Journal of Woman's Reproductive Health
ISSN: 2381-862X
Current Issue
Volume No: 2 Issue No: 2
share this page

Research Article | Open Access
  • Available online freely | Peer Reviewed
  • Coping with Pregnancy in Academic Environment: Experiences of Pregnant Students in A Public University in Ghana

    Priscilla Araba Etuah 1     Fred Yao Gbagbo 2       Jacqueline Nkrumah 2    

    1C/o University of Education Winneba, Department of Health Administration & Education. P.O. Box 25 Winneba, Ghana.

    2University of Education Winneba, Department of Health Administration & Education. P.O. Box 25  Winneba, Ghana.

    Abstract

    Background:

    The Ghanaian culture expects women of reproductive age to reproduce. This makes pregnancy an acceptable occurrence in most tertiary institutions in Ghana. Although Ghanaian Universities allow pregnancy in school, challenges associated with pregnancies do not exempt pregnant students from following the academic requirements of the universities. This study therefore explores students’ experiences of copying with pregnancy in an academic environment in Ghana.

    Methods:

    This was a case study, quantitative and qualitative design using structured questionnaires and semi-structured interview guides respectively for data collection. Respondents comprised twenty (30) pregnant full time and part time female students from campuses of University of Education, Winneba. Data collection was between October 2016 and May 2017. Quantitative data were analysed using statistical package for social sciences (SPSS) version 23. The qualitative data was transcribed and manually analysed thematically.

    Results:

    The study found that majority of participants were adults between ages 26 and 30 years. More than half of them (66.7%) had no child and this was their first pregnancy which they felt was mistimed as it occurred during schooling, posing some physiological, financial and academic challenges which compelled students to devise various coping strategies to combine academic work and pregnancy amidst limited University provisions for pregnant students.

    Conclusions:

    The study results have policy and programme implications for meeting women’s needs for pursuing academic and reproductive goals concurrently. The study recommends that public universities in Ghana should institutionalise programmes on preconception counselling and coping with pregnancy in academic environment to enable female students make informed decisions on exercising their reproductive rights in whilst in the university to ensure positive maternal health outcomes.

    Received 18 Apr 2018; Accepted 22 May 2018; Published 26 May 2018;

    Academic Editor:Qiuqin Tang, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University

    Checked for plagiarism: Yes

    Review by: Single-blind

    Copyright©  2018 Priscilla Araba Etuah. et al.

    License
    Creative Commons License    This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    Competing interests

    The authors have declared that no competing interests exist.

    Citation:

    Priscilla Araba Etuah, Fred Yao Gbagbo, Jacqueline Nkrumah (2018) Coping with Pregnancy in Academic Environment: Experiences of Pregnant Students in A Public University in Ghana. Journal Of Woman's Reproductive Health - 2(2):1-11.
    Download as RIS, BibTeX, Text (Include abstract )
    DOI10.14302/issn.2381-862X.jwrh-18-2090

    Introduction

    Following the fourth world conference on women (action for equality, development and peace) convened by the United Nations during 4–15 September 1995 in Beijing, China, Ghana instituted many interventions (i.e Free Compulsory Universal Basic Education (FCUBE), Science, Technical and Mathematics Education (STME) for girls at basic and secondary schools and Capitation Fund) to increase female enrolment in schools thus decreasing the gender disparity of education at the tertiary level education. 1. Despite the success chalked with increasing female enrolment in tertiary institutions, there remain a challenge of females combining reproductive intentions and academic work at the country’s institutions of higher studies with respect to coping with pregnancy in the academic environment. Available literature on coping during pregnancy in school focuses on teenage pregnancy and how these teenagers cope in their environment, among relatives and peers 2. Although emphasis in recent times has been put on how pregnant teenagers cope in school, their experiences in the tertiary institution has not received much attention even though the requirements in academic work could pose its own challenges.

