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"title": "Learning to cope and coping to learn – how to help teenage moms stay in school",
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"contents": "<span style=\"font-weight: 400;\">In her school uniform and sitting in a classroom with rows of wooden desks and blue plastic chairs, Otlotleng Moolikwe (18) looks just like any other Grade 12 pupil. It’s hard to imagine she’s the mother of a four-year-old boy.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe says she was 13 when she and her boyfriend first had sex. They had grown up as next-door neighbours and were both in Grade 7. They hadn’t planned on having sex that day, she recounts. “It just happened.”</span>\r\n\r\n<span style=\"font-weight: 400;\">The two found themselves home alone, and what started simply as making out quickly turned into clothes being shed.</span>\r\n\r\n<span style=\"font-weight: 400;\">They had both had the abstinence talk – at home and at school – and also knew about using a condom. But in the rushed reality that theoretical knowledge came to naught, Moolikwe says: “The condom slipped off during sex.”</span>\r\n\r\n<span style=\"font-weight: 400;\">Three months later – and after taking three pregnancy tests – Moolikwe had to accept that she was having a baby.</span>\r\n\r\n<span style=\"font-weight: 400;\">She recalls: “My mother noticed because she would buy me sanitary pads and then just see them in my wardrobe – unused.”</span>\r\n<h2>Let’s talk about sex</h2>\r\n<span style=\"font-weight: 400;\">Moolikwe grew up in Majankeng in rural North West, just under an hour’s drive from Potchefstroom. The road to her home (she lives with her parents, brother and cousin) runs past farms dotted with cows, goats and chickens. </span>\r\n\r\n<span style=\"font-weight: 400;\">Teen pregnancies are frowned upon here. But they happen.</span>\r\n\r\n<span style=\"font-weight: 400;\">There was a 25% increase in the number of girls between 10 and 14 years old who gave birth in public healthcare facilities in North West from 2017 to 2021, according to an </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/13549\"><span style=\"font-weight: 400;\">April study published in the </span><i><span style=\"font-weight: 400;\">South African Medical Journal</span></i><span style=\"font-weight: 400;\"> (</span><i><span style=\"font-weight: 400;\">SAMJ</span></i><span style=\"font-weight: 400;\">)</span></a><i><span style=\"font-weight: 400;\">.</span></i>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe shuffles on the blue plastic chair, staring at the cracks in the plaster of the classroom wall. A breeze blows through the open window, which looks out over a clump of trees and a mountain.</span>\r\n\r\n<span style=\"font-weight: 400;\">“I knew there was a chance I could be pregnant. But still, when I found out, I was scared,” she says.</span>\r\n\r\n<span style=\"font-weight: 400;\">In Moolikwe’s community, the default approach to sex education is “just don’t have sex”. But that approach isn’t working.</span>\r\n\r\n<span style=\"font-weight: 400;\">More than 80% of girls in rural KwaZulu-Natal had some sexual experience by the time they were 13, a </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/8925/6640\"><span style=\"font-weight: 400;\">2015 survey found</span></a><span style=\"font-weight: 400;\">. About one in five were having sex before the age of 15.</span>\r\n\r\n<span style=\"font-weight: 400;\">Sex itself is not the problem, but rather that children are having sex without contraception. </span>\r\n\r\n<span style=\"font-weight: 400;\">According to the </span><a href=\"https://dhsprogram.com/pubs/pdf/FR337/FR337.pdf#page=103\"><span style=\"font-weight: 400;\">2016 Demographic and Health Survey</span></a><span style=\"font-weight: 400;\">, one in six girls between 15 and 19 years old have had a child. In 2020, close to </span><a href=\"http://www.statssa.gov.za/?p=14902\"><span style=\"font-weight: 400;\">34,000 births in South Africa</span></a><span style=\"font-weight: 400;\"> were from mothers younger than 18 – and more than 600 of them were between 10 and 13. </span>\r\n\r\n<span style=\"font-weight: 400;\">The </span><i><span style=\"font-weight: 400;\">SAMJ </span></i><span style=\"font-weight: 400;\">study showed that nationally the number of births to teen girls between 10 and 14 years had increased by </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/13549\"><span style=\"font-weight: 400;\">close to 50%</span></a><span style=\"font-weight: 400;\"> between 2017 and 2021. For those between 15 and 19 births increased by </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/13549\"><span style=\"font-weight: 400;\">about 18%</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">Teenage pregnancy can have serious </span><a href=\"https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\"><span style=\"font-weight: 400;\">health complications</span></a><span style=\"font-weight: 400;\">, such as the risk of developing very high blood pressure that can cause seizures and young girls being more susceptible to bacterial infections that can enter the bloodstream and lead to death if not treated in time.