Complexity of teen mothers and its implications on family wellbeing in Rwanda

In an attempt to understand the complexity of teen parents and associated consequences, the present study was conducted. It examines the connection between teen parents and family well being in five selected Districts of Rwanda. Data were collected from 226 respondents randomly selected. Respondents included 176 teen mothers, 30 parents of teen mothers and 20 local leaders. Data were collected through questionnaire and interview. Quantitative data were presented in percentages while content analysis was used for qualitative data. The results revealed that teen mothers are exposed to various social and economic problems. Rejected and depressed, 61.4% of pregnant teens thought about abortion and were restricted by lack of financial means while 9% thought about suicide which affects physical and mental health of both teens and their children. Furthermore, 80.4% of teen mothers were not given opportunity to resume their studies after delivering which amplifies their poverty exposure and their children as well. Parents/guardians need to be supportive through good communication so as to know what their children are going through and advise them accordingly. Moreover, they should bear with them in case a pregnancy occurs so that they may not feel depressed and think of abortion or suicide. They should not chase them from home since it increases their exposure to repeated pregnancies. There is a need of sensitizing the community about strategies which can reduce teen mothers’ rate as well as appropriate action in case teens get impregnated. © 2023 by the


Introduction
A family is the nursery of each society where children observe, imitate and reproduce surrounding behavior (Allan, 2017). Childhood is a foundation which equips individuals with ability to analyze and classify problems in all its angles and find out different solutions (Alshaalan, 2022). It is the responsibility of parents to develop in their children a sense of responsibility and decision making. However, families have abdicated their responsibilities and are not providing a conducive family environment. Children are born and raised in family conflicts rooted in domestic violence, gender discrimination which destroys family well-being (Bahati et al., 2022). Such family environment makes children socialize with painful memories which in turn affect their adulthood behavior and decision making (Muasya & Muasya, 2020). This family environment is a push factor that makes complex teen-age period whereby teenagers are going thorough biological changes unaccompanied by their parents (Aulagnier, 2015). Studies have discovered that children who have not been provided with strong basic education and values are easily manipulated (Palupi, 2021). This is the key cause of teenagers who are impregnated by adults since they have emotional gap which needs to be covered. Furthermore, teenagers face the challenge of lack of information related to their physiological changes which also facilitates their manipulation (Othman et al, 2020). risk of abortion, drop out their studies due to the complexity of teen parents' situation. The phenomenon of teen mothers is a social issue which if not dealt with, would be a hindrance to social and economic development (Cook & Cameron, 2020). It is mainly rooted on poverty, lack of parental support and information to reproductive health (Bazubagira & Umumararungu, 2023). Teen mothers are exposed to different challenges namely depression, social complexity and inadequate parenting skills. Most of them get repeated pregnancies which amplifies the risk of poverty and depression (Howard & Khalifeh, 2020).
The published article on predictors of teenagers' pregnancies in Rwanda has increased the interest to analyze its effects on themselves, their children, their families and the whole community. Thus, the necessity of assessing the complexity of teen mothers and its implications on family wellbeing in Rwanda arises. The paper embraces abstract, introduction, literature review, theoretical and conceptual background, empirical review and hypotheses development, research and methodology as well as findings and discussion.

Literature Review
The section reviews different published papers, theses, reports in relation to the topic. It attempts to build a deep understanding of the topic, get an overview of what is already known in the topic field and discover the gap to be covered by the research. Different consulted documents revealed that teen mothers constitute a major challenge at individual, family and national development (Bah, 2016;Adebola, 2018;Morgan et al. 2022;Lambonmung et al., 2022). After being impregnated, a high percentage of teen mothers drop schools and a few of them resume school after delivering. Different studies highlighted that they face many challenges among others lack of financial ability to support their children, being rejected by their families and fathers of their children which amplifies their vulnerability (Farber, 2016;Vinson, 2017;Elder & Johnson, 2018;Uwizeye et al., 2020). Reviewed studies have shed light on the complexity of teen mothers both socially and economically.

Theoretical and Conceptual Background
The section presents developed theory in connection with the research. It turns around functionalist theory in all its angles.

Functionalist theory
Developed by Merton (1968), the theory states that societal functions are grounded on social actions and consequences among which some are predictable and others are not. Each decision made generates upshots. It is in this line that the theory interconnects causes of teen mothers and its implications at individual, family and societal level (Parsons, 2017). The core principle of functionalist theory is that everything which happens within any society has its purpose, causes and implications.

