A descriptive study of the reasons and consequences of pregnancy among single adolescent mothers in Lesotho

Curationis 30(3): x-y The adolescents, who engage in unprotected sex, face the risk of unplanned pregnancy and sexually transmitted diseases. It is not clear why adolescents in Lesotho engage in unprotected sex and end up with unplanned pregnancies. In addition, it is not clear what the consequences of early childbearing are on the life of the adolescent and her infant. An understanding of the reasons why a number of adolescents engage in unprotected sex and the impact of pregnancy and early childbearing on the lives of adolescent mothers and their infants will potentially assist nurses and other health workers in adolescent health promotion programmes. The purpose of this study was: 1) to determine the adolescent mother’s perceived reasons for pregnancy and 2) to determine pregnancy related joys, and problems faced by adolescent mother and her infant. M ethod: The exploratory descriptive research design was used to determine the perceived reasons, joys and difficulties relating to pregnancy and parenting. Participants consisted of a convenience sample of 51 unmarried adolescent mothers 16 to 19 years old (mean of 18.4 years, SD = .89). Findings: The main reasons that the adolescents gave for becoming pregnant were: 1) lack of knowledge about contraceptives, 2) misinformation from friends, 3) control by boyfriends, 4) lack o f planning, 5) fear o f parents and the side effects of contraceptives, 6) moral issues, 7) failed contraceptives, and 8) failure to take pregnancy seriously. The pregnancy had negative impact on the lives of the adolescents and their infants. These mothers expressed no joy in having their infants early in life and indicated that they had problems raising these infants. Their main concerns were lack of finances, lack o f contact with their boyfriends and loneliness. These findings have critical implications for the establishment o f comprehensive adolescent health programmes. Correspondence address: Dr EMYako University o f Fort Hare Department of Nursing Sciences PO Box 1054 East London, 5201 Tel: (043) 722-4371 Fax: (043) 722-4391 E-mail: eyako@ufh.ac.za


AIDS.
abortion for financial gain.
Pregnancy among adolescents poses serious problems.It comes at a time when the mother is not yet ready for parenting physically, m entally and financially (Mngadi, Thembi, Ransjo-Arvidson & Ahlberg 2002: 38).The adolescents who engage in unprotected sex in Lesotho do not only run the risk o f becom ing pregnant, but also risk their own lives, since maternal mortality is high in this country.
Despite the risks faced by adolescents who engage in unprotected sex, earlier stu d ies in d icate th at a num ber o f adolescents still continue in this manner in Lesotho (M otlom elo & Sebatane 1999:53;Yako 2000:81).Woods (1998:6) points out that risk taking and testing lim its are n ecessary for norm al p sy ch o so c ia l d ev elo p m en t in adolescence.However, most adolescents accom plish this developm ental task without risking their own lives.When risk taking and limit testing includes risky sexual behaviours, these adolescents increase their chances o f unplanned pregnancy and infection with Sexually Transmitted Diseases including HIV/ The principal investigator was interested in fin d in g out the reaso n s why adolescents risk an early pregnancy, as well as the impact o f pregnancy has on the lives of these adolescents and their infants.The purpose o f this study was to determine the reasons for adolescent pregnancy, and the joys and problems, related to pregnancy that the adolescent mother has to face.
The report presented in this paper forms part of the main study investigating the im pact o f pregnancy in the life o f adolescents and their infants in Lesotho (Yako: 2000).The main study investigated a num ber o f other factors including stress, anxiety, depression, self-concept, maternal and infant outcomes.Findings of the main study are presented in another paper.

