Overview of the Impact of Unwanted Pregnancy on Adolescent Psychological in the Working Area of Telaga Biru Community Health Center

This study aims to investigate how unwanted pregnancy affects adolescent psychology. The research approach utilized within the planning of this study is qualitative. Data collection was carried out concurring to a foreordained plan. Qualitative data collection uses different strategies such as interviews, perception, documentation, and so on. The information investigation handle is carried out by receiving and creating intuitively designs that incorporate data reduction, data introduction, verification or conclusion drawing. The result of the study shows that the frequency of undesirable pregnancy will unquestionably have an effect on the brain research of everybody who encounters it. This happens since of a few components counting; the calculation of fear of family responses, the figure of fear of future harm and fear of social sanctions that are gotten. 3 out of 5 youths have a positive acknowledgment demeanor towards undesirable pregnancy, whereas the other two have a negative acknowledgment state of mind. Typically, it is due to contrasts within the number of sources of bolster from the environment.


Introduction
Psychological development is a development in humans that is related to the psychological aspects related to it, namely the emotional, mental, will and moral aspects. Based on this, psychological development is a process of progressive change based on the growth of maturity and learning or experience by satisfying self-actualization (Amelia, 2013). The process of human psychic life is always followed by three psychological aspects, namely cognitive aspects, emotional aspects or feelings and aspects of will or interpersonal relationships. Cognitive aspects are related to perception, memory, learning, thinking and problem solving and affective aspects are related to emotions or feelings and motives. While the cognitive aspect is related to a person's behavior which includes interpersonal and intrapersonal relationships. It can be understood that in the process of human life it is always related to what is thought (cognitive), perceived (emotional) and what is done (interpersonal relationships).
Based on a report from the World Health Organization (WHO) 2014, the adolescent age group (10-19 years) in 2010 occupied one-fifth of the world's population, and 83% of them live in developing countries. Adolescence is the age most prone to experiencing reproductive health Based on the Gorontalo District Health Office, it was found that in 2017, the number of mothers with the incidence of pregnancy at a young age, namely <17 years was 150 people, 17-20 years old were 1,096 people and ages> 20 were 6,348 people. Then in 2018. Although the number of adolescents who are pregnant <17 years is less than those aged 17-20 years or more than 20 years, this problem still needs attention. Especially from the causes of pregnancy itself, and its impact on adolescents, especially in the future.
Based on the data above, one of the things that has an impact on adolescent psychology is teenage pregnancy or unwanted pregnancy that occurs during adolescence. Unintended pregnancy (KTD) is defined as a pregnancy that occurs when you do not want a child at that time (mistimed pregnancy) and unwanted pregnancy (Monea & Thomas, 2016).
The problem of pregnancy in adolescence will affect the teenager himself. From society, they are stigmatized as having behaved outside of normal norms and values, thus causing conflicts for them, such as dropping out of school, psychological, economic problems and problems with their families and communities around them. Adolescent pregnant women have less opportunities to continue their education, and are more likely to become unemployed, and have more children than women who delay having children until after 20 years of age (Manuaba, 2010).
The problem of adolescents is not only related to the problem of criminal deviation as previously described. But this problem can lead to the problem of teenage sexuality which can lead to premarital pregnancy. Pre-marital pregnancy in adolescents is caused by the inaccuracy of adolescent behavior in channeling their sexual urges. In addition, adolescents who do not recognize any physical boundaries think that having sex with the opposite sex before marriage is a common thing (Regnerus & Regnerus, 2011).
In addition, a teenager who becomes pregnant outside of marriage needs a psychologically prosperous condition to continue her life. Because the teenager who is pregnant outside of marriage will become a wife and also a mother. She must understand her duties as a wife as well as a mother. So that adolescents can become good mothers and also do not have conflicts in the household (Nikmah, 2014). Because basically the mother's emotions affect the child's development, very strong emotions will affect the autonomic nervous system, endocrine work and metabolism so that the heart rate and activity of the child will increase, Children born to sad mothers tend to be hyperactive, if this is not resolved immediately then the problem it will get bigger and bigger and mothers can be rude in caring for their babies (Nawati & Nurhayati, 2018).
Based on the results of observations in the Telaga Biru Health Center work area, it was found that there were several young women who married at the age of 13-18 years. Based on the results of interviews with adolescents who married at that age, they have admitted that they themselves married because they were pregnant outside of marriage.

