews of teenage parenthood, fathers are very often ignored, with most attention being devoted to teenage mothers. Recent studies have indicated that many of the partners of teen mothers are adult men (Dorrach and Landy, 1999:; Landry and Forrest, 1995; Males and Chew, 1996; HB). In fact, only one quarter of the men involved in the pregnancies of females under age 18 are less than age 19 themselves. Of the older male partners, nearly 40 percent are age 20 or older (AGI, 1999) (HB). However, teenage girls who are involved with amen are more likely to become pregnant than their peers whose partners are closer to their own age. Males and Chew (1996); HB reported that more than two-thirds of babies born to school0aged mothers were fathered by adult men. Landry and Forrest (1995) HB reported similar results, that about two thirds of teenage mothers had partners who were at least 20 years old. Teenage girls who are sexually involved with adult men were reported to have low contraceptive use that might be a reason for becoming pregnant. Darrach and Landry (1999) HB found that girls involved with adult men were less likely to use contraception than girls involved with teenaged boys and that unintended pregnancy is lower among girls with adult partners. Whereas 82 percent of pregnancies were unintended among teenagers with peer-aged partners, only 70 percent were unintended among those with adult partners (Darrach and Landry (1999) HB, suggesting that contraceptive use may be less consistent among female teens with adult men. Number of single-parent households created by early child bearing is one of the greatest concerns of teenage pregnancy. According to Lindberg and Sonenstien (1997) (HB,), partners are much more likely to live together when the father is an adult (35 percent before the birth and 48 percent after) than when he is a minor (22 percent and 48 percent after). The above statistics suggest that older fathers may be involved initially with teen mothers and their babies, but it should be noted that this does not guaranty long-term stability of these relationships.

Outcomes/ consequences of teen parenthood Adolescent parenthood have a number of consequences, the consequences can be discerned: consequences for adolescent mothers; consequences for adolescent fathers; consequences for children and consequences to society. A single mothers, adolescent females are more likely than their peers to drop out of high school (HB). Educational underachievement and high school dropout were significantly related to teenage pregnancy in a prospective New Zealand birth cohort analysis (Fergussan and Woodword, 2000) (HB). In an analysis of US teens who gave birth, only three out of ten earned a high school diploma by age 30, compared to over 85 percent of mothers who delayed childbirth (Hotz, McElroy and Sanders, 1997; HB) Related to their lower education, adolescent mothers also have poorer employment opportunities and lower earning potential (Hotz, McElory and Sanders, 1997) HB. The differences in earnings between an adolescent mother and a mother who gave birth in her early twenties is, however, not as large as might be expected. However, an average, adolescent mothers tended to put in more hours at work, approximately 34 percent more over the same period. (HB).Annual income for adolescent mothers varies depending on the contributions, or lack of the childs father. Adolescent males involve in teen birth, like their female partners, also tend to complete less schooling by age 27 as compared to those who waited to father children until age 21 (HB). Adolescent fathers are also overrepresented in the blue-collar labour force and are underrepresented in white-collar occupations (Buchanan and Robbins, 1990; HB). Adolescent fathers also appear to engage in more delinquent behavior than older fathers. In the Rachester youth development study (Thornberry, Smith and Howard, 1997) HB early involvement in delinquent activities and illegal drug use were highly correlated with teenage fatherhood; 47 percent of high-rate delinquents and 70 percent of drug users were teen fathers (Stouthamer-Loeber and Wei, 1998).HB. But it should be noted that the cause and effect in this research might have been reversed that there is no proof that delinquent activities and illegal drug use were the consequences of teenage fatherhood rather than indicating delinquency and illegal drug use could cause teen fatherhood. Children of adolescent mothers could also happen to be victims in the process of. That they are more likely to be born premature and are one and a half times more likely to be low-birth weight babies when compared to children born to mothers in their early twenties (Morre, Morrison and Greene, 1997; National center for Health statstics, 1994; Wolfe and Perozek, 1997. HB). Children of adolescent mothers are also affected by the quality of care and nutrition they receive (HB). They are more likely to grow up in homes in which parents provide less emotional support and cognitive stimulation. Parental affection, books, games and educational toys are less

