Duby Zoe, Bunce Brittany, Fowler Chantal, Bergh Kate, Jonas Kim, Slingers Nevilene, Mathews Catherine, Abdullah Fareed
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
School of Public Health, University of Cape Town, Cape Town, South Africa.
Reprod Health. 2025 Feb 4;22(1):18. doi: 10.1186/s12978-025-01958-7.
The framing of teenage pregnancy in social discourse influences the way in which adolescent girls and young women (AGYW) are treated, the extent to which they are supported, and to which they are able to engage with services and enact pregnancy prevention behaviours.
Through the analysis of data from a qualitative study conducted in the South African communities of Newcastle in KwaZulu-Natal and Moretele in the North-West province, we explored narratives of blame for teenage pregnancy. Data derived from seventy-one in-depth interviews conducted with forty AGYW aged between 15 and 24, twenty-four parents/caregivers of AGYW, five service providers, ten school educators, and two other community members. Interpretation of data drew upon blame, attribution and framing theories.
The overall framing of teenage pregnancy was overwhelmingly negative, with participants labelling it immoral and 'wrong'. Findings were arranged into key thematic areas that emerged in the data relating to blame for teenage pregnancy: the individual centred 'wrong-girl' and developmental discourses, in which blame was apportioned to AGYW for being immature, reckless, irresponsible, disobedient and greedy; the 'wrong-family' discourse in which blame was attributed to parents of AGYW for poor parenting and failing to adequately care for the adolescents in their responsibility; the 'wrong-men' discourse in which blame was attributed to men for luring AGYW into transactional sex, and for perpetrating gender-based violence; and lastly the 'wrong-society' discourse which attributed blame to contextual/structural factors such as poverty, a high volume of unregulated drinking establishments, and a lack of youth-friendly services.
Policies, interventions and programmes focusing on adolescents' sexual and reproductive health need to carefully consider the framing and narratives of blame and responsibility. There is an urgent need to shift away from the individualised moralistic shaming of pregnant AGYW, towards a recognition of a complex interplay of multilevel factors that enable or constrain AGYW's agency. Policies and programmes should focus on both providing sufficient support to AGYW, while also addressing structural factors and harmful narratives and thus create the conditions necessary to enable AGYW to enact safe, informed, agentic and responsible decisions and behaviours about their own sexual and reproductive health.
社会话语中对青少年怀孕的界定影响着少女和年轻女性（AGYW）的对待方式、她们获得支持的程度以及她们参与服务和采取预防怀孕行为的能力。
通过对在夸祖鲁 - 纳塔尔省的纽卡斯尔和西北省的莫雷泰勒等南非社区进行的一项定性研究的数据进行分析，我们探究了对青少年怀孕的指责性叙述。数据来自对40名年龄在15至24岁之间的AGYW、24名AGYW的父母/照顾者、5名服务提供者、10名学校教育工作者以及2名其他社区成员进行的71次深入访谈。数据解读借鉴了指责、归因和界定理论。
青少年怀孕的总体界定绝大多数是负面的，参与者将其标记为不道德和“错误的”。研究结果被整理成与青少年怀孕指责相关的数据中出现的关键主题领域：以个人为中心的“错误女孩”和发展性话语，其中指责AGYW不成熟、鲁莽、不负责任、不听话和贪婪；“错误家庭”话语，其中指责AGYW的父母育儿不善且未能充分履行照顾青少年的责任；“错误男性”话语，其中指责男性引诱AGYW进行交易性行为并实施基于性别的暴力；最后是“错误社会”话语，将指责归因于贫困、大量无监管的饮酒场所和缺乏对青少年友好的服务等背景/结构因素。
关注青少年性健康和生殖健康的政策、干预措施和项目需要仔细考虑指责和责任的界定及叙述。迫切需要从对怀孕AGYW的个体化道德羞辱转向认识到多层次因素的复杂相互作用，这些因素促进或限制了AGYW的自主能力。政策和项目应既注重为AGYW提供充分支持，同时也解决结构因素和有害叙述，从而创造必要条件，使AGYW能够就自己的性健康和生殖健康做出安全、明智、自主和负责的决定及行为。