Methods
The research approach used in the preparation of this study is qualitative. The type of research used is descriptive research, which is research that describes certain situations or events and tries to decide current problem solutions based on data. The research location was considered based on the likelihood of entry and further study. Researchers conducted research in the working area of the Telaga Biru Health Center because they saw that this area was in an environment where quite a lot of teenagers married at an early age.
Data collection was carried out according to a predetermined schedule. Qualitative data collection uses multiple methods such as interviews, observation, documentation, and so on. The data analysis process is carried out by adopting and developing interactive patterns that include data reduction, data presentation, verification or conclusion drawing.

Psychological impact during unwanted pregnancy
From the results of interviews and observations about psychology during unwanted pregnancy, it was seen that out of 5 participants stated that there was a psychological impact on him. The following is an excerpt from the informant's statement.
From the informant's statement, it shows that there are psychological impacts such as depression during unwanted pregnancy. Participant 1 said that he felt depressed, felt frightened, had thought about aborting his pregnancy until he wanted to run away. From this statement, participant 1 was classified as mild depression because they experienced main symptoms such as feelings of depression, loss of interest and enthusiasm, as well as additional symptoms in the form of decreased self-esteem and self-confidence, feelings of guilt and uselessness, pessimism about the future, and ideas of self-harm suicide according to the depression classification table.
Participant 2 said that he felt depressed, felt frightened, thought that he would be killed by his father, committed suicide attempts, felt ashamed of the environment, even thought about aborting his womb so that he had time to want to run away. From this statement, participant 2 was classified as mild depression because they experienced main symptoms such as feelings of depression, loss of interest and enthusiasm, as well as additional symptoms in the form of decreased self-esteem and self-confidence, feelings of guilt and uselessness, pessimism about the future, and ideas of self-harm or harm. suicide according to the depression classification table.
Participant 3 said that he felt tremendous inner pressure, stress, felt hopeless. From this statement, participant 3 was classified as mild depression because they experienced main symptoms such as depressive feelings, loss of interest and enthusiasm, as well as additional symptoms in the form of decreased self-esteem and self-confidence, feelings of guilt and uselessness, pessimism about the future, and ideas of self-harm or harm. suicide according to the depression classification table.
Participant 4 said that he felt emotional pressure because his parents did not allow him to get married and was desperate. From this statement, participant 4 was classified as mild depression because they experienced main symptoms such as feelings of depression, loss of interest and enthusiasm, as well as additional symptoms in the form of decreased self-esteem and selfconfidence, feelings of guilt and uselessness, pessimism about the future, and ideas of self-harm or harm. suicide according to the depression classification Participant 5 said that he felt fear, deep trauma. From this statement, participant 4 was classified as mild depression because they experienced main symptoms such as feelings of depression, loss of interest and enthusiasm, as well as additional symptoms in the form of decreased self-esteem and self-confidence, feelings of guilt and uselessness, pessimism about the future, and ideas of self-harm or harm. suicide according to the depression classification table It can be concluded that the incidence of unwanted pregnancy can affect psychologically such as depression in someone who experiences it.

Acceptance of unwanted pregnancy
From the results of interviews and observations regarding acceptance attitudes towards unwanted pregnancy, it can be seen that 3 out of 5 participants have a positive acceptance attitude towards their pregnancy while the other 2 have a negative acceptance attitude. The informant's statement shows that 3 out of 5 adolescents have a positive acceptance attitude towards unwanted pregnancy while the rest have a negative acceptance attitude. This happens because of a sense of responsibility from teenagers who experience unwanted pregnancies for what they have done and try to accept the situation. based on the answers given by participant 1, it is described that he is able to accept his situation and prefers to let go of his condition rather than blaming the situation and his environment. Participant 2 also showed a positive attitude towards his situation, where instead of feeling annoyed, he felt happy because he would marry his lover.
It is different from participant 3 who is more likely to have negative attitudes towards her pregnancy, this is because according to her this incident made her feel like she lost hope in the future. Participant 4 also had a negative attitude of affection where he was very sorry he had done an act that resulted in him being in the position he is today. Similarly, participants 1 and 2, participant 5 also responded to this with a positive attitude where even though he still felt trauma, he slowly tried to adapt and get used to accepting his situation. It can be concluded that everyone who experiences an unwanted pregnancy event tends to respond with a negative attitude of acceptance even though in the end it is the situation and circumstances that will change this view, this is due to unpreparedness to accept the reality that occurs.

