Original Article Acta Medica Anatolia Volume 2 Issue 1 2014 Being An Adolescent Mother Cem Uysal1, Ziya M. Kir2, Neval Yaman Goruk3, Abdullah Atli4, Yasin Bez5, Süleyman Gören1, Oguz M. Polat5 1 Department of Forensic Medicine, Dicle University Medical Faculty, Diyarbakir, Turkey 2 Department of Forensic Medicine, Celal Bayar University Medical Faculty, Manisa, Turkey 3 Department of Obstetrics and Gynecology, Dicle University Medical Faculty, Diyarbakir, Turkey 4 Department of Psychiatry, Dicle University Medical Faculty, Diyarbakir, Turkey 5 Department of Psychiatry, Marmara University Medical Faculty, Istanbul, Turkey Abstract Objectives: This survey study aimed to determine demographic characteristics of adolescent mothers and find out factors effecting adolescent marriages by performing a questionnaire to adolescent mothers. Methods: After obtaining the approval of the Ethics Committee of Dicle University, this survey study was performed between March 1, 2012 and August 31, 2012 for a period of 6-month in Diyarbakır Maternity Hospital during the study period. Results: In this study, results of a survey performed to 71 mothers who gave their first birth under 19 year of age were evaluated. Conclusions: Since adolescent girls involved in adolescent marriages are mostly biopsychosocially immature and poorly educated individuals they are tend to suffer early-age unhealthy pregnancies and consequently high rate of miscarriage and other pregnancy associated complications. Keywords: Adolescent mothers, marriage, education, violence. Received: 27.01.2014 Accepted: 08.02.2014 Acta Medica Anatolia Introduction World Health Organization (WHO) estimates that face interview after informing each participant about about 10% of all births worldwide each year is given questionnaire and obtaining informed consent. The by adolescents aged between 15 and 19 years (1). questionnaire was comprised of 60 questions related Many adolescents are sexually active, voluntary or to age at marriage, social type of marriage, involuntary pregnancies might happen as a result of employment status, miscarriage, abortion, intramarital or extramarital sexual intercourse. educational status, kinship with the spouse, number Pregnancy and births occurring in this age group are of children, and domestic violence. Findings were responsible for high risks for children and adolescent evaluated using IBM SPSS 20 statistical software. mothers, which might increase mortality rates compared to other age groups (1-11). Besides health Results problems, social problems such as lack of education, In this study, results of a survey performed to 71 being unemployed and financially dependent might mothers who gave their first birth under 18 year of be encountered (2, 12, 13). age were evaluated. The ages of participants ranged This survey study aimed to determine demographic between 14 and 40 years with a mean age of characteristics of adolescent mothers and find out 20.27±6.77 years. Out of all 68 (95.8%) were factors effecting adolescent marriages by performing religiously married while three (4.2%) were not. a questionnaire to adolescent mothers. Among those religiously married, only 23 (33.8%) were officially married, while 45 (66.2%) were not married Materials and Methods officially. The ages of first marriage were as follows: 23 (32.4%) 14 years, 17 (23.9%) 15 years, 17 (23.9%) 16 After obtaining the approval of the Ethics Committee years, 9 (12.7%) at 17 years and 3 (4.2%) at the age of of Dicle University, this survey study was performed 18. 40.8% of the participants were convinced for between March 1, 2012 and August 31, 2012 for a arranged marriage and 18.3% forced for arranged period of 6-month. A questionnaire was performed marriage. Additionally, 26.8% married voluntarily, to adolescents who gave birth less than 18 years of 12.9% escaped for marriage, and 1.4% were abducted age, in Diyarbakır Maternity Hospital during the study for marriage. period. The questionnaire was performed by an Obstetrics and Gynecology Specialist with a face-to- Correspondence: Cem Uysal MD, Department of Forensic Medicine, Dicle University Medical Faculty, Diyarbakir, Turkey. 