Voices of Young Mothers

Adolescent girls and young women across South Africa face challenging realities when they become pregnant, from accessing healthcare and family support to dealing with stigma and social pressures. A new study by the South African Medical Research Council (SAMRC) with NACOSA, published in Frontiers in Reproductive Health, has brought their voices to the forefront. It gives us a better understanding of their experiences with pregnancy, getting care, making decisions, and the daily problems that come with being young and a new mother.   

The study involved 68 adolescent girls and young women from seven regions, chosen from the HERStory3 impact evaluation of the My Journey Programme, funded by the Global Fund. Participants shared personal stories of support and stigma, their experiences of health services and the social pressures that influence pregnancy choices.   

For many participants, family support was key in their pregnancy journeys. Some described their mothers as anchors in uncertain times. 

Yes. There is someone I was talking with at home… My mother used to help me with everything, I got everything I needed from her.” (Gert Sibande, 18–24 years)   

This kind of support can make a big difference for a young woman navigating pregnancy. But it was not the story for everyone.  

Most of the girls say they are afraid to talk to their parents… They might feel scared because they feel that they have disappointed their parents…” (Zululand, 18–24 years).   

Others highlighted the impacts of absent or unsupportive partners, including financial uncertainty at a time when care and preparation are essential. Some young women described depression, isolation and traumatic birth experiences.   

One participant shared their experience with a difficult birth, stating, “It was depressing at the time…you don’t know what will happen during or after your pregnancy.” (Cape Town, 18–24 years)   

It’s been a hard year for me, so my health deteriorated, but I’ve managed to cope with it … a social worker was helping me actually at my school.” (Cape Town, 18–24 years). Another participant reflected on support she received from a school social worker. 

However, support for young women significantly reduced the emotional burden of stressful pregnancy experiences, and social workers emerged as important sources of emotional validation and guidance.  

Some young women delayed seeking care because they feared community stigma or did not recognise early pregnancy signs. Others struggled to navigate the health system or felt unwelcome:  

Some get the help and others don’t… they hide their pregnancy with jerseys because people tend to judge them.” (Ehlanzeni, 18–24 years)  

It was not easy because I was too young to have a baby… It depended on the people that were giving me help, some were shouting at me, (asking) why I got pregnant at this age and I felt bad. (Ehlanzeni, MP—15–17 years)  

Delays in starting antenatal care can have major health implications for both mother and baby, from life threatening problems to missed HIV testing and treatment, leading to the transmission of HIV in pregnancy or during breastfeeding.    

Rights-centred care   

South Africa’s legal and policy framework addressing the rights of pregnant and breastfeeding women is underpinned by the country’s Constitution, which guarantees fundamental human rights, including access to healthcare, education, and protection from discrimination. However, young women who become pregnant often face stigma in their families or communities which can prevent them from fully exercising these rights. 

As NACOSA’s policy brief on the rights of pregnant and breastfeeding women emphasises, legal protection alone is not enough. Turning rights into reality requires awareness, implementation, community engagement and supportive health systems that respond to the lived experiences of young women.   

These observations highlight the importance of comprehensive, rights-centred support for young mothers, including accessible and dignified healthcare, strong social and family support, and mental health care throughout pregnancy and the postpartum period.