Summary 

This study explores the strategies used by adolescent girls living in urban Accra, Ghana to cope 

with unintended pregnancies. It examines the processes leading to pregnancy and compares the 

strategy of terminating a pregnancy with that of carrying the pregnancy to term. The study was 

initiated in response to findings from the 1998 Ghana Demographic and Health Survey (GDHS) 

indicating that early pregnancy loss among girls age 15 to 19 was twice as high as that of other 

age groups, and pregnancy loss among urban teens was twice that of rural areas.  

Methods 

The study was conducted in Ga Mashi Town in Central Accra, an urban setting. Several field 

methods were used to elicit information from three groups in the Ga Mashi community: 

adolescents, school personnel, and health care providers.  

The primary method was the collection of case studies for 29 girls who had experienced at least 

one unintended pregnancy between the ages of 13 and 19. Case studies consisted of three 

interviews with the girls, each lasting from one to two hours. In addition to gathering detailed 

pregnancy, birth, and abortion histories, the case studies focused on specific areas of the girls' 

daily lives related to getting pregnant and coping with the pregnancy once it occurred. For 

example, besides gathering a family history, we also asked the girls about their experiences of 

the onset of menstruation, puberty instruction received in the home and elsewhere, their 

knowledge of contraception, their boyfriends' ages and occupations, and the nature and length of 

their involvement with these boys, including first sexual experiences. 

The other methods included community observations, focus group discussions with in school 

and out of school adolescent girls and peer promoters, and interviews with teachers and health 

care providers. 

Findings 

Growing up: work, aspirations, dating and sex:  The participants generally began working 

during their mid teens after they had dropped out of school, and their early money making 

activities usually involved selling small items. Family financial limitations, rather than getting 

pregnant, were the main reason the girls cited for not continuing schooling past junior secondary 

school. They expected to support themselves as adults and to provide some of their children's 

support. They aspired to move from selling small items to selling bigger items in the market, 

developing capital to trade, or going on to vocational jobs such as hair braiding or sewing. Along 

with developing their means of making a living, girls developed ongoing relationships with 

boyfriends during this stage of their lives. 

The majority of participants became sexually active at about age 16, after dropping out of school. 

Their first sexual partners were boyfriends either close to their own ages or between 5 and 12 

years older. Those were boys or men with whom they had an ongoing relationship in which both 

 love  and  chop money  contributions were essential for a relationship to develop. About a 

third of the girls described their first sexual experience as involving force and/or deception by a 

boyfriend, or, as a rape by a nonboyfriend.  Such actions caused a substantial number of girls to 

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