    Pregnancy is a unique experience and a major social expectation of women that most females encounter at various stages in their lives 3. Traditionally in some Ghanaian cultures, women have been carefully trained to desire motherhood and sometimes pushed into having babies against their wish 4, 5, 6. Those who choose not to follow this mantra are often questioned for their choice, or judged for it 7. Although Ghanaian Universities allow pregnancy in school, the physiological challenges associated with pregnancies does not exempt pregnant students from following the academic requirements for graduation in all the tertiary institutions of Ghana. In this regard, students who become pregnant in school expected to devise coping mechanisms towards the challenges of pregnancy and academic work 8. With the increasing number of female student’s population and intake of matured female students who are likely to combine child bearing with academic pursuits in various university this study becomes relevant to exploreexperiences of pregnant students regarding coping with pregnancy in academic environment. Findings of this study may provide valuable information for decision making by the University of Education, Winneba and other tertiary institutions in Ghana.

    Materials and Methods

    Study Design

    The study design was a case study using a mixed method (qualitative and quantitative) approach. This is because, using both designs give a better understanding of the research problem 9. The advantage of quantitative design is that it allows the investigator to measure the social world objectively without adding his/her own impressions or understanding 10. The Qualitative design component elicited participants’ account of meaning experiences or perceptions 11.

    Study Population and Sampling

    The study population comprised regular and sandwich female students in Winneba and Ajumako campuses of the University of Education, pursuing various academic programs in 2017. Because the university does not keep data on pregnant students, a purposive sampling method was used to select pregnant students for the study. In doing this, field assistants were trained and tasked to identify and enroll pregnant students from halls of resident, lecture rooms and social gatherings. By this approach, thirty (30) students were sampled for the study.

    Study Setting

    The geographical scope of the study covers the University of Education, Winneba. This is a Public University established in 1992 to provide specialized courses in education. The university has four main satellite campuses, (Winneba and Ajumako in the Central Region, Kumasi, and Mampong campuses in Ashanti Region). The Winneba campus has three (3) different campuses with a total student population of 18, 987 as at 2016/2017 academic year. Female students constitute 30% of the total student population. The Winneba campus has about six (6) faculties, and 30 departments in all the three campuses. Administratively, the Winneba campus is headed by the Vice-Chancellor and other principal officers that together run the day-to-day administration of the University. This study was conducted in this University because of its mandate of training educationist for various academic institutions in Ghana and the likelihood of graduates transferring knowledge and experiences acquired on campus to the work environment upon graduation from school.

    Ethical Considerations

    The research protocol was first presented at the Faculty of Science Education, University of Education, Winneba periodic seminars for review and ethical suitability. This seminar, brings together senior members and research fellows of the University to review research protocols and papers meant for publication. Approval for data collection and publication were subsequently granted after written permissions were obtained from heads of relevant directorates and respondents from the University of Education, Winneba.

    Data Collection Procedure

    Data collection was done between October 2016 and May 2017. Two instruments (structured questionnaire and semi – structured interview guides) were used for the data collection. The semi structured interview was employed to gather qualitative data from the participants. This took the form of face – to – face interaction between the researcher and the participants. The face – to – face semi – structured interview availed the participants the opportunity to give their own point of view regarding the situation 12. Participants were informed about the purpose and procedure for the study, that is the interview and discussions were recorded through written and audio tapped. The questionnaire was both open and closed ended and was used to gather quantitative data from the participants.

    Data Analysis

    Data analysis took a multi stage approach. The quantitative data were analysed using the statistical package for social sciences (SPSS) version 23 whiles the qualitative data was transcribed and analysed thematically. The quantitative results were presented descriptively in frequencies and percentages using tables. The researcher presented the quantitative data collected from participants in narrative form before any interpretation was done.

    Results

    Table 1 presents the demographic characteristics of respondents. A significant proportion of the respondents (50%) were within the age categories of 26 and 30 years. About 83.3% were married women and 66.7% were pregnant for first time. Majority of the respondents (56.7%) were full time students who have never been engaged in any form of occupation. About 90% of the respondents belonged to the Christian faith. All the respondents were undergraduate students at various levels (100 to 400) in their respective programmes of studies. Off campus accommodation was the most reported accommodation status (86.7%) of respondents since they were non-resident. Although the respondents resided with various significant others the majority (36.7%) were living alone.