Empirical Review and Hypotheses Development
For a prompt understanding of the situation of teen mums, related studies were reviewed. The section reviews empirical studies from which hypotheses were developed and verified by study results. Kareem et al. (2023) analyzed the situation of teenagers' motherhood in their article on Prevalence, Trends, and Factors Associated with Teen Motherhood in Nigeria. Through a desk review, data provided by Nigeria Demographic and Health Survey in 2008, 2013 and 2018 revealed that team mothers' phenomenon increased over 10 years by 50.9%, 52.4% and 55.2% and was find to be the major cause of death among teenagers. Results show that 5% of teens aborted which underlines the critical situation in which being unprepared to childbearing exposes teens to traumatic memories that can turn into worse consequences in their lives. Teenagers' pregnancies hinder girls' education since once they give birth, they are condemned to drop out their studies. Moreover, rural area is mostly affected by teen mothers' phenomenon whereby 73.4% live in poorest conditions. Margherita et al. (2017) in their research about Teen mothers who are daughters of teen mothers: Psychological intergenerational dimensions of early motherhood in Italy highlighted that being a daughter of a teen mother is a push factor leading to the risk of having early, unprotected sex and thus get early pregnancy. They pointed out that experiences from young mothers in such situations have proved the aspects of intergenerational transmission in the mother-daughter relationship. The study investigated experiences from young mothers (18-20 years) who are daughters of teen mothers. Six young mothers from Southern Italy were selected and interviewed. A semi-structured interview was used to explore early experience of pregnancy and motherhood and their relationship with their own mothers. The results confirmed that adolescent mothers born from teen mothers have difficulty in representing the meanings associated with their experience of pregnancy and motherhood. Experiences proved that there was a transmission of pregnancy from teen mothers to their daughters. Donkor & Lariba (2017) carried out a study on the impact of sex education on teenage pregnancy in basic schools of Bawku municipal District in Ghana. The purpose of the study was to explore how sex education could mitigate teenage pregnancy in the Bawku-East Municipality. A sample size of one hundred and thirty-nine (139) respondents was used for the study. Data were collected through questionnaires, in-depth interviews, focus group discussions and observation. The findings highlighted that poor parenting, poverty and peer influence were the major causes of teenage pregnancy. The study suggested parents and schools to empower youth with sex education so that they may be equipped with appropriate information which in turn helps them overcome potential consequences from social media and friends. Ogori et al. (2013) investigated causes and effects of teenagers' pregnancies in Kontagora Local Government Area of Niger State. A survey research design involving 40 teenagers was used. The results confirmed that teenagers are engaged in sexual intercourse at early age. Socio-economic background, early marriage, traditional gender roles, peer pressure, lack of sex education and none usage of contraceptive are causes of teenage pregnancy. The findings also confirmed that school dropout, stigmatization and rejection by parents, mother's health risk during childbirth and financial handicap were effects of teenage pregnancy. H1: Rejection, depression and identity crisis are social implications of teen mothers' phenomenon.
H2: Poverty, school dropout, lack of career developmental opportunities amplifies economic situation of teen mothers' phenomenon.

Research and Methodology
The study was carried out in Rwanda whereby five Districts were considered as case study. From each District, two sectors were purposively selected to get a total number of ten sectors (five rural and five urban sectors). The five sampled Districts include Rwamagana, Kicukiro, Muhanga, Rusizi and Musanze. A total number of 226 respondents including 176 teen mothers, 30 parents and 20 local leaders were randomly selected. Mixed approach was used to collect data through questionnaire and interview (Gupta & Gupta, 2022). Questionnaire was used to collect information from teen mothers while local leaders and parents of teen mothers were interviewed. Quantitative data were presented in graphs generated from excel. On the other hand, content analysis was used to categorize, classify and summarize qualitative data (Saunders et al., 2019).

