JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL SCIENCES
Socio-cultural Factors Influencing
Teenage Pregnancy In Rural West Bengal, India. J Pharm Biomed Sci
Nandi JK,Burman SK,Das D,Saha DP,Pal S.
2014;04(08):670-673.
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Research Article
Socio-cultural factors influencing teenage
pregnancy in rural West Bengal,India
Jayanta Kumar Nandi1,Sougata Kumar Burman2,*, Debasis Das3,Dipta Prasun Saha4, Sangita Pal5
Affiliation:1
RMO cum Clinical Tutor, Dept of Obs & Gynae, North
Bengal Medical College, Sushrutnagar, Darjeeling,
India
2
Assistant Professor, Dept of Obs & Gynae, College of
Medicine & JNM Hospital, WBUHS, Kalyani, Nadia,
India
3
Associate Professor, Dept of Community Medicine,
Malda Medical College, Malda, India
4
Associate Professor, Dept of Obs & Gynae, North
Bengal Medical College, Sushrutnagar, Darjeeling,
India
5
Sangita Pal, Medical Officer, Nadia District Hospital,
Nadia, India
The name of the department(s) and institution(s) to
which the work should be attributed:
1. Department of Obs & Gynae, North Bengal
Medical College, Sushrutnagar, Darjeeling, India
2. Department of Obs & Gynae, College of Medicine
& JNM Hospital, WBUHS, Kalyani, Nadia, India
3. Department of Community Medicine, Malda
Medical College, Malda, India
Authors contributions:
All the authors contributed equally to this paper.
Address reprint requests to
* Dr Sougata Kumar Burman,
Assistant Professor,
College of Medicine & JNM Hospital, WBUHS, Kalyani,
Nadia, India or at [email protected]
Article citation: Nandi JK, Burman SK, Das D, Saha DP, Pal S.
Socio-cultural factors influencing teenage pregnancy in rural
West Bengal, India. J Pharm Biomed Sci 2014;
04(08):670-673. Available at www.jpbms.info
ABSTRACT
Objective: To determine the influence of socioeconomic and cultural factors on the high prevalence
of teenage pregnancy in a rural area of West Bengal.
Methods: This was a cross sectional, observational
study conducted at Nadia District Hospital,
Krishnagar, West Bengal,India between 02/02/2013
and 02/08/2013 with a set of interview questionnaire
and discussion with 309 teenage mothers selected by
systemic random sampling technique in post natal
ward. Results: 22.8% of total deliveries were teenage
pregnancy. Cause of teenage pregnancy was early
marriage. In 92.34% cases marriage was arranged by
parents. In 68.93% cases the decision of early
marriage was taken by their parents due to poverty;
71.52% due to social pressure and 46.27% due to
large family size. Of all teenage mothers, 70.2% were
aware of contraceptive method, but 76.69% of
teenage mothers chose to be pregnant soon after
marriage due to social pressure. Unlike developed
countries all teenage pregnancies were socially
accepted and have got familial and social support.
Conclusion: To reduce the number of teenage
pregnancy and its complication improvement of
socioeconomic conditions and implementation of
legal age of marriage is important.
KEYWORDS:
Teenage pregnancy;
economic factors; influence; West Bengal.
Socio-
Competing interest / Conflict of interest
The author(s) have no competing interests for financial
support, publication of this research, patents and
royalties through this collaborative research. All
authors were equally involved in discussed research
work. There is no financial conflict with the subject
matter discussed in the manuscript.
Disclosure forms provided by the authors are available
with the full text of this article at jpbms.info
INTRODUCTION
T
eenage pregnancy is pregnancy under the
age of 19 years at the time of delivery. It is a
public health problem throughout the world.
670
In developed countries, teenage pregnancies
usually occur outside of marriage and adolescent
pregnancy is seen as social issue1. By contrast,
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teenage girls in developing countries are often
married and their pregnancies are well supported
by their families and society2,3,4,5. There is a
correlation between teenage pregnancy and drugs
& alcohol abuses in developed countries. The drugs
with the strongest evidence linking them to
teenage pregnancy are alcohol, cannabis, ecstasy
and other substituted amphetamines8. In India
teenage girls as well as teenage mothers usually do
not take any drug or alcohol. Worldwide teenage
pregnancy rate ranges from 149 per 1000 live
birth in some sub Saharan countries to 2.9 per
1000 live birth in South Korea9,10. Among
developed countries United States, United
Kingdom and New Zealand have the highest level
of teenage pregnancy, while Japan and Korea have
the lowest. Of all teenage pregnancies in the United
States 82% are unplanned11. ‘Save the Children’
(an international organization) found that annually
13 million children are born to mother aged under
20 years worldwide, more than 90% of which are
in developing countries15. Complications of
pregnancy and childbirth are the leading cause of
mortality among women aged 15-19 years in these
countries12.
