**1.1 Background**

The issue of teenage pregnancy is a global public health concern, especially in developing countries like Ghana. It is generally asserted that teenage pregnancy is a global public health concern. During the developmental stages of life, adolescents' sexual instincts increase and they may engage in risky sexual activities, which may, in turn, lead to unintended pregnancies. However, it is confirmed that pregnancy during adolescence predisposes young women (YW) to a lot of risks, which may include unsafe abortion, maternal mortality, mental retardation and sexually transmitted infections (STIs).

The issue of childbirths among young women is a socioeconomic canker, which has a greater impact on the mother, family and the entire community. This comes from the unpreparedness of young women giving birth because their bodies may not be ready

for a full-term baby, and may be dependent on their families and the social service providers, which also bring shame to the young women. According to Sedgh et al. [1], unplanned pregnancy globally is said to be 84.9 million and more than half of these seek abortion. A recent report states that apart from the complications mothers bear, newborn babies are also predisposed to risks of low birth weight and congenital abnormalities [2]. The global record for unintended pregnancies is reported to be 44% [3] and more than 56% of these result in abortions [4]. Meanwhile, a significant number of these come from the Sub-Saharan African (SSA) region [5]. According to Sedgh [6], about 11% of maternal mortality are a result of unsafe abortions. Sexual and reproductive health (SRH) care is one of the factors for reducing poverty in every nation.

For some decades, there has been a consistent reduction in the use of contraception among young women in Ghana. The study of Ashiedu Keteke in the Accra Metropolitan Assembly in the Greater Accra Region of the Republic of Ghana has a population of 149,185 with divergent ethnic groups from all walks of life [7]. Bain et al. [8] report 87% of unsafe abortions among young women within the community.

Recent studies by other studies have also recorded the promiscuous lifestyle of some adolescents who engage in coital activity at the early stages of life [9]. However, the World Health Organization [10] defines unsafe abortion as a procedure carried out to terminate unplanned or unwanted pregnancy by unskilled individuals or in an environment with less standard of medical care. It is a preparatory ground for gender equality as well as women's empowerment. The inability of women to decide on the choices of their sexual and reproductive health needs is the root cause of their healthrelated problems. Women are denied their bona fide rights to choose from possible courses of action for fear of the 'so-called' societal norms.

Sexual and reproductive health decisions on contraception are essentially significant. Every individual who wants to start contraception has the right to choose, opinion, information, safety and access to quality service. A lot of young women face challenges when choosing contraception. The key mandate to contraceptive uptake is the woman's ability to make a decision. Interestingly, one may ask if the decision to use contraception is taken by the woman or both the woman and the male partner? By what means can this be influenced if decisions on sexual and reproductive health care are taken by both parties?

Decision making (DM) is described as the study of finding out from possible alternatives and picking out the most convenient for a purpose. It is perceived as a cognitive study due to its functional role in mental reasoning or straight-thinking. Consequently, decision making is a process that limits uncertainty to a desirable level but not all uncertainty can be reduced; sometimes it has to be removed. This is because most decisions may involve some quantity of risks that needs to be obliterated [11].

The young woman's decision on reproductive health care is a need to help prevent unplanned pregnancy as well as unsafe abortion and its complications which is a public health issue of international concern. These women request that their decision on contraception should be autonomously considered significant [12]. In Ashiedu Keteke a suburb of Accra, Ghana, a significant number of young women experience increased risks of sexually transmitted infections (STIs) and abortion-related complications as a result of unplanned pregnancy. Boah et al. [13] record that Ghana's abortion rate as of 2017 is recorded to be 26.8%. The leading cause of death among young women and adolescents is complications from pregnancy and childbirth [14].

Within the reproductive age group, young women are described to be sexually active and if care is not given during peer relationship, their promiscuous lifestyle will *Perspective Chapter: Factors that Influence Young Women's Decision-Making in Contraceptive... DOI: http://dx.doi.org/10.5772/intechopen.103066*

likely increase the population growth of a nation as a result of an increase in the number of childbirths. A lot of these women are unable to develop academically, socially and economically and this affects the nation's manpower as well as young women's future growth and opportunities [15].

Consequently, the health and lives of these young women are undermined [16]. It also increases the economic burden of a nation because young women who become pregnant have to drop out of school without achieving their full potential in life. Across the globe, complications from pregnancy and childbirth are the leading killer of female adolescents and young women with 99% of maternal deaths [17].

Efforts made by the United Nations Fund for Population Activities (UNFPA) to support voluntary family planning (FP) among women of reproductive age (WRA) is an indication to secure human rights for sexually active women. The intention to decide when to become pregnant is a serious issue to consider in every woman's life since it has an immediate impact on a woman's health and well-being [18]. Ghana's prevalence rate on MC methods was recorded to be 33.2% [19]. Reasons for noncontraceptive use among young women in Ghana are what stands to influence their decision making on contraception.