14 [email protected] Original Article Uysal C et al. Table 1. The relationship between the number of children and the level of education Education Number of Child Total No 1 or 2 3 or 4 5 or more Child Children Children Children No Count 10 11 6 3 30 Education % of Total 14,1% 15,5% 8,5% 4,2% 42,3% 1-5 Count 16 13 3 4 36 Education % of Total 22,5% 18,3% 4,2% 5,6% 50,7% Years 6 or more Count 1 3 1 0 5 Education % of Total 1,4% 4,2% 1,4% 0,0% 7,0% Years Total Count 27 27 10 7 71 % of Total 38,0% 38,0% 14,1% 9,9% 100,0% Interestingly, 97.2% participants were unemployed, Out of all 32 (45.1%) participants were relative of their while only 1.2% had a regular job and 1.2% had a husbands, while no kinship was observed in 39 (54.9%) temporary job. Regarding educational status of marriages, in the presented series. Among all, 28.2% participants, 30 (42.3%) cases were totally of participants suffered from miscarriage, while 18.3% uneducated, while 36 (50.7%) had only 1-5 years of underwent a medical abortion. In the presented primary school education and remaining 5 (4.2%) series, 30 (42.3%) participants were found to suffered attend school for at least 6 years. The relationship from domestic violence, and most of these (11.3%) between educational status of participants and suffered from physical and psychological violence. number of children is shown in Table 1. Thirty-two (45.1%) participants victimized of violence after marriage; furthermore, 13 (18.3%) of these faced Evaluation of educational status of participants’ with domestic violence after marriage. Physical spouses revealed that 18 (25.4%) were totally (12.7%) and psychological (12.7%) violence were the uneducated, while 39 (54.9%) had only 1-5 years of most common types of violence among these victims. primary school education and remaining 14 (19.7%) attend school for at least 6 years. A more dramatic Table 2. The percentage of application of traditional situation was observed regarding educational status of methods participants’ parents. Interestingly, among fathers of Traditional methods n % participants 58 (81.7%) were uneducated at all, while 12 (16.9%) had only 1-5 years of primary school Dowry Yes 30 42,3 education and only 1 (1.4%) attend school for at least Payment No 40 56,3 6 years. Furthermore, among mothers of participants Do not Want 1 1,4 68 (95.8%) were totally uneducated, only 2 (2.8%) had 1-5 years of primary school education and 1 (1.4%) to Answer attend school for at least 6 years. Total 71 100,0 Cradle Yes 2 2,8 Overwhelming majority of marriages was based on customary applications; bonnet money was given for Engagemen No 69 97,2 30 (42.3%) participants, cradle engagement was seen t Total 71 100,0 in marriages of 2 (2.8%) participants. Among remaining, “Berdel (in this custom two men from Berdel Yes 8 11,3 different families that marry each other’s sister Weddings No 63 88,7 without dowry or any bonnet payment)”, a custom Total 71 100,0 unique for Turkey was performed in marriages of 8 (11.3%) participants (Table 2). Acta Med Anatol 2014;2(1):14-18 15 Original Article Uysal C et al. Discussion In studies regarding adolescent pregnancy, low educational level of the family members and spouse In Turkey, regulations relating to marriage are based have been identified as a risk factor (18, 19). In the on the Turkish Civil Code (TCC) and the Turkish Penal present study, among participants’ spouses 18 (25.4%) Code (TPC). According to the TCC article 124 men and were totally uneducated, while 39 (54.9%) had only 1- women can’t marry before the age of 17, and in 5 years of primary school education and remaining 14 accordance with the article 143 religious marriage can (19.7%) attend school for at least 6 years. only be performed after official marriage (2). Since Furthermore, overwhelming majority of parents was TCC does not let official marriage before 17 years, in dramatically uneducated. In accordance with the marriages of individuals less than 17 years traditional literature, 81.7% of fathers and 95.8% of mothers practices such as "religious marriages" are preferred were uneducated at all. (14). Participants of presented series were noticed to be married at the age of 14 to 16 years, which is lower Pregnant adolescents generally perform an induced than age of legally acceptable marriage. The vast abortion to terminate unwanted pregnancies (20). A majority of the participants (95.8%) were found to be study from Equador revealed that 83.1% of adolescent religiously married. Among religiously married ones, pregnancies were unintended pregnancy (21). A study only 23 (33.8%) were officially married, while 45 conducted in Aydın, Turkey 63.4% adolescent (66.2%) were not married officially. A previously pregnancies were unwanted, while this rate was conducted study in our country revealed that, the rate 43.5% among adults (22). On the other hand, the rate of who have official and religious marriages at the of induced abortions is reported between 3 and 12.4% same was 88.5%, while 7.4% had only religious among married women in the 15-19 age group (17). In marriage and 3.8% were only officially married; on the addition to higher rate of unintended pregnancy, other hand only 0.3% had no wedlock (15). Avoiding complication such as pelvic infection, infertility, and the civil marriage appears to be a major problem since risk of death due to induced abortion can be seen in it causes loss of rights given by the laws.