Literature review
Studies done in South Africa indicate that the partners o f adolescent girls often pressure adolescent girls into sexual intercourse.Wood, Maforah and Jewkes (1998:233) found that male partners dictated the terms for sex and often beat their girlfriends.These girls never terminated the relationships for fear o f further beatings.Vundile, M aforah, Jewkes and Jordaan (2001:52) reported similar results o f male domination o f teenage girls.In this study, the partners o f adolescent girls were likely to be older and less likely to be at school.The teenagers were more likely to have had forced sexual initiation and were less likely to confront their boyfriends if they d isco v ered th at th ere w ere o ther girlfriends.
Using a sample o f 768 randomly selected single senior secondary school girls in a study on sexual ac tiv ity and contraceptive use in Nigeria, Okpani and Okpani (2000: 40) reported that 24.7 % were sexually active and that 74.2% of their male partners were older working m en, w hich su g g ested th at these adolescents were in these relationships for material gain.Silberschimidt andRasch (2001:1815)) reported sim ilar results in a study done in Dar es Salaam in Tanzania on illegal abortions and 'sugar daddies.' Investigation indicated that adolescents who had had illegal abortions had older working partners, and that they were willing to expose themselves to the risks o f pregnancy and Using a sample o f305 adolescents in their baseline study, Motlomelo and Sebatane (1999:53) reported that only 29 % of these adolescents indicated that they had ever used contraceptives.No studies have been done in Lesotho on reasons for adolescent pregnancy.Therefore, it is not clea r w hat facto rs prom pt ad o lesc en ts to engage in risk y u n p ro tec ted sex and end up w ith unwanted pregnancies.It is also not clear w hat preg n an cy re la ted jo y s and problems adolescents face.This study attem pted to answ er the follow ing questions: 1.
What are the adolescent mothers' perceived reasons for becoming pregnant?2.
What are the adolescent mothers' perceived joys and problems, relating to pregnancy and parenting?Findings o f this study will potentially assist the nurses in planning health promotion programmes for adolescents in Lesotho.

Method Design
The study used both quantitative and qualitative methods.The exploratory descriptive research design was used to determine the perceived reasons, joys and difficulties relating to pregnancy and parenting.This descriptive design was deemed adequate, because it sought to sp ecify the c h a ra c te ristic s o f a phenom enon o f interest, and used a single sample (Bums & Grove 1993:293).

Instruments
The principal investigator developed the instruments used in the study presented in this paper.The instrum ents were assessed for content validity by three experienced nurse researchers who are experts in m idw ifery and neonatal nursing.The instrum ents were pilottested using a sample o f ten adolescents.T hese ad o lesc en ts en c o u n te red no problems with the instruments used in this study.Consequently, no changes were made to the instruments.
Infant Form : This instrum ent was designed to provide information about the infant.Respondents fill in blank spaces or circle the appropriate answer.Items included in the questionnaire were birth weight, Apgar score, method of feeding and immunizations.P e rs o n a l D a ta P ro file : This questionnaire was designed to provide d esc rip tiv e in fo rm atio n about the participants.Respondents fill in the blank spaces or circle the appropriate answer.The items on this questionnaire included demographic information, such as age and marital status, and information about the present pregnancy, such as date and method o f delivery.

Reasons and Effects of Pregnancy Guide:
T his in stru m en t co n sisted o f five questions.The first question was the only close-ended question and asked whether the pregnancy was planned or not.
The re m ain in g o pen-ended questions asked for the reasons and the effects o f the pregnancy on the mother and the infant.The respondent indicated w h eth er she has had any jo y s or difficulties due to the pregnancy.

Population
Adolescent m others, who attended a postnatal clinic six weeks after delivery at the selected hospitals and health centres at the time o f study, were eligible for participation.To be included, the single adolescent mother had to meet criteria including being between the ages of 15 and 19 at the tim e o f study; singleton birth; primiparity; attendance of the clinic visit six weeks post delivery at the time of study and; an understanding o f Sesotho or English.Criteria for exclusion from the study were firstly hospitalization with a serious m edical or surgical condition and, secondly, severe mental disturbance.

Sample
A convenience sam ple o f 51 single adolescent mothers participated in this study.The principal investigator selected the sample.At each visit at the health facility, every adolescent meeting the selection criteria was included in the study.This was repeated until the required number was reached.

Procedure
Adolescent mothers were recruited from three hospitals and two health centers (clinics) in the low lands o f Lesotho.The sample came from Queen Elizabeth II hospital, the main hospital in Maseru which is the capital city; Butha-buthe governm ent hospital in Butha-buthe tow n; M aluti A dventist H ospital in Mapoteng town; and two health centers in Maputsoe town.
The study w as in tro d u ced to the adolescents and their accom panying relatives during a postnatal clinic visit six weeks post delivery.All single adolescents, who participated in the main study, were invited to participate in the in terv iew s.O ut o f 64 single ad o lesc en t m o th ers, 51 ag reed to participate in the interviews.Those who declined gave transport problems as their reason for n o n -p a rtic ip atio n .The majority of these adolescents used public transport, which in some rural areas of Lesotho is scarce.
After the study had been introduced, adolescents over 18 years o f age, willing to participate in the study were asked to sign a written consent form.Parental consent was obtained for adolescents under 18 years old.In Lesotho, a child is legally defined as a young unmarried p erson under the age o f 18 years (Ministry o f Health & Social Welfare 1993: 23).The legal age for consent for marriage is 18 for boys and 16 for girls (Interpol 2006, 1).The principal investigator conducted interviews using an interview guide developed by the same investigator.The interview was selected as a means o f data collection in order to cater for adolescent mothers with minimal education, as it would take them much longer to complete questionnaires and to provide in-depth information.

