KNOWLEDGE
SUMMARY
RESEARCH ON TEENAGE PREGNANCY IN
KWAZULU-NATAL
Teenage pregnancy is recognised as a serious problem amongst young people in South Africa. Research1 suggests that
poverty and age-disparate relationships may be some of the key drivers of the high rate of teenage pregnancy.
In 2013, the South African Red Cross Society of KwaZulu-Natal (SARCS-KZN) undertook a study2 to uncover personal
stories of pregnant teenagers and young mothers in the Ugu and Uthungulu districts of KwaZulu-Natal. The study
explored how six young girls, twelve parents or care-givers, and three young fathers and fathers-to-be thought and
felt about the pregnancy. The study also explored how these pregnant teens responded to prevention messages, how
they accessed antenatal and postnatal care, and what their antenatal and postnatal care experiences were.
Findings on Teenage Pregnancies in KwaZulu-Natal
Teenagers are naive about the risk of pregnancy: With the overwhelming majority of pregnancies discussed being
unplanned, many of the teenagers demonstrated considerable ignorance of their sense of risk of pregnancy (and by
implication, transmission of STIs and HIV and AIDS). This is despite having access to relevant information on family
planning. Teenagers also demonstrated lack of knowledge on the difficulties of actually raising a child.
Understanding of the range of pregnancy prevention options is limited: Condoms were almost exclusively the only
means of pregnancy prevention mentioned by interviewees. Termination of pregnancy was largely considered to be
immoral or irreligious by care-givers, who either did not discuss it or actively advised against it. Emergency
contraception and post exposure prophylaxis were not mentioned by any of the respondents. Virginity testing was
cited as a useful method for prevention by some care-givers.
Male partner support is variable: Male partners’ attitudes and their families’ attitudes appear to vary from denial that
the child is theirs to loyal and loving support. All of the young men interviewed report finding it difficult to provide
financial support for the child.
Young people do not communicate well with parents and care-givers: A problematic lack of inter-generational
communication about sex revealed itself throughout the study. Care-givers describe not having discussed sex or
pregnancy with teenagers until after they became pregnant, while teenagers describe an inability to discuss sexual
activity with their parents and elders because of the cultural norms of these communities.
Pregnancy and parenthood isolate teenagers and their families: Both teenagers and their care-givers felt the
judgement of the community and felt unsupported. This isolation extended in some cases to the teenagers’ peer
groups, and is reflected in a lack of facilities to support teenage parents and their care-givers in the community.
Teen pregnancy places an overwhelming burden on the family: Parents and care-givers note increased financial and
emotional stress because of the increased number of people in the household. For many, the unplanned pregnancy
means a change in circumstances not only for the young mother but for the entire family.
Negative attitudes of health workers and other community members: A culture of blame is evident in the
judgemental attitude of clinic staff towards pregnant teenagers, leading to limited uptake of antenatal services. Health
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workers’ attitudes improved after the birth of the child, however, reinforcing the sense that while teenagers are
responsible for their pregnancy, the new baby is nonetheless to be treated as a “blessing”.
There is a low uptake of clinic services by pregnant teens: Antenatal and postnatal care was inconsistently accessed
by the girls interviewed. A range of factors contributed to this, including girls’ fear of confirming the pregnancy, fear
of being ‘found out’ by the community, and personal circumstances such as not having money to travel to the clinic.
Clinic staff’s judgemental attitudes also exacerbate their unwillingness to attend. Clinics were rarely seen as resources
for family planning advice prior to pregnancy, but rather as a means of coping after pregnancy.
Young people want to prioritise education over parenthood: It was notable that almost all interviewees felt strongly
that education should be prioritised. They were also concerned about the impact of pregnancy and parenthood on
their education, and, where possible, had returned or planned to return to school as soon as possible.
Low levels of employment are seen to blame for the rise in teenage pregnancy: Lack of employment was discussed
widely amongst interviewees, both in terms of preventing unwanted pregnancies (by keeping teenagers busy) and as
a problem for young parents and their care-givers, who face increased demands on extremely limited family resources,
without access to income-generating opportunities.
Recommendations to Address Teenage Pregnancy
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Pregnancy prevention efforts with a focus on greater knowledge and challenging stereotyped attitudes about
sexuality and sex education should be enhanced and expanded.
Community norms should be challenged to encourage more open communication about sex and pregnancy.
Early uptake of antenatal care can be improved through increasing young people’s knowledge about recognising
pregnancy and their knowledge of services offered, as well as a shift in attitudes of clinic staff.
Support programmes are required for young mothers, which should include psycho-social and economic support
and referrals to health and other community services.
Community-based support programmes should offer emotional and material support to care-givers and families
of both teenage mothers and fathers.
1
Baumgartner, J. N., Morroni, C., Mlobeli, R., Otterness, C., Myer, L., Janowitz, B., Stanback, J. and Buga, G. (2007) ‘Timeliness of
Contraceptive Reinjections in South Africa and its Relation to Unintentional Discontinuation’. In International Family Planning
Perspectives, Volume 33: 22, June 2007.
2
Durden, E. (2014) A Narrative Report on the KZN Red Cross Investigation into Teenage Pregnancy.
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