Abstract

ObjectivesThis study explores the barriers to accessing antenatal care (ANC) services amongst pregnant adolescents within a particular community of South Africa.MethodsAn exploratory qualitative design was applied to examine the views of pregnant adolescents. In-depth interviews were conducted with pregnant adolescents at the Mitchells Plain Midwifery Obstetric Unit, as well as nursing staff working at the facility. Thematic analysis was then used and analysis was framed using the social–ecological model for health-seeking behaviour.ResultsThis study found that barriers to adolescents seeking ANC often centered on a discourse of adolescent pregnancy being deviant, irresponsible, and shameful. Pregnant adolescents often absorbed these beliefs and were fearful of other’s reaction within their family, the community, at school, and within the ANC facilities.ConclusionsStigma regarding adolescent pregnancy participates in the perpetuation of a culture of non-disclosure and shame, which stands in the way of young pregnant people seeking the care they require. Such beliefs and attitudes need to be challenged at a community and national level.

Highlights

  • South Africa’s (SA) adolescent birth rate is high, with 49 per 1000 births (The World Bank 2015)

  • Objectives This study explores the barriers to accessing antenatal care (ANC) services amongst pregnant adolescents within a particular community of South Africa

  • This study found that barriers to adolescents seeking ANC often centered on a discourse of adolescent pregnancy being deviant, irresponsible, and shameful

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Summary

Introduction

South Africa’s (SA) adolescent birth rate is high, with 49 per 1000 births (The World Bank 2015). Maternal disorders are the second leading cause of death amongst adolescent girls, and adolescents face a higher risk of complications and death from pregnancy and childbirth than older women (AbouZahr 2013; WHO 2014). Adolescent pregnancy is associated with increased HIV incidence (Christofides et al 2014). Adolescents have shown slower uptake of antenatal antiretroviral (ART) and higher mother-to-child transmission of HIV (Fatti et al 2014). Adolescents face barriers to accessing maternal health services creating missed opportunities for HIV testing and treatment, and early detection of potential complications. Access to antenatal care (ANC), amongst pregnant adolescents, is a priority in reducing maternal morbidity and mortality (Tsawe and Susuman 2014; Atuyambe et al 2008)

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