Protection of participants
This study was carried out following the guidelines o f the research committee of the (Lesotho) Ministry o f Health and Social Welfare.In addition, permission was obtained from administrators of the institutions where data was collected.The benefits and risks o f this study were explained to the adolescents and their parents.There were no anticipated risks in this study.
Participants were informed that their decision to participate in this study would not affect their care or the care of their infants.The clients were informed that they were free to withdraw from the study at any point and that raw data would only be accessible to the research team.Adolescents willing to participate and the p aren ts o f m in o rs, w ere requested to sign written consent forms.

Data analysis
Data was first analyzed manually.The responses to open-ended questions were classified and coded.Quantitative data was then analyzed using SPSS for Windows software.Descriptive and inferential statistics were employed in describing the findings.

Sample
Every adolescent mother (N = 51) that participated in this study was a Mosotho.Their ages ranged from 16 to 19 years, with the mean o f 18.4 years, (S D = .89).The majority, (N = 20) 39.2% o f these adolescent mothers, had seven years of schooling or less.Seventy-six percent (N = 39) o f the ad o lesc en ts w ere unemployed, 9.8% (N=5) were employed and 13.7 % (N=7) were students and not working.The majority (N= 30) 59.4%, of these adolescents lived with their own mothers.They came from low-income families, which is typical o f the families in the population.Thirty five percent of the adolescents did not know their supporters' income.Only 65 % o f the adolescents reported to know th eir supporters' income.These adolescents reported an income o f less than R 1000 per month.The median income was R0 to R499.When asked how well this income met their needs, they stated that it w as in ad eq u ate.Every participant in this study was a C h ristian .The majority (N= 31,60 1.

Reasons for pregnancy and effects of pregnancy
The main reasons that the adolescent m others gave for beco m in g p reg n an t were: 1) lack o f knowledge about contraceptives, 2) m isin fo rm atio n from frien d s, 3) co n tro l by b o y frie n d s, 4) lack o f planning, 5) fear of parents and the side effects o f contraceptives, 6) moral issu es, 7) failed c o n tra c e p tiv e s, and 8) failure to take pregnancy seriously.The pregnancy had a negative impact on the lives of the adolescents and their infants.These adolescent mothers expressed no joy in having their babies early in life, because they had problems raising their infants.T h eir m ain co n cern s w ere lack o f finances, lack o f contact w ith their boyfriends and loneliness.T his rem edy n ever worked as she became p reg n an t and the pregnancy progressed to full term without any ill effects on her health and the health o f her Consequently, they were not able to exercise their rights.

Misinformation from friends
Eight percent (N = 4) o f the adolescent mothers indicated that their friends told them that contraceptives make people sick.T h erefo re, if they used the contraceptives, they too would become sick.The illness was not spelt out and it was not associated with any specific type o f contraceptives.They had never seen anybody who had become sick from the use o f contraceptives.They believed what their friends told them without verifying their credibility.

Control by boyfriend
Eight percent (N = 4) o f the adolescent 77 Curationis September 2007 infant.

Lack of planning
Ten percent (N = 5) o f the adolescent mothers indicated that they did not plan to have sex.The sexual intercourse hap p en ed spo n tan eo u sly .E ighty percen t (N = 4) o f this group had consensual sex.Twenty percent o f this group (N= 1), was an orphan raped by a relative, the father's cousin, who later had no contact with the adolescent and the infant.This adolescent m other indicated that she lived with the grand mother, who never pursued the case.The case was never reported to the police or any other authorities.It was kept a family secret to avoid scandal.Eight percent (N = 4) o f the adolescent mothers reported that they were afraid of their parents.They did not want their parents to know that they were sexually active.They were afraid their parents w ould d isco v er th e ir hidden contraceptives, but they never thought o f the consequences of pregnancy.Eight percent o f the adolescents indicated they were afraid o f the side effects o f the contraceptives.They believed that the contraceptives would make them sick.The side effects reported by this group w ho used c o n tra c e p tiv e p ills and injection, were irregular menstruation and heavy bleeding.This group believed th at o th er form s o f co n tracep tiv es probably caused com plications too.However, in spite o f this belief, they never so u g h t in fo rm atio n from health professionals.