    Table 1. Demographic Characteristics of Respondents
    Variable Frequency Percentage (%)
    Age (in years)      
    21 – 25 11 36.7
    26 – 30 15 50.0
    30 – 35 4 13.3
    Marital status      
    Married 25 83.3
    Single 4 13.3
    Engaged 1 3.3
    Religious affiliation      
    Christian 27 90.0
    Islamic 3 10.0
    Traditional 0 0.0
    Occupation      
    Student 17 56.7
    Teaching 11 36.7
     Level in programme    
    100 6 20.0
    200 10 33.3
    300 6 20.0
    400 26.7 
    Number of children    
    none 20 66.7
    One 7 23.3
    Two 10.0 
    Accommodation status    
    Resident 4 13.3
    Non – resident 26  86.7 
    Person living with    
    Alone 11 36.7
    A friend 9 30.0
    Partner 9 30.0
    Parents 1 3.3

    Participant’s Partner’s Frequency of Visits

    It was noted that partner’s frequency of visit depends on the place of residence during pregnancy. About 87% of the participants lived outside the university halls. With those staying outside the halls, majority live alone whiles a small portion of the participants live with their parents. With those living with their parents, their partners visits them only when necessary. Among those living with their friends, about 9.52% of their partner’s visits them once a month, 14.29% of the partners visits them when necessary and 4.7% of the pregnant students rather visits their partners. However, 14.29% of the partners do not visits their pregnant women at all. With those living alone, 4.76% of the partners visits them once a month and frequently, whiles about 23.81% of the partners visit when necessary.

    A previous study on pregnant students 13 found that 7% of respondents felt loneliness during pregnancy because their families lived far away from them. This was evident in the current study as majority of the pregnant students (30%) do not live with their partners or significant others on campus and are neither visited regularly nor support as expected.

    Participants Emotions upon Discovery of Pregnancy

    Responses from the participants revealed that about 46.67% were happy upon the discovery that they were pregnant whiles in school. A respondent indicated that: ‘I’m very happy I’m pregnant at this time after many previous unsuccessful attempts. This pregnancy has really made my husband to become very support of my education and provides all my needs as expected’ (Level 100 English student).

    Planning of Pregnancy

    From the responses, 60% planned their pregnancy whiles 40% did not. This contradicts findings of the study 13 where majority by 63% did not planned their pregnancies whiles the remaining 37% did. Various reasons accounted for pregnancy planning to coincide with academic work on campus. Among the participants who planned their pregnancies, 16.67% reported that they wanted to finish child bearing before age 35 years and because they can have time for their baby separately, majority by 33.33% indicated that they were mature and can have a baby, 5.56% indicated that they have other plans after school whiles 16.67% indicated that because they were married whilst in school and wanted a child to bring happiness into marriage. Participants who did not planned their pregnancies (18.18%) reported that the pregnancy was either due to contraceptive failure, took them by surprise (36.36%) or occurred due to miscalculation of menstrual cycle to whilst using natural family planning method (9.09%).

    Likelihood of Pregnancy Again in School

    Only 26.7% of the participants indicated that they would like to be pregnant again in school given the second chance whiles 73.3% indicated that they wouldn’t like to be pregnant again in school given the second chance. Majority 63.74%, of those who do not want to be pregnant are of the view that study becomes difficult whiles pregnant, 13.64%, indicated that because of busy schedule on campus, 9.09% said they wanted to space their birth, 4.55% said they have finished child bearing.

    Generally, the difficulty of combining pregnancy with academic work was a major deterrent.

    Some participant said due to the difficulty in combing pregnancy with academic work they wouldn’t like to be pregnant again but wouldn’t have any alternative than to bear with it when it comes. A respondent explains as follows:

    ‘I wouldn’t like to be pregnant given the second chance whiles in school, especially with the program I’m offering. It’s difficult combing pregnancy with the practical aspect. However, if it comes, I will carry it.(A level 200 home economics student).

    For those participants who expressed the desire to be pregnant again in school given the second chance, 40% said they could still learn while pregnant while 20% indicated that it will help them to achieve their aim as they feel comfortable being pregnant in school. A respondent indicated her reason as to why she would want to be pregnant in school given the second chance as follows:

    ‘I have decided to give birth during a certain stage in my life, and if I’m in school during that time, I would’ (level 200 integrated science education student).