Findings and Discussions
Teenage pregnancy refers to pregnancy of a young woman aged between 10 to 19 years. Apart from common complications faced during any pregnancy, there are many consequences associated with pregnancy at teenage age including physical, mental, social, financial and risk of death (Chung et al, 2018). Stigmatized and rejected by parents and peers, teen mothers are exposed to the violation of their rights and those of their children. Furthermore, the phenomenon affects families and communities development. Respondents asserted that they started using contraceptives at the age of 15 (8%) but a big number started using them at the age of 17 (22%), 18 (28%) and 20 (4%). Early usage of contraceptives has long lasting effects even after stoping using them. It has been observed by researchers that using contraceptives at early age has more risk of developping cancer (Iversen, 2017;Simmons, 2019). If 62% of teenagers use contraceptives, they are exposed to a high risk to cancer which undermines socially and economically the future families.
Concerning teenagers' awareness about being pregnant, the majority of teen mums (75.5%) asserted that were aware when their pregnancies were 2 to 4 months. The first trimester of pregnancy has diverse complications including high blood pressure, gestational diabetes, bleeding, amniotic fluid complications to list few. As being not informed about pregnancies, in case of pregnancies' complications teenagers may be given chemicals which can cause serious malformation to their fetus as they are not suspected to be pregnant. All signs of pregnancies are overlooked because of their early age. This situation may provoke miscarriage followed by bleeding that may end up into death (Wasihun, 2021).
The majority of teenagers (36.9%) got pregnancies while they were staying with both parents. This implies the lack of appropriate parental guidance as far as physiological changes are concerned. Parents are no longer close to their children; they do not communicate smoothly and advise their children on how to behave at every stage of their evolution. The findings are in line with those of Donkor & Lariba (2017) who confirm poor parenting to have impact on sex education. Moreover, there is a need to increase communication between parents/guardians to make children open to them so that they may tell their parents/guardians about every life circumstance they encounter. Teen mothers who were impregnated when they were staying with mothers only are (25.6%). Some of them asserted that their fathers left home, others were from sex workers and others from single mothers. There is also a considerable number (25.6%) who got pregnancies when they were living with sisters, brothers, uncles, bosses, cohabitated with husbands while (6.2%) was staying alone. A small number (1.1%) were staying with their fathers, (0.6%) street children while 4% did not answer to the question. The findings revealed that some of teen mothers were impregnated by their bosses and family relatives they were staying with.

Figure 2: Complexity of teens' pregnancies
From the total number of 176 teen mothers who participated in the study, 60.8% were impregnated while they were students and 39.2% were not. After delivering, findings revealed that a big number (80.4%) did not resume their studies. Considering reasons of not resuming, poverty comes at the top with 60.5% followed by 27.9% who were caring about their children. Furthermore, 9.3% did not go back to school because of fearing to be laughed at while 2.3% were abandoned by sponsors.
As regard to what is done to make teen mothers resume their studies, interviewed local leaders asserted that confirmed that they try to conduct home visits and family discussions. Active listening to teen mothers and their families, offering counseling sessions can help them resume their studies after giving birth. They also emphasized that poverty remains a big challenge. Assisting teen mothers to resume their studies is a very complicated situation since they have to take care of babies. It is also unfortunate that teen mothers keep moving from one place to another after being chased by their families.
Concerning whether they revealed their pregnancies to parents/guardians, 51.7% revealed it and 48.3% did not. Interviewed parents asserted that they knew about their daughters' pregnancies when they realized physical changes and signs, others were chased from boarding schools and a few of them informed their parents that they were pregnant. The reasons of hiding their pregnancies were that the majority (50.6%) feared to be chased from home. Other reasons were shame, fear to be beaten and more others. Teen mothers are challenged by social rejection which rings long run consequences to them and their children. None resuming their studies amplifies their poverty transmission from mothers to children.