available on average, especially in homes were the mother is working increased hours or the childs father in absent. Children born to teenage mothers score lower in cognitive tests of mathematics, reading recognition and reading comprehension than children born to parents in their early twenties (Moore, Morrison and Greene, 1997) (HB). Children of adolescent mothers are also more likely to drop out of high school than peers with older mothers (Haveman, Wolfe and Peterson, 1997) HB children of teenage mothers when they grow older they are at greater risk for running away from home (Moore, Morrison and Greene, 1997) (HB).and sons born to teen mothers are 2.7 times more likely to spend part of their lives in prison (Grogger, 1997)HB. The other effect of teenage parenting for children of teenage mothers is they are more likely to become parents themselves before the age of 19 and are more likely to bear children out of wedlock when compared to children born to women who delayed birth. Adolescents childbearing have also societal impacts. As studies have shown that delaying adolescent births could significantly lower population growth rates, potentially generating broad economic and social benefits. (adol preg 4) which implies adolescents parenthood could cause the vise verse.

Personal reflextion Adolescent girls who give birth each year have a much higher risk of dying from maternal causes compared to women in their 20s and 30s. These risks increase greatly as maternal age decreases, with adolescents under 16 facing four times the risk of maternal death as women over 20. Moreover, babies born to adolescents also face a significantly higher risk of death compared to babies born to older women.WHO About 16 million adolescent girls aged 15-19 give birth each year, roughly 11% of all births worldwide. In developing countries, about 90% of births to adolescents occur within marriage. The proportion is close to 100% in Western Asia/Northern Africa, Central Asia, and SouthCentral and South-Eastern Asia, while between 70-80% in South America and in sub-Saharan Africa WHO which include our country. Maternal death is prevalent in adolescent mothers too-early childbearing also negative impacts the survival of newborns.

Prevention and curative supports Adverse outcomes such as low birth weight can be reduced by improving the nutritional status of adolescents before pregnancy and preventing sexually transmitted infections before and during pregancny. Curative After adolescents pregnancy both the mother and the baby need care in pregnancy, for child birth and after birth. Health care facilities should be made available, espeiscially in the rural areas. It is important to provide adolescents with an early start to antenatal care and to options for continuing or terminating pregnancy, particularly because adolescents tend to delay seeking abortion, resort to the use of less skilled providers, use more dangerous methods, and delay seeking care for complications. They are, therefore, more likely to suffer serious complications and even death. Special attention should begiven to adolescents under 16 during obsetetric care because they and their infants are at especially high risk of complications and death. Adlo preg 4

 Pregnant adolescents especially first time mothers are particularly susceptible to malaria, a major factor in maternal deaths in some countries. Priority should be given in treatment and management of malaria in pregnancy. Adverse outcomes such as low birth weight can be reduced by improving the nutritional status of adolescents before pregnancy and preventing sexually transmitted infections before and during pregnancy. Since adolescents are especially susceptible to anemia in pregnancy, it is important for programs to make a special effort to diagnose and treat for anemia. Adverse Child marriages are still a tradition in Ethiopia. Young brides, even below 10 years of age, are married off to husbands. Ninety percent of Ethiopian population lives in rural areas. The age old logic of early marriage in most parts of our country is marrying girls while they are still virgins and do not have any risk of being raped. Early marriages lead to early motherhood. In rural Ethiopia girls as young as 10 or 12 become pregnant. There are no medical facilities available in their area. Thus they suffer from post pregnancy complications including fistula disease. Many girls don not even survive their first pregnancy. Those who survive might not get post-pregnancy care and proper nutrition. The children of these young mothers in turn suffer from poor growth and malnutrition. The government should strive to stamp out child marriages and increase penalty for those arranging such marriages. Also there is a need for more awareness creation programs that can be carried out by both NGOs and Government organizations. Religious organilizations and Community based organizations intervention is also highly required to fight early marriage that is taking the lives of many in our country.