    Some however were uncertain as to whether they would like to be pregnant or not, but said they would cope with it once it comes. This is exemplified in the following comments made by a respondent during the interview:

    ‘I can’t tell, because it’s nature that will determine. Because you don’t even sometimes plan it and it happens. So when it happens, you have to accept it and cope with it’ (level 300 French education student).

    Likelihood of advising a colleague student to become pregnant in school

    When asked the likelihood of advising a colleague student to become pregnant in school, 23.3% of the participants said they would like to whiles 76.7% said otherwise. This could be related to the fact that studies become difficult when combined with pregnancy as majority of those who did not want to be pregnant in school given the second chance indicates reasons why they would want to or wouldn’t want to advice colleague student to be pregnant. A respondent gave the following reason as to why she would advise a colleague to be pregnant in school:

    Yes, I would advise a colleague because looking at some of our age, some of us are trained teachers before coming to the university. So, we can’t be in school for another four years before we give birth. This is because, it might affect the age of giving birth (level 200 integrated science education student).

    A respondent who wouldn’t like to advice a colleague has this to say:

    I won’t advice because it depends on everyone and her make up. Mine is favourable but the pregnancy of my colleague may not be favourable for her whiles studying (A level 300 French education student).

    Another Participant Echoed Similar Opinion as:

    It depends on the individual. Everyone and how her pregnancy works. Some are lazy, some always are falling sick and others. With mine, it doesn’t worry me. I eat and behave normal. I’m ok. If you know yourself, it will depend on the individual (level 400 English education student).

    Such comments are indication of the difficult experiences that participants might have gone through combining pregnancy with academic work in the university.

    Challenges Confronting Pregnant University Students

    The study realised that physical discomforts and inadequate finances are the major challenges faced by pregnant students in the university. Regarding challenges associated with physical discomfort, 60% of respondents experienced tiredness, vomiting and/or excessive salivating and spitting. One participant who is a hall resident expressed her worry saying,

    ‘I’m in the hall and when people are cooking different dishes, the aroma or flavour of the food makes me feel nausea and uneasy’(level 300 integrated science education student).

    Regarding financial challenges reported being faced it was noted that even though some of the respondents receive salaries since they are trained teachers on study that was not adequate to support them during pregnancies compared to when they were not pregnant as their financial needs have changed with pregnancies. A participant indicated that:

    ‘I do face financial challenges a lot. I could walk to campus from where I stay but I can’t walk back home, therefore I have to take a taxi. Moreover, you have to eat a lot of fruits and buy a lot of things. You also have appetite for something, you buy it and can’t eat it. You also go for Antenatal clinic, lab, scanning etc. It is not easy when it comes to finances (level 400 English education student).

    Another Participant had this to say:

    ‘I do sometimes face financial challenge, because going for ANC and going for laboratory test and scanning demands money, and by the time I come from the hospital, the money on me is finished. At school, I feel like eating something but I can’t get it due to finances. But if I were to be in the house with parents and partner around me, they would support me (Level 200 home economic student).

    Challenges Associated with Combing Pregnancy with Studies

    The task of combing pregnancy with studies is a difficult undertaking considering the different kinds of discomfort and challenges pregnant women experience even when not in school. This was evident from the responses received when participants were asked ‘how is it like to be pregnant and studying’. A participants said:

    ‘It’s not quite normal because sometimes you don’t feel very well and depending on how you study. If you are the type that don’t like to study, you can’t study while pregnant. Because you have to lie prostrate and read. Sometimes you are simply tired and weak and can’t study’

    (Level 200 integrated science student).

    A similar Response was also given by another Respondent who said:

    It’s very hard, difficult and stressful (Level 200 home economic student). With regards to concentration, majority were able to concentrate during lectures, however few participants could not concentrate during lectures.

    A participant who claimed she does not fully concentrate during lectures reported that:

    ‘I go for lectures alright but my concentration is however not in classes. Sometimes I even sleep when lectures is going on and don’t understand at all (level 300 Ga Adangbe student).