</span>\r\n\r\n<span style=\"font-weight: 400;\">Also, because their bodies may not yet be fully developed, adolescent girls are </span><a href=\"http://apps.who.int/iris/bitstream/handle/10665/43368/9241593784_eng.pdf;jsessionid=97843C7A472EC6F7033A50E41C89E076?sequence=1\"><span style=\"font-weight: 400;\">more likely to have complications</span></a><span style=\"font-weight: 400;\"> during labour and mothers between 15 and 19 are </span><a href=\"https://apps.who.int/iris/bitstream/handle/10665/43368/9241593784_eng.pdf\"><span style=\"font-weight: 400;\">twice as likely to die</span></a><span style=\"font-weight: 400;\"> during childbirth than those who have babies in their twenties. </span>\r\n\r\n<span style=\"font-weight: 400;\">A pregnancy at a young age can also be </span><a href=\"https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\"><span style=\"font-weight: 400;\">bad for the baby</span></a><span style=\"font-weight: 400;\">. The foetus is likely to </span><a href=\"https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\"><span style=\"font-weight: 400;\">develop slower</span></a><span style=\"font-weight: 400;\"> when the mom is in her teens and the baby could be born too early, which could raise the risk of the infant dying from </span><a href=\"https://www.who.int/medicines/areas/priority_medicines/Ch6_23Neonatal.pdf\"><span style=\"font-weight: 400;\">complications</span></a><span style=\"font-weight: 400;\"> such as its lungs not being fully developed.</span>\r\n\r\n<span style=\"font-weight: 400;\">But kids often don’t know how to broach talking about sex and pregnancy – something Moolikwe experienced. Even when she was worried about the chance that she might be pregnant, she wasn’t sure how to bring up the taboo topic with her family.</span>\r\n\r\n<span style=\"font-weight: 400;\">She recalls: “I couldn’t talk to my parents. I always talked with my friend or my cousin. I’m more comfortable talking with them, because they always listen to me.”</span>\r\n<h2>The tangled relationship of teen pregnancy and school dropouts</h2>\r\n<span style=\"font-weight: 400;\">The worry about teen pregnancies is about more than health risks since it can also disrupt young girls’ education and cause them to </span><a href=\"https://journals.sagepub.com/doi/abs/10.1177/1090198119831755\"><span style=\"font-weight: 400;\">drop out of school</span></a><span style=\"font-weight: 400;\">. This can jeopardise their chances of </span><a href=\"https://www.opensaldru.uct.ac.za/bitstream/handle/11090/920/1-s2.0-S0167629616301977-main.pdf?sequence=1\"><span style=\"font-weight: 400;\">finding a job later</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">There were 3,449 young people who were unemployed and didn’t finish school in the </span><a href=\"http://www.nids.uct.ac.za/images/papers/2019_11_NIDSW5.pdf\"><span style=\"font-weight: 400;\">2019 National Income Dynamics Study</span></a><span style=\"font-weight: 400;\">. Of these, 81% are women. The most common reason for not looking for a job is responsibilities at home, and one in five said having a baby or being pregnant was the reason they stopped going to school.</span>\r\n\r\n<span style=\"font-weight: 400;\">“Pregnancy is both a cause and a consequence of school dropout,” the authors of a </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625926/\"><span style=\"font-weight: 400;\">2019 paper</span></a><span style=\"font-weight: 400;\"> published in </span><i><span style=\"font-weight: 400;\">Health Education & Behaviour </span></i><span style=\"font-weight: 400;\">showed.</span>\r\n\r\n<span style=\"font-weight: 400;\">The study found that girls who fell pregnant while still in school were </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625926/\"><span style=\"font-weight: 400;\">twice as likely to drop out</span></a><span style=\"font-weight: 400;\"> than their peers who didn’t get pregnant. Similarly, pupils who left school before completing their studies had a </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625926/\"><span style=\"font-weight: 400;\">four-times greater risk of falling pregnant</span></a><span style=\"font-weight: 400;\"> than girls who stayed to finish school.</span>\r\n\r\n<span style=\"font-weight: 400;\">Given South Africa’s </span><a href=\"https://dhsprogram.com/pubs/pdf/FR337/FR337.pdf#page=103\"><span style=\"font-weight: 400;\">high teenage pregnancy rate</span></a><span style=\"font-weight: 400;\"> and the disruptive effect on girls’ schooling, the Basic Education Department introduced a </span><a href=\"https://www.gov.za/sites/default/files/gcis_document/202112/45580gen704.pdf\"><span style=\"font-weight: 400;\">new policy</span></a> <span style=\"font-weight: 400;\">in December to help keep teenage moms in school.