Teenage pregnancy

Teenage pregnancy rates are difficult to calculate directly because it is hard to determine how many pregnancies end in miscarriage, still-birth or abortion: these are not necessarily known to the respondent, or accurately reported. In the absence of reliable data on pregnancy, researchers tend to rely on childbearing data (i.e., the percentage of women in an age group who have given birth to a live child).

Despite widespread assumptions that teen pregnancy in South Africa is an escalating problem, the available data suggest that the percentage of teenage mothers is not increasing. A number of studies have suggested a levelling off and even a decrease in fertility rates among teenagers in South Africa.[1-3] Teenage fertility rates declined after the 1996 census from 78 births per 1,000 women aged 15 – 19 years, to 65 births per 1,000 adolescents in 2001. The adolescent birth rate recorded in the 2011 population census suggested an increase to 72 per 1,000, and the 2016 SA Demographic and Health Survey recorded a similar (slightly lower) rate of 71. These patterns (the decline, increase and stability over the past two decades) are not exclusive to adolescents but follow the overall fertility trends for the country.[4]

Stats SA regularly reports the number of ‘recorded live births’, using vital statistics data. The pattern over the past decade (from 2011) has been a decrease in adolescent births, this decrease being reflected in both the rate of current year birth registrations and late birth registrations. In 2023, out of 950,000 current-year births registered, 100,000 were registered to the mothers of adolescents aged 19 or younger.[5] The share of all births registered to teens up to 19 years was 12%, down from 16% of births that occurred a decade before.

Department of Health data between 2004 and 2019 showed a consistent decline in the share of teenagers aged 15 – 19 who attended antenatal clinics and participated in the national HIV sero-prevalence survey.[6] The share remained stable in 2022, with teens aged 15 – 19 representing 13% of participants in the antenatal survey, down from 17.5% in 2013). All of these data sources suggest that pregnancy and fertility rates among teenagers did not increase in last decade. 

Fertility rates are, of course, an indicator of possible exposure to HIV. HIV prevalence rates are higher among women in their late twenties and thirties, and lower among teenagers, and the prevalence rate in the 15 – 24 age group has decreased over the past decade. However, prevalence rates are still worryingly high: of the young pregnant women surveyed in antenatal clinics in 2022, 7.6% of those aged 15 – 19 and 16.4% of those aged 20 – 24 were HIV positive.[7]  For many years the majority of deaths in young mothers were caused by HIV.[8] Much of the overall decline in maternal deaths since 2011 is attributed to implementation of policies to manage and prevent HIV,[9] but it is still important that safe sexual behaviour is encouraged and practised.

Studies have found that early childbearing – particularly by teenagers and young women who have not completed school – has a significant impact on the education outcomes of both the mother and child, and is also associated with poorer child health and nutritional outcomes.[2][8][10] For this reason, it is important to delay childbearing, and to ensure that teenagers who do become pregnant are appropriately supported. This includes ensuring that young mothers can complete their education, and that they have access to parenting support programmes and health services. Although pregnancy is a major cause of school drop-out, some research has also suggested that teenage girls who are already falling behind at school are more likely to become pregnant than those who are progressing through school at the expected rate.[11] So efforts to provide educational support for girls who are not coping at school may also help to reduce teenage pregnancies.

Poverty alleviation is important for both the mother and child, but previous studies on take-up of the Child Support Grant (CSG) among teenage mothers have found that access is low compared with older mothers.³,[12][13] In 2024, fewer than 1% of the 7.5 million CSG beneficiaries (caregivers) were under 20 years old.[14] This suggests that greater effort should be made to assist young mothers to obtain identity documents for themselves and birth certificates for their babies so that they can apply for CSGs. Ideally, birth registration and social security services should form part of a comprehensive maternal support service at all maternity facilities.

Since 2009 the nationally representative GHS conducted by Stats SA has included questions on pregnancy and fertility. The pregnancy question asks the household respondent: “Has any female household member [between 12 – 50 years] been pregnant during the past 12 months?” For those reported to have been pregnant, a follow-up question asks about the current status of the pregnancy. This indicator calculates the number and percentage of young women who have given birth in the past year.

According to the GHS, the national childbearing rate for young women aged 15 – 24 was 5.4% in 2024. This is equivalent to 281,000 births to young women in this age group, out around 1 million births per year, according to the population models  and represents a statistically significant decline since 7.7% in 2009 when the question was first asked in the survey.

As would be expected, childbearing rates increase with age. Only 2% of girls aged 15 – 17 were reported to have given birth in the previous 12 months (representing 41,000 teenagers in this age group). Childbearing rates rose to 6% among 18 – 20-year-olds (85,000 when weighted), and 8% in the 21 – 24 age group (155,000). This pattern has been been fairly stable over the past decade, and in the group defined as children (under 18) the childbearing rate has never risen above 3.2% (its peak in 2013).