    Inability to Attend Antenatal Clinic (ANC)

    Few (10.0%) of the participants indicated that they were not able to attend any Antenatal Clinicdue to time constraints. A respondents indicated that: ‘I have not attend any Antenatal Clinic since I became pregnant for the past four months. I simply don’t have the time to attend the clinic because of my tight lecture schedules which coincides with clinic days. (Level 300 Akan students).

    Coping strategies of pregnant students within the academic environment

    About, 53.3% representing majority of the participants indicated difficulty in coping with their pregnancy whiles 26.67% said it was easy combing pregnancy with studies.

    To cope with their pregnancy, majority of the pregnant students have made changes to their studies one way or the other. The participants felt that movement from their place of resident to campus for group discussions is tiring and thus chose to study at home. A participant said

    ‘I don’t come to campus to study in the night. I study in the house because of the distance from my home to campus’ (level 100 integrated science student).

    Pregnant students who miss lectures also consult their colleagues for their lecture notes and if possible some briefing and explanations. A student narrated that:

    ‘Once a while I miss lectures when I’m to go for ANC. However, I look for a day when I have only one lecture. Once I’m back, I consult my friends and take their notes’ (level 200 French education student)

    Attitudes of Students and Lecturers

    A significant proportion of the participants (66.7%) indicated that their classmate’s attitude towards them were good whiles 33.3% said their attitudes towards them were normal. 56.7% responded that their lecturer’s attitudes towards them were good, 40% said their attitude were normal whiles 3.3% of the participants indicated that the attitude of lecturers towards her was bad. When participants were asked whether they feel embarrassed or awkward among colleagues due to their pregnancy, 6.7% indicated that ‘YES’ they do whiles 93.3% said ‘NO’ they do not. However, in study a finding 14 stated in 15, pregnant girls are not accepted by their peers which means the attitudes of their classmates (peers) are bad towards them. There were some reported evidence of similar situations in the current study as some respondents reported that they are always side lined by their colleagues during group assignments since only few of their colleagues are willing to work with them during group assignments for reasons of their inability to contribute effectively in group assignments especially those involving field work and research.

    Effect of Pregnancy on the Academic Performance of Students

    Although majority of the participants (53.3%) indicated that it was difficult to cope with studies during pregnancy, 93.75% of them have not failed any test so far because of the pregnancy. Missing lecturers because of Antenatal care visits lead to some pregnant students missing a lot of vital information from lecturers. Even though they reported their colleagues sometimes explain concepts to them, the explanation might not be exhaustive to make them cope with the lectures fully. Additionally, the length of studying has also been reduced due to frequent tiredness as a result of prolong sitting. A participant said:

    ‘I used to meet with colleagues for group discussions but I can’t now. I also used to read a lot from my computer but I can’t now. I sit for about 10 minutes and I’m already tired. I used to read for about more than 30 minutes previously’ (level 400 English student).

    Pregnant University Students and Nutrition

    Good nutrition is key during pregnancy hence it’s expected that pregnant women eat well for the desired outcome. It is however during pregnancy that some women lose appetite for food hence become malnourished 16. Among the participants, 43.3% reported to have often lost appetite for food. This loss of appetite leads to nutritional deprivation and associated challenges among majority of the respondents (75.00). When participants were asked how many times they ate on campus, 10.0% said they eat once, 16.7% said twice, 3.3% said thrice whiles 70.0% said they eat as and when they feel like on campus. This could be attributed to the loss of appetite experienced by some pregnant students and financial difficulties pregnant students’ experience which prevent them from eating what they actually want and not what they can afford or have. A respondent indicated that:

    Although I frequently crave for fruits and ‘good food’ I just can’t afford since they are expensive on campus. I’m just a student and my husband is currently unemployed and has no money to support me so I just mange the little money I have and eat what I can afford to get some energy even if I don’t like it( Level 300 home economics student)

