“I faced discrimination both at school and at home, says Priscilla a young mother from Cape Town, “Friends were gossiping about me at school, and my father chased me out of the house when he found out I was pregnant.” While South Africa has strong legal and policy frameworks protecting the rights of pregnant and breastfeeding people, many women – particularly young mothers like Priscilla, women in rural areas, and those working in the informal economy – still struggle to access their rights in practice.
Despite progress in improving maternal health, disparities persist due to factors such as socio-economic status, geographic location, and access to quality healthcare services. By age 19, almost one in three young women have begun childbearing in South Africa and at least 33% of learners drop out of school due to pregnancy. Babies born to mothers under 20 are more likely to have low birth weight, be born early, and face serious health conditions such as the acquisition of HIV in the first 18 months of life. Only 20% of young mothers receive the child support grant. This contributes to the fact that South Africa has not been able to eliminate the transmission of HIV from mothers to their children, with about 10,000 new HIV infections in children each year (UNAIDS 2023).
A new research and policy brief, developed by NACOSA with law firm Covington & Burlington as part of the Thomson Reuters Foundation’s TrustLaw programme, highlights both the progress made and the challenges that remain. Gaps in implementation, resource shortages, stigma, and weak enforcement undermine access to essential services, from antenatal care to maternity protections at work and school.
The brief sets out South Africa’s legal and policy framework for pregnant and breastfeeding people in healthcare, education, employment and social services. It also draws on lessons from peer countries like Botswana, Zimbabwe, Zambia, and further afield in the United Kingdom, Brazil, and India – where community health workers, culturally sensitive sexuality education, and innovative material support schemes have improved maternal and child health. Finally, it reviews the relevant international and regional human rights instruments that South Africa is a signatory to and assesses the degree of compliance and practical application of these treaties.
Some recommendations from the brief include:
- Raising awareness of rights and policies in understandable language, especially among vulnerable groups.
- Strengthening reintegration support for young mothers in schools.
- Expanding community health initiatives, including home visits and nutritional support.
- Strengthening protections for women in the informal sector and exploring practical measures to support pregnant and breastfeeding women in informal work.
Ensuring that pregnant and breastfeeding women can realise their rights requires not only government action but also partnerships across families, schools, workplaces, communities, and the health system. All new mothers deserve the right support to enable them and their babies to thrive. As Pricilla wisely advises:
Remember, it’s not over until you give up. Love yourself and your baby, and stay busy with education or work to create a better future.”
