TEENAGE PREGNANCY IN SA NEEDS A RADICAL REVIEW
MUCH has been made recently about the increase in teenage pregnancies in the past year, fuelled by the Covid-19 pandemic and lockdowns.
Sensationalisation of such pregnancies isn’t new. Every couple of years, newspaper headlines shout moral outrage at the rates of early reproduction. Solutions posed are mostly premised on the assumption that young women are responsible for their situation – through ignorance, fecklessness, rebellion or lack of assertiveness.
We argue that a different approach is needed. Instead of asking: “How can teenage pregnancies be prevented?”, we should ask: “How can reproductive injustices in relation to young women be reduced?”
Reproductive justice, as a concept, has gained ground in the past decade. The principles are that women and gender queer people with uteri have:
The right not to have a child. The right to have a child.
The right to parent children in safe and healthy environments.
Reproductive justice approaches are focused on how individual rights intersect with the socio-political or health contexts.
We unpack the principles and explain how reproductive injustices prevent them from exercising their agency and rights.
It is important to note that not all pregnancies among young people are unplanned, and not all unplanned pregnancies are unwanted. In addition, most pregnancies occur in the upper age range – 17 to 19 years old.
Reproductive injustice No 1
For the young people who have unwanted or unsupportable pregnancies, knowledge about and access to abortion services are limited. Abortion is legal on request up to 12 weeks of gestation, and thereafter on certain conditions.
Information is in short supply about the legality of abortion, that minors do not need parental permission to access the services, and where services can be found.
Reproductive injustice No 2
Policy allows minors (younger than 18) to access contraception without parental consent. In reality, accessing services is complicated. Stories abound of harsh and scolding attitudes of clinic staff; clinics operating at inopportune times and being oversubscribed and underresourced; frequent stock-outs; and young people being turned away without contraception.
Reproductive injustice No 3
Research shows that learners, including in primary school, expect and experience high levels of sexual violence or coercion from peers and adults. Coercion may take many forms, including gifts in exchange for sex (so-called transactional sex).
Reproductive injustice No 4
Sexuality education has been offered in schools for years. However, research shows that the messages contained in the curriculum don’t reflect the complexities and realities of learners’ lives.
Instead, what is emphasised is damage – you may conceive and ruin your life – and disease – you may contract a sexually transmitted infection. Teachers are ill-prepared, and tend to use moralising modes of teaching, rather than engaging in dialogue with learners.
Reproductive injustice No 5
Teenage mothers are seen as “illegitimate” reproductive subjects. A range of reasons are given, including obstetric complications, poor child outcomes, and curtailed career prospects for the parent. But comparative research shows that when other variables are taken into consideration, in particular socioeconomic status, younger and older parents fare pretty much the same.
Reproductive injustice No 6
The knee-jerk reaction that “teenage pregnancy” should be prevented at all costs means that they don’t get the health care they need. Teenagers tend to report late for antenatal care as with many older women, they may not pick up the signs that they are pregnant. Third, they fear the reprobation of antenatal clinic staff.
Reproductive injustice No 7
Early reproduction occurs more frequently among people living in low-resource or poor settings than in middle-class neighbourhoods. Life prospects – including employment, accessing further education, affording decent childcare, healthy life expectancy – are circumscribed.
Childbearing offers meaningful adult activity and strengthens family networks. In addition, having children early means you can rely on extended family for childcare. Finally, given a foreshortened healthy life expectancy, having children while young and healthy makes sense.
Reproductive injustice No 8
Feminists fought long and hard for the rights of reproductive bodies in the workplace. When it comes to schools, however, there has been little progress. Although expelling learners for pregnancy is illegal, many leave anyway because of pressure or stigma. Few arrangements to cover maternity leave, arrange on-site childcare, and enable breastfeeding are made.
What to do?
First, the injustices must be addressed. This includes:
Making abortion services known and accessible.
Training and supporting all clinic staff in providing patient-centred, non-judgemental care.
Tackling sexual and gender-based violence with rigour.
Training and supporting sexuality education teachers in providing relevant, open and dialogical pedagogy.
Tackling youth unemployment. Extending the rights enjoyed by working people to pregnant pupils.
Second, set up monitoring and evaluation of the efforts to see how they are faring.