    Institutional Support for Pregnant Students

    From the narratives and the analysis of data, it was apparent that pregnant students receive little support from the university administration. Among the thirty participants who filled out the questionnaire, only 13.3% of the respondents were accommodated in the university halls whiles the remaining 88.87% lived outside the university halls. When participants were asked whether the university has policies that supports pregnant students, 63.3% answered no. This illustrate that most of the participants were unhappy about the support the university gives to pregnant students. When a respondent was asked during an interview session whether the university has structures that attends to the needs and challenges of pregnant students, she responded by saying:

    I don’t really know, but I think other departments have considerations for their pregnant students in terms of them missing lectures and not being able to perform an assignment unlike my department (Level 300, Science student)

    Most (90%) respondents expressed concerns about the university support for accommodation on campus or their personal efforts in seeking suitable accommodation on campus whilst pregnant. From the respondents, majority of them reside outside the university regulated halls since the university policy does not give any preferential treatment to students for accommodation just because they are pregnant. As per the universities accommodation policy, first year students are considered for university halls accommodation before continuing students and most of the participants are continuing students who don’t qualify as first priority for accommodation as per the university policy. In situations where some respondents had university hall accommodation, they preferred staying off campus on their own because these pregnant students do not want to live in the halls for the sake of privacy. A respondent was of the view that:

    Even though I had an accommodation in the hall, I had to rent my own apartment on campus because my husband visit me on weekends and we can’t share the same room with my colleagues in the university hall. (Level 400 science student).

    Discussion of Results

    The study revealed variedbackground characteristics of respondents which influenced their coping mechanism in time of pregnancy whilst in school. With regards to age, significant proportion of the participants were adults within the categories of 21–30 years and were married. This is consistent with a study finding that an individual’s marital status might indicate little or no choice on issues pertaining to childbirth or pregnancy 17. All the participants belong to a particular religion. But the religious affiliations was not reported to have had any influence on the timing of the pregnancy. Rather, the religion of respondents influenced the decision to keep the pregnancy despite the associated challenges since some respondent expressed an initial desire to have the pregnancy terminated because it was unplanned at the time it occurred. Regarding respondents’ occupation, about (36.7%) of them were trained teachers on study leave and receives salary as a source of their finances. The majority thus were unemployed and dependent on either a partner or significant others for financial support whilst in school. Few of the participants (26.7%) were in their first year whiles the remaining were continuing students. With respect to accommodation status on campus, the observation that majority of the participants resides outside the university regulated halls since the university policy does not give any preferential treatment to students for accommodation just because they are pregnant. As per the university’s policy for residential accommodation in the halls, first year students are given first priority for accommodation before continuing students. In the case of this study, most of the participants were continuing students who automatically are not the priority group for accommodation in the University halls of resident. There were also reported evidence to show that most pregnant students do not want to live in the University halls of resident for the sake of privacy and uninterrupted life style. Pertaining to the number of children a respond had, most of the participants (66.7%) had no children, indicating that the current pregnancy is their first pregnancy and its so much cherished even if unplanned hence the effort to develop coping mechanisms to combine the pregnancy and academic work despite the perceived challenges encountered.

    Planning of pregnancy is crucial in combining academic work and pregnancy. The findings indicates that although majority of the participants (60%) had planned their pregnancies, the timing of its occurrence (i.e. in school) seemed inappropriate. Planning of the pregnancy was tied to the age group of some of the respondents as some of them were above thirty years and felt time was not on their side for childbearing. In line with findings from a similar study 18, some respondent’s marital status compelled them to have little or no choice on issues pertaining to childbirth or pregnancy. These women had either no say or just a little say in the number of children to bare and when to start childbirth hence could not plan their pregnancies as they would have expected to ensure a smooth academic pursuit. In such situations women are unable to negotiate family planning to either delay or space child birth for schooling. In situations where they hide and take a contraceptive there are challenges with adherence to follow up instructions leading to inconsistent use or contraceptive failure hence unplanned pregnancy .

    It was evident from the responses obtained that carrying a pregnancy in an academic environment negatively affects student’s studies and academic performance in various ways.

    An observation that participants were not able to learn for the number of long hours which they used due to fatigue, their inability to meet with colleagues for discussions, couple with the challenge to fully concentrate during lectures accounts for the declined academic performance in most reported cases and confirms the observation that coping with pregnancy in an academic environment can be challenging.