Figure 3: Critical situation of impregnated teens
Teens' pregnancies involve their social and economic vulnerability. They develop feelings of hopeless about their lives (28.4%) and anguish (18.2%). They even think about suicide (9%), depressed (8.5%) and many other signs of desperate life. Their depression is rooted on their families' reactions whereby they are blamed, harassed, dismissed sometimes with their mothers. Asking them whether they thought about abortion, 61.4% confirmed to have planned about it and were limited by financial means, others were fearful that they could die. Interviewed parents stated that after being informed about their daughters' pregnancies, they reacted differently. Most of parents were extremely unhappy, blamed their children and chased them as they were a shame to their families. There is a small number of parents who took their time to talk to their children, took them to hospital and advised them on how to behave for their wellbeing and their babies.
The findings of the study are in line with those of Lince-Deroche et al. (2019) who found out that a big number of adolescents get unplanned or unwanted pregnancies which influence the increment of abortion rate. In countries where abortion is outlawed or highly restricted, adolescents think of unsafe abortion which put their health and lives at high risk. Studies revealed that in developing countries there are about 3.9 million of unsafe abortions which occur among girls aged 15-20.
The results of the present study revealed that social and economic situation of teen mothers is worsened by the fact that before and after delivering, 54% of teen mothers are abandoned by their parents/guardians as well as fathers of their children. A high number of those who impregnate teenagers (76.7%) abandon them and do not provide any support to help teen mothers care of their children. Only 20.5% provide insignificant support to lessen teen mothers' tension so that they may keep quiet as they are mostly impregnated by adults even those with wives and children.
When teen pregnancy occurs, the entire family is affected which lead to stress that will impinge on family relationships. The first dilemma faced by a pregnant teen and her family is about continuing with the pregnancy and have the baby or abort. A pregnant teenager usually feel that she is not yet ready for caring the baby and opt for abortion. The problems become worse when they pass through illegal way which may result in legal sentence.
Teen mothers bare higher risk of getting mental health troubles such as depression, intense stress and pressure to become parents prematurely. Because of being stigmatized, pregnant teens develop feelings of shame, guilt, anger, denial which lead to depression and low self-esteem. Stigma attached to teenagers' pregnancies out of marriage makes them feel isolated and lack of support from families and friends. A considerable number of interviewed parents emphasized that teen mothers worsened their financial situation. Most of them are from poor families and when they bring in new babies, poverty is amplified. Caring both teens and their babies increases the vulnerability of families. Moreover, parents do not even know the identity of new born. Teen mothers' families are humiliated among others and accused for not having provided a good education to their children. Teen mothers also contribute to family conflicts as regard to decision to be taken. One parent may suggest keeping impregnated teen while another suggests chasing her and conflict comes in. Parents and local leaders confirmed that there are mothers who are chased with their impregnated teens. Such conflict is extrapolated from nuclear families to friends and the entire community.
Teenagers' pregnancies constitute a major challenge which amplifies maternal and child mortality rate. Complications relating to pregnancy and childbirth are the leading cause of death for girls aged 15-19 globally. Moreover, pregnant adolescents and their babies are exposed to health risks during childbearing due to their immature bodies. Teen mothers (aged 10-19 years) face higher risks of eclampsia, puerperal endometritis and systemic infections than mature women. In addition, babies from teen mothers are at higher risks of low birth weight, preterm birth and severe neonatal condition which result in long term effects (Bah, 2016;Kiani et al, 2019).
Due to stigma, shame and rejection, most of pregnant teenagers are strained to stop schooling which reduces their competitiveness on labor market. They lack opportunities to build a better future life and live in continuous poverty which passes on their children as well. Few of teen mothers who resume their studies are affected by their living conditions and pre-natal challenges which lower their grades in school. In addition, they lack emotional, psychological, social, moral and financial support. It has been revealed that daughters from teen mothers are at higher risk of becoming pregnant during teenager age (Margherita et al, 2017). Thus, teen pregnancies are threat to economic development of teen mothers, their children, families and community at large. Teen mothers' phenomenon intensifies the problem of identity crisis with its associated consequences as underscored by teen mothers' parents and local leaders during interview.

Conclusion
Teen pregnancies phenomenon is a severe issue which if not cared for may results in long run consequences and amplifies identity crisis which has been proved to be a push factor of street children. Previous researches have pointed out push factors of teenagers' pregnancies and the present research has highlighted consequences attributed to it. The results revealed the phenomenon to be a hindrance to social and economic development and it cannot be addressed without having a combination of efforts from family to national level. Pregnant teenagers face many problems which affect themselves, their children, family relationships and society at large.
Preventing teen pregnancies is fundamental towards the achievement of Sustainable Development Goals (SDGs) especially in reduction of maternal and infant mortality. Teen mothers suffer from social rejection from parent/guardians, peers and even those who impregnated them which led to depression and continuous poverty. A high number of teens were impregnated while students and did not resume their studies. There is a need of preparing teens about their physiological changes and education on sexual behavior. Improving parents-children relations, campaigns and consistent education of adolescents on reproductive health would bring lasting solutions. Parents should be closer to their children, communicate with them in order to know what they are going through, what they need and provide social and economic support from early age. In case a teen gets impregnated, they should bear with them so that they may not think about abortion, suicide or throwing their babies after delivering. This would reduce the abortion rate, depression and its related consequences. The research shed light on the necessity of community sensitization about strategies which are likely to decrease teen mothers' rate as well as appropriate treatment in case teen gets impregnated.