As per census 2011 total number of adolescent
population (10-19 years) in India is 253.2 million,
which is 20.9% of the total population. In India
early marriage and teenage pregnancy are an
important social, educational, and health problem,
particularly in rural regions. India is fast
approaching to be the most populous country in
the world and increasing incidence of teenage
pregnancy is an important factor in the population
rise. As per the National Family Health Survey
(NFHS-III) 16% of women aged 15-19 years have
already started child bearing. This rate is highest in
the state of Jharkhand (28%) followed by West
Bengal (25%) and Bihar (25%) -all are states of
eastern India15. Early marriage may have a
significant effect on the level of education and
employment opportunities of women which
increases their economic and social dependency on
family and neighbour.
MATERIALS AND METHODS
This study was conducted at Nadia District
Hospital, Krishnagar, West Bengal, India. Most of
the patients of this hospital come from rural areas.
This is one of the busiest district hospitals of West
Bengal with over more than 10000 deliveries
annually. The study was a cross sectional
observational study with a set of interview
671
questionnaire and discussion with the teenage
mothers.Teenage pregnancy was defined as
pregnancy occurring during maternal age of ≤ 19
years at delivery.
Investigators visited the postnatal ward and
interviewed teenage mothers accompanying with
Nursing Staff of the ward. Data collected from teen
age mothers admitted in between 02/02/2013 and
02/08/2013.
Applying a systemic random
sampling technique every 5th mother was selected
and total 309 mothers were interviewed. Teenage
mothers admitted with miscarriage were excluded
from the study.
RESULTS
During the study period, total numbers of
deliveries were 6784 with 6627 live births. Total
number of teenage deliveries were 1547(22.8%)
with 1489(22.4% of all live births) live births. This
result is in conformation with the report of
National Family Health Survey -III.
Every 5th teenage mother was interrogated of total
1547 teenage deliveries. Total no. of cases was
309.
No unmarried teenage mother found to come for
delivery. Early marriage is the most important
cause of teenage pregnancy.
It was found that 285(92.34%) teenage marriages
were arranged by parents who are socially and
culturally well accepted. 24(7.76%) marriage was
decided by teenage girl themselves.
Teenage
mothers
opined
that
poverty
[213(68.93%)], social pressure [221(71.52%)] and
large family size [143(46.27%)] were the reasons
for their parents’ decision of their early marriage.
90% of these teenage mothers have not pretested
against their parents’ decision as they were rather
sympathetic to the helpless condition of their
parents.
Regarding literacy of the parent of the teenage
mother, 168(54.36%) father and 243(78.64%)
mother were attended less than class IV and rest
undergone secondary school education (Table 1).
59.22%, teenage mother’s monthly income was
5000 – 10000 Indian rupees. 30% had less than Rs.
5000 and only 9.38% had income more than Rs.
10000.
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Table 1. Literacy status of parents of teenage mother.
Last Class passed
≤ Class IV
Class V – VIII
˃ Class VIII
Total
Father
No.(%)
168(54.36)
117(37.86)
24(7.76)
309(100.00)
Mother
No.(%)
243(78.64)
57(18.44)
9(2.90)
309(100.00)
Table 2. Economic status of families of teenage mothers.
Family income
(Rs./Month)
< 5000
No.(%)
97(31.39)
5000 – 10000
183(59.22)
10000
Total
29(9.38)
309(100.00)
Table 3. No. of sibling of teenage mother.
No. of Sibling
No.(%)
1-2
69 (22.33)
2-4
179 (57.92)
>4
Total
61 (19.74)
309(100.00)
Table 4. Frequency of antenatal visit paid by teenage
mothers.
No. of antenatal visit
No.(%)
≥6
3-5
243(78.64)
51(16.50)
<3
Total
15(4.85)
309(100.00)
61(19.74%) mothers had sibling more than four,
179(57.92%) teenage mothers had siblings from 2
to 4 and 69(22.33%) had sibling between 1 to 2.