    Studies have shown that, Physiological changes occur in pregnancy to nurture the developing foetus and prepare the mother for labour and delivery. Some of these changes could be challenging as they influence normal biochemical values while others may mimic symptoms of medical disease 19. Results from this study revealed that physical discomforts, dizziness, morning sickness, tiredness, excessive spitting and general body pains were some common physiological challenges reported that prevented most pregnant students from learning effectively. In most situations, morning sickness prevented students from attending morning lectures particular when the lecture is scheduled for the early hours of the day. Despite receiving some financial support from their salaries, partners and/or significant others, the respondents admitted facing various financial difficulties as they require more money than before to cope with activities of daily leaving on campus. Because majority of the pregnant students live outside the university regulated halls, they had to walk to and from campus for both academic and social activities. With their current conditions, the distance from their place of resident to campus sometimes is challenging to walk hence are compelled to rely on private or public transport at extra cost. Regular missing of impromptu scheduled lectures and examinations is also common as pregnant student reported that sometimes these activities coincides with their planned antenatal care visits which they have no control over.

    In the mist of all challenges associated with combining pregnancy with academic work on campus, developing effective coping mechanisms is key to successful outcomes. The study observed that one of the essentials factor which pregnant women need in developing effective coping mechanisms is a friendly and enabling environment. All the participants testified the cordial relationship they have with friends, colleagues and lecturers. Pregnant students feel comfortable and less stress when those around them gives them a sense of belonging and behave well towards them. Because of the positive attitudes of colleagues towards pregnant students, they do not feel embarrassed nor awkward in the mist of colleagues. Besides, those who for various reasons might not have been able to attend lectures and/or social gatherings are encouraged and supported by course mates and social group members to fill in gaps created by missing lectures and social functions. For missed lectures, course mates were noted to copy notes for pregnant students who missed lectures and constantly seek permission for them from lecturers when absent to enable them to catch up with the class. Additionally, pregnant students who for some reasons absent themselves from lectures do well to attend study group discussions as a coping strategy for not missing key concepts explained during lectures.

    Although the University might not have an explicit policy for preferential treatment of Pregnant students, responses obtained from the study suggests that the University does not frown on pregnancy in an academic environment but rather receptive to the needs of pregnant students when channelled appropriately.The study results however shows that pregnant students have some reservations about the support being received from the university whilst pregnant.Aside accommodation provided to pregnant students, the participants were not aware of any other support that the university provides. However, some departments give consideration to their pregnant students. This is a clear indication that the university do not have any special treatment or facility for its pregnant students. This finding supports findings from another study that school administrations do not support their pregnant students 20.

    Conventional knowledge shows that when one is pregnant, eating healthy foods is more important than ever. This is the period that one need more protein, iron, calcium, more calories and folic acid than required before pregnancy. But "eating for two" doesn't mean eating twice as much. It means that the foods one eat are the main source of nutrients for your baby. Sensible, balanced meals will therefore be best for the pregnant woman and the baby 21. Responses obtained in assessing the nutritional patterns of pregnant students on campus shows that student don not necessarily eat what they desire to eat but rather what they can afford or readily available because of financial difficulties. In an academic environment where the academic work is naturally tedious and energy intensive, most students usually are malnourished. The state of pregnancy and its physiological demands on a pregnant mother compounds the nutritional states of a pregnant student. Malnutrition in an academic environment amidst pregnancy is a public health challenge which requires some policy and programme interventions to ensure positive maternal and child health.

    Conclusion

    The study examined experiences of pregnant students in the University of Education, Winneba. Various challenges associated with combining pregnancy and academic work and how pregnant students are able to cope in the academic environment were identified. Although it was a recurrent response that the University administration do little to support the pregnant students, pregnant students in the university have devised various copying strategies for effective combing of pregnancy and academic life. Findings of the study calls for policy decisions at the university and perhaps national levels to support students plan their pregnancies, prevent unplanned pregnancies and to effectively combine pregnancy and academic work on University campuses if they so desire to be pregnant at any stage of their academic work. The study recommends that the University administration should develop and implement policies to support pregnant students in the University community and to provide preconception counselling services during induction of new students and for those who might be in need of it. Where feasible public universities in Ghana can institutionalise a programme dubbed coping with pregnancy in academic environment to educate students on their rights and challenges in this regard.

