Menu
Menu
Menu
Menu
Background: Adolescent pregnancy and childbearing pose challenges to young women’s educational attainment. Studies show that while adolescent childbearing reduces educational attainment, not becoming pregnant and resorting to induced abortion when pregnant increases women’s educational levels. This study examined relationships between adolescents’ resolution of their first pregnancies and subsequent educational outcomes, for all women ages 20-49 years and across three age cohorts: 20-29, 30-39 and 40-49 year olds. Methods: Using the 2007 Ghana Maternal Health Survey (GMHS) dataset, we conducted ANOVA, bivariate and multivariate linear regression analyses on 8186 women ages 20-49 years. Women’s first adolescent pregnancy outcomes were measured as live births, induced abortions, spontaneous abortions or no pregnancy, while educational attainment constituted their years of schooling. Results: Findings showed years of schooling was highest for women who had induced abortions, and lowest for those who experienced live births. Women with live births as teenagers experienced significantly fewer years of schooling compared to their counterparts who terminated their pregnancies. Also, women with miscarriages and stillbirths exhibited levels similar to those who gave birth. Although women with no teenage births had higher educational levels than their childbearing counterparts, controlling for age at first pregnancy resulted in similar years of schooling compared to those who gave birth. Finally, the 30 to 39 year olds were the only age group whose results contradicted those of all women. These findings may be due to the socio-economic and political events that affected women’s educational attainment at the time. Conclusions: Childbearing during adolescence does impact women’s educational attainment levels. Therefore, in addition to encouraging young mothers to continue schooling, all other interventions to help keep young girls in school must focus on preventing and/or delaying their adolescent pregnancies.
We used the 2007 GMHS dataset to assess the relationships between young Ghanaian women’s pregnancy outcomes and their educational attainment. To the best of our knowledge the GMHS is the only survey that enables us to access nationally representative information on women’s pregnancy histories as it provides detailed accounts of their pregnancy outcomes. Despite being a dated source, its findings have implications that are still relevant for women’s health at this time. Ethical clearance for the survey was provided by the ICF Macro Institutional Review Board, Maryland, USA. The surveyed women were sampled using a multi-stage cluster sampling approach. A total of 420 enumeration areas (EAs) were randomly selected across the nation and households in these EAs were then systematically selected. Eligible women, that is, those in the reproductive ages of 15 to 49, were selected from the households to partake in the study. The participation rate was quite high as 98.7% of sampled women were interviewed for the study. In total, 10,370 women were interviewed; however, this study focuses on two groups of women. The first group consists of all women between ages 20 and 49 years. After adjusting for missing cases for some of the variables, the final sample of women in this group was 8186. Less than 2 % of the sample was removed at this stage. The second group consists of 7208 women ages 20 to 49 years who had ever been pregnant. The outcome of women’s first pregnancies as adolescents (pregnancies below age 20) was the predictor variable. Women were asked about the outcomes of each of their pregnancies, whether they ended in a live birth, stillbirth, miscarriage or abortion. We selected women’s first pregnancies that occurred when they were below age 20 (and for some these were their only pregnancies) and re-categorized the outcomes. We combined the responses of women who had miscarriages and stillbirths, and also included women who had not been pregnant as adolescents. Combining miscarriages and stillbirths was necessary, primarily for statistical reasons, which are further discussed as part of the data limitations of the study. Thus, the variable consisted of the following categories: live birth, spontaneous abortion (miscarriage/stillbirth), induced abortion, and no pregnancy. Once again, these refer to outcomes for women whose initial pregnancies occurred when they were teenagers. A woman’s current educational attainment was measured using ‘number of years of schooling’ at the time of the survey. This was computed using three variables in the dataset, ‘ever been to school’, ‘highest educational level’ and ‘highest grade attained at that level’. Using cross tabulation results from the education variables, we were able to generate the years of schooling variable for women. One key variable in the study was age group. Women were divided into three age cohorts: 20–29 years, 30–39 years, and 40–49 years. Socio-cultural variables included religion and ethnicity. Religion was categorized as follows: Catholics, Protestants, Pentecostals/Charismatics, Other Christians, Muslims and ‘Others’. Ethnicity included the four major groups of Akan, Ga-Dangme, Ewe, Mole-Dagbani and also ‘Others’. Socio-economic proxy measures were ‘place of residence’, measured as urban and rural settings, and ‘household wealth’ which was split into five quintiles ranging from poorest to richest. The number of pregnancies a woman has had and her age at first pregnancy were continuous measures, while the number of abortions a woman she has had was re-coded into 4 categories: 0, 1, 2, and 3+. Age at first pregnancy was measured as a continuous variable comprising of the ages at which all women that had ever been pregnant had their first pregnancies. Bivariate and multivariate linear regression models were conducted to assess relationships between women’s first adolescent pregnancy outcomes and their years of schooling. The mean years of schooling of women across the four pregnancy outcome categories and by age group was also computed and graphed. The linear regression models were run with pregnancy outcome and years of schooling to assess the bivariate relationships between the main independent and dependent variables. Models were run for all women and women who had ever been pregnant, as well as across the three age cohorts. Additionally, multiple linear regression models were conducted to examine the association between pregnancy outcome and years of schooling while controlling for all covariates, with an exception. Only the models conducted with ever been pregnant women included the age at first pregnancy variable. The statistical software package, STATA version 12, was used for the analyses. There were a few data limitations to this study. First, the information available on women’s educational attainment levels was inadequate as no question was asked on their schooling at the time of the pregnancy. Thus, there was no evidence to indicate whether pregnancies occurred before respondents ended their education or vice versa; in addition, there was no information to indicate whether the respondent was in school at the time of the survey. The absence of such information does not enable us to make definitive conclusions about the women’s education since some may not have ended their education at the time of the survey. However, we specifically chose women starting from age 20 where we presume they should have finished their secondary education by age 18. Cross tabulation results show that the 20 to 29 year old women have more education than their older counterparts and it is highly likely that some of the younger ones may still be in school. Second, although stillbirths and miscarriages represent different durations at which women experience pregnancy loss, for example, a fetus may die at delivery and in this case the stillbirth will be almost akin to a live birth, and a miscarriage may take place as early as in the first few weeks of conception, the frequencies of women who had miscarriages (n = 181) and stillbirths (n = 60) were far too small to leave them as separate categories. Despite this limitation, we argue that ideally both forms of pregnancy loss were unexpected spontaneous and involuntary occurrences, and although duration and timing of the pregnancy loss varied, women were expecting to keep those pregnancies that were ultimately terminated. Third, it would have been ideal to factor in the timing of the induced and spontaneous abortions which could provide an opportunity to observe its effect on their educational attainment. However, there are many complexities associated with including this variable and this was also beyond the scope of this paper. Finally, the under-reporting of induced abortions or misreporting them as spontaneous abortions is always a major concern in abortion studies as social desirability and fear of stigma may result in women denying their abortions or reducing the number of repeated abortions they report [34, 35]. In the same manner, there may be under-reporting of adolescent pregnancies, where women refuse to acknowledge their teenage pregnancies due to the shame and stigma that is generally associated with premarital and adolescent pregnancy [33]. Also, women may have reported their pregnancies but misreported the ages at which they had them and this could pose another limitation to us concluding on a true effect of an adolescent pregnancy on women’s educational attainment levels.
N/A