Environmental response to pregnancy experienced
From the results of interviews and observations regarding the response of the surrounding environment to the pregnancy experienced, it can be seen that out of 5 participants overall experienced a bad environmental response to their pregnancy. The following is an excerpt from the informant's statement. From the informant's statement above shows that there is a bad response from the environment towards adolescents who experience unwanted pregnancy events. This happens because the occurrence of an unwanted pregnancy is a disorienting incident of circumstances that are contrary to religion, culture, customs and beliefs of the surrounding community. It can be concluded that everyone who experiences an unwanted pregnancy tends to receive social sanctions in the form of insinuation, insults, and even isolation from the surrounding environment, especially if this occurs outside of a legally valid marriage bond.

Attempts made to be able to accept unwanted pregnancies
From the results of interviews and observations regarding the efforts made to accept her pregnancy, it can be seen that out of 5 participants as a whole have their own ways of making efforts to accept her pregnancy. Considering the family, especially the parents, is one of the participants' efforts to accept the unwanted pregnancy. The informant's statement shows that the family, especially the parents, is the main support for the respondents in their efforts to accept the unwanted pregnancy. Respondents feel responsible for what has been done in this case to improve personal and family reputation as well as so as not to add to the burden on parents' thinking. There are also those who think that regretting the situation that has happened will not provide any benefit.
It can be concluded that everyone who has an unwanted pregnancy event needs more effort to convince himself to accept the current situation. The role of family and positive thinking are the main factors in the process of accepting unwanted pregnancy events.
Results have been identified that are representative of the core psychological effects of unwanted pregnancy on adolescents. The four themes are psychological impact during unwanted pregnancy, adolescent acceptance of unwanted pregnancy, environmental response to teenage pregnancy. Efforts made to accept unwanted pregnancies. Each theme will be described based on the research objectives.

Psychological impact during unwanted pregnancy
Based on research conducted by researchers from the results of in-depth interviews, it was found that all 5 participants felt the negative psychological impact of the participants during unwanted pregnancies. From the results of interviews conducted, researchers found that the psychological impact felt by adolescents who experienced unwanted pregnancy events was very large, this was evidenced by an explanation that described how depressed teenagers were when they found out that their pregnancy was even thought that their father would be killed if their family found out about her pregnancy. There are also those who feel depressed due to thinking that current events will take away their future where at this age they should focus on schooling and continue to higher education instead of being a mother who is busy taking care of her family, the level of education does not affect the presence or absence of psychological impact during having an unwanted pregnancy. This shows that the incidence of unwanted pregnancy will definitely have an impact on the psychology of everyone who experiences it. This is in line with research conducted by Nawati & Nurhayati (2018), where the results of her research explain that psychosocial problems in families who are not ready to accept pregnancy and babies are internal factors of unwanted pregnancy. This theme arises from the categories of psychosocial complaints, family problems, disturbing problems, psychosocial problems, psychosomatic problems. Four participants said they were stressed after finding out that they were pregnant and afraid that their family would find out about their pregnancy.
According to Corcoran et al. (2000), teenagers who are pregnant will experience stress. Excessive stress causes hyperemesis gravidarum (excessive nausea), an increase in blood pressure or poisoning in pregnancy, which is called pre-eclampsia or progresses to eclampsia and can be life-threatening and increase maternal mortality. This is also in accordance with the results of research by Hanum (2016) where the results obtained are that the results of the study show that all adolescents experience psychological disorders such as stress, depression, stop continuing their education and abuse of babies. The conclusion of the study is that there are psychological disorders of stress, depression, abuse of babies, stopping schooling in pregnant women in their teens in accepting their pregnancy.
Researchers argue that the occurrence of psychological stress is common among adolescents who experience unwanted pregnancies considering several factors that underlie this, including the age factor which is classified as not ready to accept changes in social roles in the family, the fear factor of what they will experience either. it is from the internal and social scope.

Adolescent's acceptance of unwanted pregnancy
Based on research conducted by researchers from the results of in-depth interviews, it was found that 3 out of 5 participants had a positive acceptance attitude towards their pregnancy while the other 2 had a negative acceptance attitude. From the results of interviews conducted, the researcher found that a positive acceptance attitude towards teenage pregnancy who experienced an unwanted pregnancy was greater than adolescents who had a positive acceptance attitude, this was evidenced by the explanation of 3 out of 5 respondents who felt they were able to accept their condition while 2 of them again regretting the incident he experienced. This shows that the incidence of unwanted pregnancy is the result of actions that are done without thinking about the risk, even though there are also those who have thought about risks but ignore them. This is in line with research conducted by Ardianti (2016), where the results of her research explain that the attitude of late adolescent subjects who are pregnant outside of marriage looks quite good because they are able to accept their condition when they are pregnant outside of marriage, do not fall down regretting what has happened and are able to get up. to correct mistakes. The subject also accepts and cherishes his child, the subject has a desire to become a good mother and wife. The subject believes that her pregnancy is God's destiny which has been outlined for her life path, the subject understands the strengths and weaknesses that exist in her.
Researchers argue that the emergence of a positive attitude of acceptance from within adolescents who experience unwanted pregnancy events is a form of responsibility that must be accepted by these adolescents because it is a better choice than continuing to fall into a state.