    Acknowledgments

    The authors are grateful to all participants in the study.

    Authors’ Contributions

    GFY conceptualized the study and provided guidance to the field work. EPA supervised the field work, analyzed the data and drafted the initial report. JN reviewed the manuscript for content accuracy. All authors approved the final submission.

    Funding

    This study was fully and collectively funded by the authors.

    References

    1.National Population Council. (2010) State of Ghana population report: Investing in young people - The nation’s precious assets. NPC. , Accra, Ghana
    2.Asare H, Esia–Donkoh K. (2014) Coping in silence: Challenges faced by pregnant – students atUniversityofCapeCoast,Ghana. , International Journal of Education and Practice 2(10), 222-223.
    3.Choi P, Henshaw C, Baker S, Tree J. (2005) Super mum, super wife, super everything: Performing femininity in transition to motherhood. , Journal of Reproductive and Infant Psychology 23(2), 167-180.
    4.Johnson S, Burrows A, Williamson I. (2004) Does my bump look big in this?’ The meaning of bodily changes first–time mothers–to–be. , Journal of Health Psychology 9(3), 361-374.
    5.B K Rothman. (2000) . Recreating motherhood (2nded.).NewJersey:RutgersUniversityPress
    6.Tam S. (2005) Engendering youth: Shortcomings of Canadian youth employment programs. Women ad Environments International Magazine,66/67,34-36.
    7.Merrill B. (1999) Gender, change and identity: Mature women students in universities. London: Antony Rowe ltd.
    8.Mamhute R. (2011) The Educational Challenges of Pregnant and Nursing Adult Learners: a case study of Morgenster Teachers’College. , University of South Africa
    9.J W Cresswell. (2006) Qualitative inquiry and research design. Choosing among five traditions. Thousand Oaks.CA;SagePublications.
    10.W L Neuman. (1997) Social research methods: Qualitative and quantitative approaches,(3rded.)New York:Allyn&Bacon.
    11.C B Fouche, Delport C S L. (2002) Research at grass roots: For the social sciences and human service professions. (2nd edition) Pretoria: Van Schaik. 339-355.
    12.Gall M A, Borg W R, Gall J P. (1996) Educational research: An introduction. (6thedition).NewYork:Longman.
    13.Sekgobela C B. (2008) Pregnancy – related challenges encountered by student nurses at the South African Military Health Services Nursing College. Unpublished masters‟ dissertation.PretoriaUniversity,SouthAfrica
    14.Luttrell W. (2003) Pregnant bodies, fertile minds: Gender, race, and the schooling of pregnant teens.NewYork:Routledge.
    15.Bali T, Maluni F. (2014) Exploring experiences of pregnant and mothering secondary school students in Tanzania. Research on Humanity and social sciences. , Vol.4, No.1
    16.American College of Obstetricians and Gynecologists (2018): Nutrition during pregnancy. Assessed from:www.acog.org/Patients/FAQs/Nutrition-During-Pregnancyon23/01/2018.
    17.V J Ehlers. (1999) Factors influencing women’s health in developing African countries. , Health SA Gesondheid 4(2), 48-55.
    18.Berg G, Mamhute R. (2013) Socio–educational challenges of pregnant students and student mothers. , Anthropologist 15(3), 305-311.
    19.Nelson-Piercy C Soma-PillayP, MebazaaA. (2016) Physiological changes in pregnancy.Cardio vascular. , Journal of Africa;27,(2);Mar-Apr2016,PMC4928162
    20.Netshikweta M L. (1999) The problems associated with pregnancy amongst student nurses in the Northern Province. Unpublished masters‟ dissertation.Pretoria:University of South Africa.
    21.WHO (2016).World Health Organization’s recommendations on antenatal care for a positive pregnancy experience. Assed on 3rdNovember 2016, from Http://www.who.int/nutrition/publications/pregnant/en/.