Influence of Abortion Stigma, Behaviour Pattern and Distress Tolerance on Substance Use Amongst Adolescents
Chapter One
Objectives of the study
The main objective of this study was to examine the influence of abortion stigma, behaviour pattern and distress tolerance on substance use amongst adolescents.
- To investigate if young women resort to abortion in the event of an unwanted pregnancy.
- To examine if abortion if a reason for the increased mortality rate among young women.
- To examine the chances of survival of young women who engage in abortion.
- To investigate the effect of drug abuse as a result of abortion stigma.
CHAPTER TWO
LITERATURE REVIEW
Introduction
This chapter deals with the review of related literature on abortion as a causative factor to the increase in mortality rate among adolescents.
Concept of abortion
Abortion is the ending of pregnancy by removing a fetus or embryo before it can survive outside the uterus (Grimes, 2010). Maternal morbidity and mortality related to complications of unsafe abortion have been identified as major public health problems. Around 56 million abortions are performed each year in the world with a little under half done unsafely (WHO, 2012). Since ancient times, abortions have been done using herbal medicines, sharp tools, or through other traditional methods. Abortion laws and cultural or religious views of abortions are different around the world. In some areas abortion is legal only in specific cases such as rape, problems with the fetus, poverty, risk to a woman‟s health, or incest (Culwell et al, 2010). In many places there is much debate over the moral, ethical, and legal issues of abortion. Those who oppose abortion often maintain that an embryo or fetus is a human with a right to life and may compare abortion to murder. Those who favour legality of abortion often hold that a woman has a right to make decisions about her own body (Mahowald, 2017). In many places where abortion is illegal or carries a heavy social stigma, medical reporting of abortion is not reliable. The reasons why women have abortion are diverse and vary across the world. Some of the most common reasons are to postpone child bearing to a more suitable time or to focus energies and resources on existing children (Culwell et al, 2010). Other reasons include being unable to afford a child either in terms of the direct costs of raising a child or the loss of income while caring for the child, lack of support from the father, inability to afford additional children, desire to provide schooling for existing children, disruption of one‟s own education, relationship problems with their partner, a perception of being too young to have a child, unemployment, and not being willing to raise a child conceived as a result of rape or incest (Culwell et al, 2010). Some abortions are done as a result of societal problems. These might include the preference for children of a specific sex, disapproval of single or early motherhood, stigmatisation of people with disabilities, insufficient economic support for families, lack of access to or rejection of contraceptive methods, or efforts towards population control (such as China‟s one-child policy).
Spontaneous abortion has been identified as a complication associated with early pregnancy. According to the World Health Organisation (WHO), expulsion of fetus weighing 500g or less or at 20-22 weeks gestation is termed spontaneous abortion (Regan, 2000). It was reported that most causes of spontaneous abortion are of maternal origin (Goddijn, 2000). Of the total pregnancies, 15-20% will result in spontaneous abortion (Linda, 2011). A study conducted by Lubna et al. (2014) reported that older age at menarche, husbands older than 50 years, consanguineous marriage, and family history of abortion, was significantly associated with spontaneous abortion whereas age of the mother, parity, socioeconomic status, use of spacing method, and diabetes or obesity were not associated with spontaneous abortion.\
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter describes the method and procedure that were used in the study under the following sub-headings:
- Design of the study
- Population
- Sample and sampling procedure
- Instrumentation
- Validity of instrument
- Reliability of instrument
- Method of data collection
- Data analysis
Design of Study
The survey research was used in this study according to Davis (1975), the survey research may be employed to enumerate the characteristic abilities, behaviour or opinions of subject to delineate through words or qualitative values the status of a group, institution, structure or other facilities or to human beings or subject.
The design was used to investigate the influence of abortion stigma, behaviour pattern and distress tolerance on substance use amongst adolescents in Uyo Local Government Area of Akwa Ibom State.
Study area
The study was conducted in Uyo local Government Area (LGA) of Akwa Ibom State. Uyo is the state capital of Akwa Ibom, in South South Nigeria. The city became the capital of the state on September 23, 1987 following the creation of Akwa Ibom State from erstwhile Cross River State. The University of Uyo Main campus is located at Nwaniba, While the Town campus and Annex campus are located along Ikpa road. The population of Uyo, according to the 2006 Nigerian Census which comprises Uyo and Itu, is 427,873, while the urban area, including Uruan, is 554,906.
Population
A study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitute of individuals or elements that are homogeneous in description (Utibeabasi: 2019). The population of this study consisted of students and teachers in Uyo Local Government Area of Akwa Ibom State, which was about 600 in total.
Sample and Sampling Procedure
The study was organized using a random sample. A total of 521 respondents were randomly selected from the various catUyoies of teachers, students and parents respectively in Uyo Local Government Area of Akwa Ibom State and were used as subject for the study.
CHAPTER FOUR
RESULTS AND DISCUSSION
Results
Associations between pregnancy outcomes and mental health (15–29 years)
Supplementary Table 1 shows the relationships between pregnancy history and mental health measured at Waves
CHAPTER FIVE
Conclusion
These findings contribute to the growing body of evidence that supports the claim that exposure to abortion among women facing pregnancy is implicated in higher rates of mental distress. As far as repeated longitudinal measures can establish, the effect of abortion appears to be causal and independent of confounding associations. The overall level of distress, accounting for about a tenth of mental disorders for women in their late 20s, may be characterized as moderate, but it is not trivial. Ideological claims that all abortions are psychologically devastating, or that abortion has no ill effect on mental health, are both inconsistent with these findings.
To date, the evaluation of abortion by British and American psychological associations has not adequately acknowledged the persistent findings of harm, and ideologically influenced discussions of abortion in the scholarly literature continue to mislead readers about the risks of induced abortion. Moreover, as Fergusson has pointed out, the premise of expanded access to abortion is the expectation of therapeutic benefit, not merely the absence of harm. To date, although some studies have minimized the risk of distress following abortion, not a single study has documented mental health benefits for women from the practice of induced abortion.
The absence of reduced distress following abortion may have implications for American jurisprudence, which currently precludes the prohibition of abortion after fetal viability when it is deemed medically necessary for the preservation of the health, including the mental health, of the mother57 (paras 164–165), and justifies permitting abortions before viability on the grounds, in part, that “the mother who carried a child to full term is subject to anxieties, to physical constraints, to pain …”58 (p. 10) The assumed premise of these arguments is that procuring an abortion will result in less anxiety, constraint, pain, and mental distress than will bringing a pregnancy to term. This study contributes strong evidence from American women to the research consensus that that premise is without basis in evidence.
This study reinforces two patient care initiatives proposed in prior literature on this topic. As already noted, this study’s findings are congruent with those of similar prior studies by Fergusson and Pedersen, respectively, of women in New Zealand and Norway. The American cultural and legal context for abortion is similar to and thus moderates between that of both of these other countries. In America, up to the point of fetal viability, there are few restrictions on abortion, as in Norway; past that point of viability, abortion is permitted only with medical certification, as in New Zealand. For American women seeking abortions after fetal viability, therefore, the present findings lend support to Fergusson’s recommendation for stricter, evidence-based psychiatric scrutiny that the pregnancy poses harm to the woman’s health. Prior to viability, this study’s conclusion support Pedersen’s recommendation that “women who terminate a pregnancy would probably benefit from post-abortion counseling.”
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