Teenage pregnancy is often explained in simple terms. Girls are said to lack knowledge about contraception, take sexual risks or make poor choices.
But is it that simple?
For almost three decades, I have been researching how gender and sexuality come to matter in the lives of young people in South Africa.
My collaborators and I are currently working on The Teenage Pregnancy Project: Classroom, Cradles and Care and related projects on teenage fathers and caregivers. These projects seek to examine how pregnancy and parenting is experienced and understood by teenage fathers, mothers and their caregivers. The research is conducted mainly in KwaZulu-Natal province in South Africa with linked projects in Zimbabwe. It involves interviews and group discussions including the use of visual methods to understand teenage pregnancy.
The research findings tell a more complicated story than the usual explanation. It’s that poverty, unequal relationships and institutional barriers narrow girls’ choices about contraception, with dramatic consequences.
Our findings matter because they shift attention to the socio-cultural and structural conditions that shape what choices are actually possible. Decisions about sex, contraception and pregnancy are made within gendered relationships and economic and institutional constraints that may limit what young women can do.
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Understanding teenage pregnancy in this way changes the question from “Why did she make that choice?” to “What made some choices easier, harder or impossible?”
Situating girls’ choices within gendered, economic and institutional environments underlines the complexity of the interventions needed. These include involving families, schools and comprehensive sexuality education.
Relationships tied to money and survival
Our Zimbabwe study involved 26 teenage mothers aged 16 to 19 from Shamva district in Mashonaland Central Province. All had experienced pregnancy while attending school. Our South African study drew on interviews with young mothers aged 15 to 18 and forms part of the Classrooms, Cradles and Care project. Together, the studies show what can happen both before pregnancy and after it becomes visible.
In our Zimbabwean research we used the term “reproductive pipeline” to describe how poverty, unequal gender relations, family expectations, sexual coercion and inadequate reproductive healthcare can combine to push girls towards pregnancy and early motherhood.
The idea of a pipeline does not mean that girls have no agency. The girls we spoke to made decisions, resisted, negotiated, sought contraception and imagined different futures for themselves. But they did so within circumstances that could sharply narrow what was possible.
Many of the girls in our South African study knew what they wanted for their futures. They wanted to finish school, find work and delay motherhood. Some knew how pregnancy could be prevented and actively sought contraception.
But wanting to avoid pregnancy and having the power and resources to do so are not the same thing.
One of the young women in our Zimbabwe study began a relationship while she was still at school. Her boyfriend, who was older than her, was already thinking about marriage. She was not. As she put it:
I was still too young and wanted to finish school, get a job … I did not know I would get pregnant.
Her experience captured a central problem in how teenage pregnancy is discussed. People tend to ask why a girl made a particular choice. Less is asked about the conditions in which that choice had to be made.
Poverty shaped intimate relationships in powerful ways. In Zimbabwe, Grace had lost both parents and was living with her elderly grandmother. Food was scarce. She explained that she entered a relationship partly because her boyfriend sometimes gave her small amounts of money:
If he could give me even 50 cents, at least I would buy whatever it could get me. I just needed the money.
Another participant, Anesu, wanted to return to her grandmother’s home. She was living with her sister and she could see that life was difficult. Unable to afford the bus fare, she entered a relationship hoping her boyfriend would give her the money. Instead, she said, he forced her to have sex and she became pregnant.
Contraception does not guarantee control
The studies’ findings also challenge the assumption that information alone prevents pregnancy.
Mutsai, in Zimbabwe, knew that condoms could prevent pregnancy. She even had condoms available. But her boyfriend refused to use them.
Girls described relationships in which older or more powerful male partners influenced whether sex happened and whether contraception was used. Some talked about how age differences, male authority, economic dependency, fear and the threat of social shame constrained their capacity to act.
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Healthcare can create another barrier. Zimbabwean participants described being unable to afford transport costs to reach services, contraceptive shortages and judgment from healthcare workers. One participant could not afford US$2 for a contraceptive implant. Another could not raise the US$1 needed to travel to a government hospital and US$1 to return home. One sought contraceptive pills at a clinic but said she was required to buy a pregnancy test first.
What needs to change
Based on our findings, we make a number of recommendations.
The first is that reducing teenage pregnancy requires more than telling girls to abstain from sex or giving them information about contraception.
Secondly, sexual and reproductive healthcare must be accessible, affordable, adolescent-friendly and non-judgmental.
Thirdly, sexuality education needs to go beyond the biology of pregnancy prevention and create space to discuss love, relationships, consent, coercion, gender inequality, material dependence and the power differences that can make negotiating contraception difficult.
Fourth, boys and men must be part of the response. Pregnancy prevention cannot remain girls’ responsibility when male partners can refuse condoms, pressure girls into sex or exercise greater control over reproductive decisions – then escape much of the blame when pregnancy occurs.
Fifth, reproductive health cannot be separated from poverty and material inequality.
Sixth, schools, families and communities also need to support girls’ educational aspirations after pregnancy rather than turning young mothers into warnings about failed girlhood.