The response of the surrounding environment to pregnancy experienced by adolescents in the Telaga Biru Health Center Work Area
Based on research conducted by researchers from the results of in-depth interviews, it was found that out of 5 participants overall felt a bad response from the environment during unwanted pregnancies. From the results of interviews conducted, the researcher found that the bad response from the environment during unwanted pregnancy was very visible, this is evidenced by the explanation that illustrates that all respondents received the same treatment from the surrounding environment where respondents often heard people talking about their pregnancy, causing Some respondents prefer to shut themselves up in the house until the storm of blasphemy against them ceases or slowly begin to get used to negative words conveyed by people in their surroundings. This shows that the incidence of unwanted pregnancy will greatly impact people's views because it contradicts the moral values that exist in the surrounding environment. This is in line with research conducted by Menon et al. (2018), in which the results of his research explain that the social impact caused by young marriage due to pregnancy outside of marriage is that large families receive non-wearing treatment from the surrounding community, alienated by residents and for the perpetrators of the marriage will usually feel ashamed and not socialize with the residents. According to Sari (2014), pregnancy outside of marriage is a disgrace to the family or society, regardless of the initial cause of the pregnancy. Teenagers who get pregnant out of wedlock are labeled as bad things, which should be hidden if they happen.
Researchers argue that the occurrence of negative responses from the community is caused by contrary to the values and norms prevailing among the community. The problem of unwanted pregnancy is always related to pregnancy outside of marriage, religiously this is a form of deviation that can become a bad record which not only affects the internal family but also affects the surrounding environment.

Attempts made to be able to accept unwanted pregnancies
Based on research conducted by researchers from the results of in-depth interviews, it was found that of the 5 participants as a whole tried to be sincere and accept the situation that had already occurred. Family, especially parents, is the main factor driving the respondent's effort to accept this unwanted pregnancy. From the results of the interviews conducted, the researcher found that the efforts made by respondents to be able to accept unwanted pregnancies were by trying to accept and take lessons from what had happened. Respondents believe that there is something good behind this unexpected incident, this is evidenced by an explanation that illustrates that all respondents have lived a good life and have learned about mistakes that have been made in the past. This shows that everyone is able to get out of the downturn that is felt when undergoing an unwanted pregnancy as long as it continues to receive support and motivation from the closest people, especially parents. This is in line with research conducted by Melender & Lauri (1999), where the research shows that most informants are not psychosocially ready to undergo pregnancy. Psychological problems that arise in the form of feelings of depression, fear, sadness, anger, annoyance, and confusion. Meanwhile, existing social problems such as informants who are still in school are forced to quit, even those who are still working must be willing to leave their workplace. The greatest support received comes from parents.
According to Dunkel Schetter (2011) inner conflicts are present in them, resulting in psychological pressure which ultimately makes people who are pregnant outside of marriage look for various ways to solve the problem. Researchers argue that the acceptance efforts made by respondents are imperative so that respondents can live their lives in peace. In addition, acceptance here is a form of respect for the encouragement and motivation of parents who are willing to accept the situation that has happened.

Research Limitations
The research was conducted using qualitative methods and using primary data obtained through in-depth interviews with respondents. The limitations of this study include the subjectivity that the researcher has. This research really depends on the interpretation of the implied meaning in the interview so that the tendency to be wrong still exists. To reduce errors, a double check is carried out by paying attention to existing vocabulary, and readjusting it with the results of interviews that have been recorded through a voice recorder. Researchers also have difficulty finding supporting journals and theories to strengthen research results.

Conclusion
The incidence of unwanted pregnancy will definitely have an impact on the psychology of everyone who experiences it. This happens because of several factors including: the factor of fear of family reactions, the factor of fear of future damage and fear of social sanctions that are obtained. 3 out of 5 adolescents have a positive acceptance attitude towards unwanted pregnancy, while the other two have a negative acceptance attitude. This is due to differences in the number of sources of support from the environment. Adolescents who experience unwanted pregnancies experience poor environmental responses. This is because it is believed that it is