In Gauteng’s Ekurhuleni District, the number of teenage girls between the ages of 10 and 19 who gave birth in public health facilities in the 2022/2023 period is 6 670, the highest in the country. It’s an increase from 5 928 births the year before. Ekurhuleni and Nelson Mandela Bay in the Eastern Cape have both seen a rise in teenage births since the 2018/2019 financial year. Nationally, estimates of the number of girls between the ages of 10 and 19 years who had babies in the 2022/2023 financial year range between 132000-150 000. 

“In Heidelberg alone, between January and March, there are 57 teenage girls who fell pregnant”, says Mmatsie Tsotetsi, a prevention and programme manager at Aids Healthcare Foundation (AHF).

At a recent event hosted by AHF in Ratanda, Heidelberg, teenage girls, parents and health workers spoke openly about the challenges of teenage pregnancy. “As a foundation, we need to capacitate them on how to start these conversations with their children. Parents should also take responsibility and play their role in having honest conversations with their girls,” says Tsotetsi. 

One nurse at the event told Health-e News she’s ‘concerned that most teenagers don’t go to clinics to access contraceptive services’. 

She says that in Ratanda, health facilities are within 5 km of most homes, but accessing sexual and reproductive health services seems challenging for adolescents. 

“These teenagers should know that they don’t have to pay to get contraceptives or PrEP [ARVs prescribed to prevent HIV] pills from public health facilities. I understand there is also the issue of the staff attitude in our clinics that might scare them away but not everyone is like that,” the nurse says. 

Another concern, she says, is the ‘stigma of promiscuity that comes with using contraceptives’. 

Teens have their say 

A 16-year-old tells Health-e News that they attended the event to learn about teenage pregnancy and how parents can be supportive.

“Parents need to be supportive because at times young girls fall pregnant from sexual abuse. Our parents don’t talk to us about available methods of preventing pregnancy or have a conversation with us about our boyfriends,” she says. 

She says the information she received will help when she starts engaging in sexual activities. 

“These are things I was not comfortable speaking to my parents about. We hear a lot of stories from our friends about taking contraceptives. I was told that taking contraceptives at a young age will limit my chances of getting pregnant when I am older,” she says. 

“I decided to wait before engaging in sexual activities because I would love to complete my studies before falling pregnant. I can’t afford to have a responsibility whereas I am still my parents’ responsibility.”

A 15-year-old says she learned from the event that it is best to delay sexual debut.

“Some teenagers fall pregnant because of peer pressure. They sleep with boys because they want to teach their friends a lesson and show them that they can have any guy they want,” she says. 

She says she has seen a lot of pregnant girls at her school Kgoro Ya Thuto Secondary School. 

“I wouldn’t want to be in that situation, they always look tired especially when the pregnancy is showing. At times you hear others complaining about feeling sleepy because there is a pregnant learner in class. Others end up dropping out of school because of the comments that are made by teachers and their classmates,” she says. 

She says she finds the negative comments against pregnant teens unfair, especially since some may have been sexually abused.

Teenage pregnancy a permanent responsibility 

“Falling pregnant at a young age has lots of limitations in one’s life. You will be pregnant for nine months and after you have a responsibility for life. You can’t continue with your life as normal,” says 51-year-old Thoko Xuku, one of the parents who attended the event. 

The mother of four tells Health-e News that her daughter was 16 years old when she fell pregnant. 

“I always talk to my children who are between 12 and 19 years old about HIV and contraceptives that are available. I was disappointed when my second-born fell pregnant and she was in Grade 10 at the time. She had to drop out of school to take care of her child when she was still a baby,” she says. 

When the baby was one year old, her daughter had to register at an adult school because she did not feel comfortable going back to a mainstream school. 

“Every time there was a family gathering, she had no choice but to take her child along. I am also busy trying to hustle for the younger ones,” she says. 

Xuku says a teen mother is faced with a lot of responsibilities. You have to cook, attend to your books, and look after your child. 

“Mothers are not there to look after your children especially if you are a child yourself and still need to be looked after,” she says. 

Added risks 

“Being pregnant also means that you are not using any protection and you might be exposed to HIV infections. We want to teach the girls about HIV testing, different contraceptives that are available in public health facilities and methods to prevent one from being infected with HIV,” says Tsotestsi.

Adolescent girls and young women are among the population groups most vulnerable to HIV infection.  The most recent HIV Prevalence Survey shows that HIV prevalence among adolescent girls and young women aged 15-24 years old was 6.9%.  This is twice as much as the 3.5% among boys and young men of the same age. – Health-e News