The study findings contradict to some extent the assertion that the boyfriends or sexual partners 

of adolescent girls routinely do not take responsibility for mistimed pregnancies or insist on 

abortions. Rather, it seems that in this community, getting pregnant and having a child together 

as a couple can be the first step in forming a long term union. In cases where the couple decided 

not to continue the pregnancy, the boyfriend usually took responsibility for the abortion costs, as 

much as he could afford. While it does happen that boyfriends refuse responsibility for a 

pregnancy, this did not happen in the majority of cases, and care should be taken not to assume 

this is the rule. 

Girls' early awareness of pregnancy, the availability of abortion information and services, and 

the ability to raise the money, all contributed to obtaining apparently safe abortions. This is not 

to dismiss the possibility that a minority of girls who are alienated from family and the 

community may have tragic experiences with other abortive measures.  However, this does not 

appear to be the common experience in this community. Adolescent girls appear to use abortion 

both to delay childbearing and to space children.  

These girls' experiences of adolescent pregnancy challenge some of the basic assumptions on 

which health surveys of teenage pregnancy and abortion are based and can be used to refine 

survey strategies. For example, one assumption is that   married  as opposed to  unmarried  is 

an unambiguous distinction that can easily be measured by asking one question.  

The differences in findings between this study of adolescent abortion and those conducted 

among other groups, such as street youth, or middle class youth, suggest that looking at the data 

at the aggregate level masks differences that are important for program planning and 

implementation. Standardizing approaches rather than adapting them to specific groups, can lead 

to programs that do not address the health behavior of the adolescent group the program is 

designed to change.  

Recommendations 

Pregnancy and Sexual Violence Prevention  

Since girls who become pregnant often begin having sexual relationships after they leave school, 

pregnancy prevention efforts should focus on both male and female out of school as well as in 

school adolescents and youth. The following strategies might be used to reach these groups. 

Build on existing puberty practices of parents and other caretakers. Parents and other 

caretakers might be educated to include information on the biological fertile period, modern 

methods of contraception, and the dynamics of date rape, to their existing practices of 

puberty instruction. An example of a message aimed at boys through their parents and 

caretakers is,  When a girl says no to sex it means no.  For girls,  It is important to say no 

both verbally and non verbally through body language.   

Many girls who have recently migrated to Accra from other areas of Ghana might be reached 

with pregnancy prevention and sexual violence education through the  madam  for whom 

they sell food items and with whom they live. Others might be contacted through local  susu 

collectors  or mobile bankers, since many save their money this way. 

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