Moral reasons
Four percent (N = 2) o f the adolescent mothers gave moral reasons for not using the contraceptives.The reasons were that the church did not advocate the use o f contraceptives.The second reason that was given was that contraceptives en c o u rag e d p ro m iscu ity as they in cre ased the u s e r 's lib id o .The adolescent stated: 'I believe that the contraceptives will make me wild.'

Failed contraceptives
Eight percent (N = 4) o f the adolescent mothers reported failed contraceptives as the reason for becoming pregnant.Almost all the adolescents (N = 3) in this group were on the pill, but did not take the pills regularly.The reasons for not taking contraceptives regularly were that they forgot or a lack o f time to collect the pills.The only adolescent who was on Depo-Provera injection, indicated that she did not adhere to the recommended dates for the next injections.

Failure to take pregnancy seriously
Six percent (N = 3) o f the adolescent mothers did not take early childbearing seriously.They engaged in sex without thinking o f the consequences.One adolescent gave the following reason: 'I was just playing and did not think I could actually get pregnant.'One stated: 'I had no interest in contraceptives.'Another one indicated: 'It was an accident.'The reasons for pregnancy are presented in Figure 1.

Joys
Almost all the adolescent mothers (94%, N =48) reported that their infants did not bring them any joy.The majority o f adolescents perceived their infants as a burden to them (adolescent mothers), as these adolescents depended on their own families for physical, emotional and financial support.Only 6% (N = 3) reported positive attitudes towards the infants and these expressed their love towards their infants.One actually expressed that her baby boy was a potential asset to the family.She stated: 'This boy will help our family in looking after the cattle in the future.My parents are struggling to find someone to look after the cattle, as I have no male sibling.'

Problems
Seventy-two percent (N = 37) o f the adolescent m others reported lack of finances as the major problem in their lives.They did not have enough money to take care o f their needs and the needs o f their infants.Almost all (92 %, N= 47)) adolescent mothers were supported by their parents while the rest were supported by other relatives such as sib lin g s and grand p aren ts.This situation added more strain on those relatives who were also poor, with an income o f less than R1000.00 per month.Almost all (96%, N = 49) adolescent m others had no co n tact w ith th eir boyfriends.They stated that they felt betrayed and abandoned by their boyfriends when they needed them the m ost.They in d icated th at they w ish ed th eir boyfriends could contact them, see their infants and take part in the upbringing of the infants.One adolescent m other re p o rted th at she did not love her boyfriend anymore.Therefore, she did not mind that the boyfriend had not contacted her and the infant.She further indicated that she had gone back to school with the hope o f improving her life and that o f her infant.Only one adolescent was in contact with the boyfriend and was supported by the boyfriend.Those that had gone back to school (13.7%,N = 7) indicated that they found it strenuous to study and take care o f their infants simultaneously.The parents o f the adolescent mothers helped the adolescents with their infants, but they expected these adolescents to take responsibility for their infants.Another factor mentioned by 20% (N =10) o f the p artic ip a n ts w as lon elin ess.Because they had dropped out o f school, they felt cut off from their friends, who made no effort to contact them.They themselves on the other hand, felt too shy to take the initiative and contact their 78 Curationis September 2007 friends.

