A Closer Look at Social and Structural Realities of Repeat Pregnancy for Young Mothers

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Dr Eunice Kyabaishiki’s doctoral research in Population Studies, ‘Repeat Pregnancy and Contraceptive Use: The Experiences of Teenage Mothers in King Sabata Dalindyebo (KSD) Local Municipality, Eastern Cape Province, South Africa’, moves beyond statistics.

It centres the lived realities of young mothers navigating complex social and structural constraints.

A researcher deeply interested in how young women manage the challenges of daily life, Kyabaishiki’s work is grounded in a clear purpose: to give young women a voice and to ensure their experiences shape policy and practice. That focus was sharpened during her fieldwork. ‘It became clear that numbers alone cannot fully explain these experiences,’ she said.

While research often points to risk factors such as early pregnancy or multiple partners, Kyabaishiki found these explanations incomplete.

“These findings did not explain why young women experience repeat pregnancies or how they manage their situations,” she noted. 

Instead, she turned her attention to what happens after the first pregnancy - how young mothers navigate stigma, relationships, contraception and survival in rural contexts where services are limited.

Some of the stories she encountered were disarmingly simple. One young woman shared, “I wasn’t even aware that I was pregnant.” Others revealed far more difficult realities. One participant spoke of coercion and being rejected by her family, forcing her to live alone in a shack. For Kyabaishiki, these moments underscored a deeper truth: repeat pregnancy is often shaped by unequal circumstances rather than individual choice.

Supervised by Professor Pranitha Maharaj, her findings show that inconsistent contraceptive use is rarely about carelessness. Missed clinic appointments, severe side effects, misinformation from peers and lack of transport all played a role. Service disruptions during and after COVID-19 made access even harder.

“Consistency is not just about knowledge; it is shaped by everyday realities,” Kyabaishiki explained.

The study also challenges common assumptions about autonomy. Many young women understood contraception and tried to use it, but their choices were often constrained by partner pressure, financial dependence, stigma and fear of judgment at clinics. In some cases, decisions were influenced by economic insecurity, including reliance on social grants. 

“Repeat pregnancy is not just about individual behaviour; it’s shaped by social and economic conditions where young women are making decisions within constraints,” she added.

Health services, participants said, are experienced less through infrastructure and more through interaction. Being treated with respect, having privacy and receiving clear, honest information made a difference. While some nurses were supportive and encouraging, others were dismissive or harsh, discouraging young women from returning.

These pressures are often most visible in everyday decisions. A young mother may have to choose between paying for transport to a clinic or buying food and nappies. Childcare responsibilities can make returning to school difficult, especially without support. Over time, poverty, disrupted education and limited options begin to reinforce one another.

Some stories stayed with Kyabaishiki long after the research ended. One young mother described dropping out of school after her second pregnancy - “how quickly opportunities can be lost,” she reflected. 

Another account was more troubling: a participant was forced out of her home after a pregnancy resulting from sexual abuse by a family member. Her investigation revealed not only vulnerability, but also how “those meant to protect young girls can sometimes be the source of harm.”

The emotional weight of early motherhood also emerged strongly. One participant spoke about feeling overwhelmed to the point of wanting to harm herself. Others described initially rejecting their pregnancies, only to later develop a sense of acceptance and care. These layered emotional journeys, Kyabaishiki noted, are often missing from policy conversations.

Her message to policymakers is clear: repeat teenage pregnancy is not simply a behavioural issue, but a structural and relational one. Addressing it requires more than awareness campaigns. It calls for youth-friendly services that are respectful and accessible, better information around contraception, support for young mothers to stay in school and meaningful engagement with families and partners.

Kyabaishiki is grateful to the young women who shared their stories “so openly,” as well as healthcare workers who supported the study. She also credits Maharaj’s guidance, particularly during the challenges following COVID-19, as well as the support of her sister, Jane Busingye, her children, family and friends.

Support from Walter Sisulu University and the University of KwaZulu-Natal (UKZN) made the work possible, but, as she reflects, it was faith that sustained her. She gives thanks to “God, Jehovah Shalom - the Lord is Peace,” for carrying her through the journey.

Words: Rakshika Sibran

Photographs: Sethu Dlamini