Teenage pregnancies in South Africa have been increasing over the past five years, more so over the past two years, during which time access to schools and clinics have been limited due to the lockdown.
Five public health specialists detailed the pregnancy figures and associated societal issues in an academic study published by the South African Medical Journal. They disaggregated public health data for the study.
P Barron, H Subedar, M Letsoko, M Makua and Y Pillay wrote in the study: Very disturbingly, birth rates in adolescent girls in the rural provinces increased at a much faster rate than in the urbanised provinces, where the rates were relatively stable, thus accentuating the differences.”
“ ... On the whole, teenage birth rates in rural provinces such as Limpopo, Mpumalanga and the Eastern Cape were much higher than in more urbanised provinces such as the Western Cape and Gauteng.”
Gauteng and Western Cape had rates between 35 and 45 births per 1 000 teenagers, “the more rural KwaZulu-Natal and Limpopo had rates closer to 60 to 70 per 1 000 teenagers”.
Overall, teenage pregnancies increased from 129 951 in 2017/18 to 152 292 in 2020/21.
Among children aged from 10 to 14, births increased from 2 726 in 2017/18 to 4 053 in 2020/21. This was an increase of 48.7%.
“Although the numbers of deliveries in this group are relatively small, each one represents a failure of society in general and often a personal tragedy for the girl and family involved,” the academics wrote.
Among those aged from 15 to 19, the number of births increased from 114 329 in 2017/18 to 134 267 in 2020/21. This represented an increase of 17.4%.
The academics linked the increase in pregnancies to the problems with access to healthcare in the public sector in the past five years. The issue became compounded during the lockdown.
“Injectable contraceptives, for example, were out of stock for several months from 2015 to 2019, and then during Covid-19, access to facilities and health workers has sometimes been difficult because of lock downs and diversion of health workers to Covid-related activities,” they said.
Teenage pregnancies resulted in a range of problems for the youngsters, the academics said.
“Early childbearing can have negative effects on the education, livelihoods and health of adolescents. Many girls who are pregnant drop out of school, which can impact on their educational and employment opportunities.
“Pregnancy in very young adolescent girls aged 10 to14 is a savage indictment of SA society. Each of these pregnancies is de facto evidence of statutory rape.”
It is possible to reduce teenage pregnancy rates in South Africa, the academics added. “In the USA, for example, the pregnancy rate in adolescents aged 15 to 19 has been falling since 1991, and in 2019 was 16.7 per 1 000 (teenagers).
“Although reasons for the declines are not totally clear, evidence suggests they are due to more teens abstaining from sexual activity, and more teens who are sexually active using contraceptives,” the academics said.