Discussion
The majority of adolescents gave a lack of knowledge about contraceptives as the main reason for becoming pregnant.Adolescents need to be given enough information about contraceptives: what they are, how they work and where to obtain them, so that they can make informed choices.If they do not have adeq u ate in fo rm ation on the contraceptives, they are less likely to use them.
Although some adolescents gave other reasons such as failed contraceptives and fear o f complications, the underlying reason was a lack o f knowledge.Those who used contraceptives used them irregularly and as a result fell pregnant.The contraceptives need to be used regularly in order to be effective.Health w orkers should not show negative attitudes towards adolescents who use contraceptives or to those who become pregnant outside m arriage.These negative attitudes deter adolescents from using the services (Zabin & Kiragu 1998: 224).Health workers need to give social support to these adolescents, and to counsel them in o rd er to prev en t subsequent unplanned pregnancies at an early age (Mngadi et al. 2002:38).
The majority o f parents in Lesotho are not comfortable discussing issues o f sex and sexuality with their children, due to their upbringing and religion.Culturally, anything that deals with sex is a taboo.It is never discussed with children.R elig io n em p h asizes m o rality and th ere fo re the ex p e ctatio n is that adolescents should not engage in sex before marriage.Most parents in Lesotho perceive that talking to adolescents about sex would be encouraging them to engage in sex prematurely.Because most parents do not talk to their children about sex and sexuality, m ost adolescents obtain their information from their peers, w ho m ay also be m isinform ed (Motlomelo & Sebatane 1999:2).
Findings of this study are consistent with the fin d in g s o f ea rlie r stu d ies on b o y frien d in flu en ce in ad o lescen t pregnancy, w here adolescents were dominated by their boyfriends (Wood, Maforah & Jewkes 1998:73;Vundile et al. 2001:733).In this study, some boyfriends denied their girlfriends the opportunity o f using contraceptives because they believed the co n tracep tiv es w ould weaken them (boyfriends) sexually.The boyfriends put their own interests first w ith o u t c o n sid erin g the p otential complications of pregnancy and the long term effects of early childbearing on the adolescent and the infant.Prescription o f a false remedy by the boyfriend put the life of the adolescent and the unborn baby in danger, since none o f these adolescents knew the side effects o f these concoctions.The ad o lesc en ts, who gave m oral reasons for non-use o f contraceptives in d icatin g that c o n tra cep tiv es encouraged prom iscuity am ong the adolescents or that the church did not allow use of contraceptives, failed to put issues into their right perspective.This finding supports earlier findings that adolescents sometimes think and act irrationally due to limited experience and cognition that is not well developed (W haley, 1999: 377).It is not the co n tra cep tiv es per se th at m ake individuals promiscuous, but rather the choices that one makes.It is contrary to the Christian philosophy to engage in sex outside marriage (Bible Society 2000: 199).If adolescents abstain from sex, then there is no need for contraceptives.Taking only one aspect of this teaching puts such adolescents at the risk of unw anted pregnancies.Those who choose not to follow the teaching of abstinence before marriage need to admit to them selves that they are sexually active and take responsibility for their actions.They need to use some form of birth control because failure to do so, will not only result in unwanted pregnancies, which have long term negative effects, but the church will also sanction such adolescents for becom ing pregnant outside marriage.
Findings o f this study indicate that some ad o lescen ts did not take early engagem ent in sexual in terc o u rse seriously, stating that they were 'just p la y in g ' or 'it w as an a c c id e n t,' su p p o rtin g e a rlie r stu d ies th at adolescents like taking risks (Manzini 2001: 44;W haley 1999: 377;Woods 1998:6).
A d o lesc en ts p erceiv e themselves to be invincible, and that nothing detrimental will happen to them (Woods 1998:6).They failed to put issues into their right perspective due to their inadequate knowledge and their limited cognition (Whaley 1999:377).
Lack of finances and support from the 79 Curationis September 2007 boyfriends w ere the m ain stressors among adolescents in this study.The p aren ts and o th er re la tiv e s o f the ad o lescen ts had to sup p o rt the adolescents and their infants.This brought much strain on the families who were already struggling financially.The findings o f this study support the earlier stu d ies that in d icate th at early ch ild b ea rin g p erp etu ates p o v erty (Mngadi et al. 2002:38;Yako 2000: 124).Lack o f support from the boyfriends traumatized the adolescent physically and emotionally.These adolescents had to deal with not only their parents, who were angry with them for becoming pregnant early in life, but also felt betrayed by their boyfriends.
Kaufman, de Wet and Stadler (2001:147) give the reason for the boyfriends o f adolescents not admitting to parenting o f infants in South Africa as fear o f the n eg ativ e in flu en ce on the b o y 's ed u catio n and em ploym ent opportunities.Perhaps the boyfriends of adolescents in Lesotho had the same fears.Because the boyfriends took no part in the upbringing o f the adolescents' infants, their parents too did not feature anywhere in the upbringing o f their grandchildren.It is not clear if these parents would be willing to assist in the upbringing of these infants even if they knew o f their existence.

