“My friends said they should no longer be with a b*tch like me…”: A qualitative study to explore the consequences of adolescent childbearing among teen mothers in Gatsibo district, Rwanda

Abstract

In low and middle income countries (LMICs), the rate of teenage pregnancy continues to be high, with significant implications for maternal health. The prevalence of teenage pregnancy is worrisome in Rwanda, and little is known about the consequences faced by teen mothers aged 15–19. Therefore, the present study aims to explore the consequences of adolescent childbearing among teen mothers in Gatsibo district, Rwanda. A descriptive qualitative study design was carried out. We purposively recruited 20 teen mothers aged 15–19 from four health centers in Gatsibo district for in-depth interview. Conversations were conducted in Kinyarwanda and audio recorded. The research team, fluent in both English and Kinyarwanda, carefully listened to each recording and verbatim translated them into English ensuring they are clear and understandable. Transcripts were entered into Dedoose and then inductively and thematically analyzed. Three themes were identified: (1) self-reported health outcomes; (2) socio-economic consequences; and (3) perceived structural barriers of access to healthcare services. Teen mothers in this study reported experiencing physical and psychological problems during pregnancy and after delivery. The socio-economic consequences included lack of social support, feelings of guilt and stigmatization, discrimination, domestic violence, school interruption and dropout, and financial constraint. The structural barriers of access to healthcare included adverse health facility requirements, feeling stigmatized by adult mothers in the healthcare environment, and confronting healthcare providers’ negative attitudes toward teen mothers. The results from this study indicated that adolescent childbearing is associated with several negative consequences. Therefore, there is a need in Rwanda to develop interventions addressing these consequences and revise policies and laws to ensure they support the needs of teen mothers.