In response to query whether they wanted to
continue their study, 83(26.86%) answered that
they wanted to continue their study instead of
early marriage. 226 (73.13%) were either school
dropout or did not want to continue study.
After being teenage mother, 9(2.91)% mothers
told that they will continue their study and
109(35.27%) told that they will not; 191(61.81%)
mothers said that they would take permission
from their husband and in-laws.
Among mothers who wanted to continue study
only 14(4.53%) said that their husband and in
laws will allow them to continue their study;
69(19.41%) said most probably will not allow and
226(73.13%) said that they do not know.
In the present study it is found that 217(70.22%)
teenage mothers were aware of different
contraceptive methods. They have learned it from
senior family members or from health workers.
672
92(29.77%) were unaware of contraceptive
methods.
Teenage mothers were asked about the
background of the current pregnancy and it was
found that 56(18.12%) conceived voluntarily;
237(76.69%) were in pressure from family and
neighbours to conceive and 16(5.17%) conceived
in a case of contraceptive failure.
All the mothers under study visited antenatal
clinic. 15(4.85%) visited less than three times and
the rests more than three times.
They also have got good familial support and
adequate nutritional supplement.
Another important finding came from the current
study was that 91% of teenage mothers and their
families knew that legal age of marriage of women
is 18 years in our country.
No teenage mother had any addiction of drugs or
alcohol.
DISCUSSION
The current study was conducted in a district
hospital, which is situated in rural West Bengal.
During the study period, total numbers of
deliveries were 6784, out of which teenage
deliveries were 1547(22.8%). Similar results was
published by other authors15,16. All teenage
mothers were socially married with familial and
social support. None of them was addicted to drugs
or alcohol; 78.68% of them have got the good
antenatal
care
and
with
nutritional
supplementation. In developed countries most of
the teenage pregnancies is outside of marriage and
are not supported by family and society and a good
number of them are addicted to drugs and alcohol,
which further increases the complication of
teenage pregnancy17.
In the current study all the teenage pregnancy are
associated with early marriage. Most of the studies
show that teenage pregnancies are the result of
early marriage in India13,14. In the present study, it
is seen that 92.34% of teenage marriages were
arranged by parents. Regarding the cause of
teenage marriage, 68.93% blamed it on poverty,
71.52% thought it due to social pressure and
46.27% said it is due to large family size.
In the other study it is being postulated that
education could play a significant role in
developing self-confidence, increasing age at first
sexual intercourse and delaying marriage7. In the
present study it has seen that the educational
standard of parents of teenage mothers were not
so much.
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In the current study it has seen the poor economic
conditions is an important factor for early
marriage and teenage pregnancy with all its
complications.
It is seen in the study that 57.92%, teenage
mothers had 2-4 siblings. Too many children of a
couple are an important cause of arranging an
early marriage.
2.91%, teenage mothers wanted to continue their
study. But it was not supported by their families
and society, even actively opposed by their in laws
and guardians of other students of their school.
It is interesting to see in the present study is that
70.22% of the teenage mothers were aware of
contraceptive methods. They have learnt it from
health workers, media and senior persons. Many of
them knew that teenage pregnancy may be more
complicated. In spite of the knowledge they did not
use any contraceptive method and chose to be
mother. They have revealed during interrogation
that if they do not become pregnant soon after
marriage, they will be considered as infertile and
will face neglect and harassment in their family
and society. So it is the social and cultural
pressure, which forces them to be pregnant at their
adolescent age. This finding is in conformation
with other studies which showed that teenaged
married girls became pregnant to satisfy their
mother-in laws and husband14. Across countries
and cultures, women have been victims to social
pressure and are often in a position to neither
regulate their pregnancy nor make decisions
regarding their reproductive performance.
Husbands and mothers-in-law are the primary
decision-makers. In many cases, this decision
making structure appears to be driven by a
woman's lack of economic independence. Even
access to the most effective services is highly
dependent on the involvement of influential family
members19,20. As a result, early pregnancy and its
complications continue to remain highly prevalent.
CONCLUSION
From the present study it may be concluded that
teenage pregnancy with all its complications such
as anemia, pre-eclampsia, preterm labor etc. are
associated with early marriage and desire to have
baby soon after marriage. The Current study also
identified several factors which are associated
with higher teenage pregnancy, such as women's
age at marriage, poor economic condition, low
educational level of parent of the teenage mothers,
social and cultural pressure. Hence the family
structure has a strong effect on early childbearing.
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