Implications for nursing
The nurses in Lesotho need to ensure that adolescent health programmes are incorporated into Primary Health Care services.Currently, the programmes specifically for adolescents are not yet well established.A dolescents need programmes designed specifically for them, in which they can discuss their problems without fear of adults.These programmes should not only focus on prevention o f pregnancy, but should also look at the adolescents holistically (Yako 2000: 120).
The programmes should aim at boosting the ad o lescen ts' self-esteem , even before the impact o f the pregnancy is felt.The adolescents should be helped to see that they are important people who can m ake th e ir ow n d ec isio n s.T hese programmes should also address the boys since they are also directly involved in early childbearing among adolescent girls.
Zabin and Kiragu (1998: 220) point out that the decision to practise safer sex is influenced to some extent by the belief of what is considered socially acceptable behaviour from the sex partner.The ad o lesc en ts, w ho su b scrib e to the traditional model in which the male is p erceived as the sexually assertive macho man, while the female is perceived as a shy and passive partner, are less likely to negotiate condom use or to com m unicate their decisions not to engage in sexual relations (Buysse & Van Oost 1997:178;Zabin & Kiragu 1998:220).The majority o f adolescents in Lesotho subscribe to this model due to their cultural upbringing.In this culture, the female is ascribed a lower status than a male.In this context, the adolescent female may understand the dangers of unprotected sex, but may engage in unprotected sex because of the partner's refu sal to use condom s (C am bell 1995:197).This mindset needs to be changed through education, with the understanding that it may take time because it is culturally embedded.A dolescents, irrespective o f gender should be assisted to channel their energy into activities that will potentially assist them to dev elop ph y sically , mentally, socially and spiritually.These include activities such as sports, music, scholarly debates, peer education and voluntary com m unity service.The n u rses in L eso th o and o th er stak eh o ld e rs, such as the L esotho Planned Parenthood Association, other health professionals, teachers and the co m m u n ity need to send a strong message about pregnancy prevention.Age appropriate education on sex and sexuality should form a component of the ad o lesc en t p ro gram m es.This education should start before the age of 10 years or before puberty so that the adolescents can make informed decisions (Ehlers, Maja, Sellers & Gololo 2000:43).Comprehensive adolescent programmes should be ongoing in order to maximize their effectiveness.A secondary finding o f this study is that a number o f adolescents are at risk of HIV/AIDS infection.Pregnancy is an indication that these adolescents did not use co n d o m s, th ere fo re p u ttin g themselves at the risk o f infection with Sexually Transmitted Diseases including HIV/AIDS.

Limitations
The methodological limitation o f this study is that it used a small convenience sample from the lowlands in Lesotho.
T h erefo re, the re su lts m ay not be generalized to the entire population, in clu d in g ad o lesc en ts in the mountainous areas.

Conclusion
Despite the methodological problem, this study provides useful baseline information on the reasons for and the impact of pregnancy on the adolescent mothers and their infants in the lowlands o f Lesotho.Nurses and other health workers can potentially use findings of this study in planning and implementing comprehensive adolescent programmes in Lesotho.

Recommendations
It is recommended that a larger study, using a randomly selected sample that in clu d es ad o lesc en ts from the mountainous areas be done in order to generalize the findings to the entire p o p u la tio n in L esotho.It is also recom m ended th at fu rth e r studies addressing the problem o f HIV/AIDS among adolescents in Lesotho, should be done.

References
L esotho is a sm all m ou n tain o u s, landlocked country.It is about 30,355 square kilometers and is surrounded by the Republic o f South Africa (Brainy Atlas 2006:2).More than 85% of the country's population o f two million lives in rural areas (World Bank 2004:1).The m ajority o f these people live in the lowlands o f the country, in which there is arable land for subsistence farming and near to most towns that provide limited em ploym ent o p p o rtu n itie s (U nited N atio n s D evelopm ent P rogram m e (UNDP), 2005:1).Lesotho is classified as one o f the least developed countries o f the world with the Gross National per capita o f U S $ 402.8 (approximately R2558) (UNDP 2005:1).Unemployment rate is quite high and is estimated at 45%, based on the 2003 statistics.The household income, once supplem ented by the wages o f Basotho employed in the mines of South Africa, has fallen due to retrenchment.A total of 58% o f the Lesotho's population live below the national poverty line (U N D P 2005:1).T his study was conducted in the low lands due to the accessibility o f subjects and costs.
Forty eight percent (N = 25) o f the adolescent mothers reported a lack of know ledge o f contraceptives as the reason for their pregnancy.They did not know what contraceptives were, how they worked and where to obtain them.They w ere u n aw are o f n atio n al p olicy concerning the use o f contraceptives.