Author/s: Katharine HallDate: November 2019
This indicator shows the number and proportion of young women aged 15 – 24 who are reported to have given birth to a live child in the past year.
Statistics South Africa (2010-2019) General Household Survey 2009-2018. Pretoria, Cape Town: Statistics South Africa. Analysis by Katharine Hall, Children's Institute, University of Cape Town
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 Teenage fertility rates declined after the 1996 census, and Department of Health data between 2004 and 2017 showed a consistent decline in the share of teenagers aged 15 – 19 who attended antenatal clinics.2
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 10 years. However prevalence rates are still worryingly high: of the young pregnant women surveyed in antenatal clinics in 2017, 11.3% of those aged 15 – 19 and 21.9% of those aged 20 – 24 were HIV positive.3 For many years the majority of deaths in young mothers were caused by HIV.4 Much of the overall decline in maternal deaths since 2011 is attributed to implementation of policies to manage and prevent HIV,5 but it is still important that safe sexual behaviours are 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.6 For this reason is it important to delay childbearing, and to ensure that teenagers who do fall 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.7 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 take-up of the Child Support Grant among teenage mothers is low compared with older mothers.8 This suggests that greater effort should be made to assist young mothers to obtain birth certificates to apply for GSGs. Ideally, home affairs and social security services should form part of a comprehensive maternal support service at clinics and maternity hospitals.
Since 2009 the nationally representative General Household Survey (GHS) conducted by Statistics South Africa 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 7% in 2017. There has been no significant change in this rate since 2009 when the question was first asked in the survey, and the estimated number of young women giving birth in a year has remained fairly stable at around 350,000.
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 31,000 teenagers in this age group). Childbearing rates rose to 9% among 18 – 20-year-olds (125,000 when weighted), and 10% in the 21 – 24 age group (188,000). These rates have also been stable over the past decade.
1 See, for example: Jonas K, Crutzen R, van den Borne B, Sewpaul R & Reddy P (2016) Teenage pregnancy rates and associations with other health risk behaviours: A three-wave cross-sectional study among South African school-going adolescents. Reproductive Health, 13(50). DOI: 10.1186/s12978-016-0170-8;
Ardington C, Branson N & Leibbrandt M (2011) Trends in Teenage Childbearing and Schooling Outcomes for Children Born to Teens in South Africa. SALDRU Working Paper 75. Cape Town: Southern African Labour & Development Research Unit, UCT;
Makiwane M, Desmond, C Richter L & Udjo E (2006) Is the Child Support Grant Associated with an Increase in Teenage Fertility in South Africa? Evidence from National Surveys and Administrative Data. Pretoria: Human Sciences Research Council.
2 Department of Health (2004 – 2019) National Antenatal Sentinel HIV and Syphilis Prevalence Surveys 2004 –2017. Pretoria: DoH.
3 Department of Health (2019) National Antenatal Sentinel HIV and Syphilis Prevalence Surveys 2017. Pretoria: DoH
4 Ardington C, Menendez A & Mutevedzi T (2015) Early childbearing, human capital attainment and mortality risk. Economic Development and Cultural Change, 62(2): 281-317.
5 Department of Health (2018) Saving Mothers 2014 – 2016: Seventh triennial report on confidential enquiries into maternal deaths in South Africa: Short report. Pretoria: DOH
6 Branson N, Ardington C & Leibbrandt M (2015) Health outcomes of children born to teen mothers in Cape Town, South Africa. Economic Development and Cultural Change, 63(3): 589-616;
Ardington et al, 2015 (above)
Ardington et al, 2011 (above).
7 Timæus I & Moultrie T (2015) Trends in childbearing and educational attainment in South Africa. Studies in Family Planning, 46(2): 143-160.
8 Makiwane M (2010) The Child Support Grant and teenage childbearing in South Africa. Development Southern Africa, 27(2): 193-204;
Kesho Consulting and Business Solutions (2006) Report on Incentive Structures of Social Assistance Grants in South Africa. Report commissioned by Department of Social Development, Pretoria;
Makiwane et al, 2006 (above).