</span>\r\n\r\n<span style=\"font-weight: 400;\">This </span><a href=\"https://www.gov.za/sites/default/files/gcis_document/202112/45580gen704.pdf\"><span style=\"font-weight: 400;\">document</span></a><span style=\"font-weight: 400;\"> says all pupils should have access to sex education and pregnant girls should be allowed to carry on attending classes as long as they can and then be encouraged to return after giving birth.</span>\r\n<h2>One plus one makes another one</h2>\r\n<span style=\"font-weight: 400;\">However, keeping pregnant girls in school is an uphill battle.</span>\r\n\r\n<span style=\"font-weight: 400;\">In 2021, </span><a href=\"https://cramsurvey.org/wp-content/uploads/2021/07/11.-Shepherd-D-_-Mohohlwane-N.-2021.-Changes-in-education-A-reflection-on-COVID-19-effects-over-a-year.pdf\"><span style=\"font-weight: 400;\">an update</span></a><span style=\"font-weight: 400;\"> of the earlier National Income Dynamics Study showed that, compared with 2018, </span><a href=\"https://cramsurvey.org/wp-content/uploads/2021/07/11.-Shepherd-D-_-Mohohlwane-N.-2021.-Changes-in-education-A-reflection-on-COVID-19-effects-over-a-year.pdf\"><span style=\"font-weight: 400;\">triple the number of students</span></a><span style=\"font-weight: 400;\"> between the ages of seven and 17 were no longer in school.</span>\r\n\r\n<span style=\"font-weight: 400;\">And although it doesn’t specify how teen pregnancies have been affected, a report by </span><a href=\"https://www.samrc.ac.za/sites/default/files/attachments/2021-07-27/HERStory2%20Process%20Evaluation%20Report%20Overview.pdf\"><span style=\"font-weight: 400;\">the South African Medical Research Council</span></a><span style=\"font-weight: 400;\"> noted that teenage girls struggled to access contraceptives during Covid-19 lockdowns, which, they say, could be part of the reason for the rise in teen pregnancies during the first year of the pandemic. </span>\r\n\r\n<span style=\"font-weight: 400;\">That’s a pattern seen at Matsukubyane Secondary School, which Moolikwe attends. </span>\r\n\r\n<span style=\"font-weight: 400;\">Tinyiko Rakobela of the HIV prevention organisation </span><a href=\"https://showmeyournumber.org.za/about-us/\"><span style=\"font-weight: 400;\">Show Me Your Number</span></a><span style=\"font-weight: 400;\"> has been working with pupils at Matsukubyane since 2019. In the past year there have been 16 pregnancies at the school (the school has 1,018 pupils) – a definite spike since pupils started returning after lockdown. Typically, the school saw only one or two pregnancies a year, she says.</span>\r\n\r\n<span style=\"font-weight: 400;\">“During Covid, kids were at home most of the day, so they had lots of free time and little supervision,” explains Rakobela.</span>\r\n\r\n<span style=\"font-weight: 400;\">Rakobela says their organisation helps with clinic referrals, offers financial assistance and creates a space for young moms when they need to talk. She helps to answer questions about their relationships and sex, what type of protection to use, where to get contraceptives and how giving consent to sex works.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe says: “Without the support of my friends at school and my family, I’m not sure I would have stayed in school.”</span>\r\n\r\n<span style=\"font-weight: 400;\">She speaks to Rakobela about her relationship with her boyfriend or problems at home, but she also relies on the network of teen mothers at the school.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe says: “We can support each other. The others will always come to me and ask me about what kind of things they should be doing when their child is crying.”</span>\r\n<h2>Parental guidance advised</h2>\r\n<span style=\"font-weight: 400;\">When Moolikwe gets home from school, she is greeted by her mom, who takes care of her son. He’s across the street spending the afternoon with his father and paternal grandparents.</span>\r\n\r\n<span style=\"font-weight: 400;\">When he returns, he heads straight for the floral couch and his grandma immediately pulls him onto her lap.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe is preparing to apply to university and is doubling down on studying. </span>\r\n\r\n<span style=\"font-weight: 400;\">Her biggest help? Her mom.</span>\r\n\r\n<span style=\"font-weight: 400;\">“My parents insisted that they would look after the baby so that I could finish school,” she says. “Dropping out was not an option.”</span>\r\n\r\n<span style=\"font-weight: 400;\">But many girls don’t have a good support system.</span>\r\n\r\n<span style=\"font-weight: 400;\">Even though the </span><a href=\"https://www.justice.gov.za/legislation/constitution/SAConstitution-web-eng-02.pdf\"><span style=\"font-weight: 400;\">law</span></a><span style=\"font-weight: 400;\"> protects girls’ right to remain in school while pregnant and after giving birth, schools are not obliged to go to extra lengths to make that happen. </span>\r\n\r\n<span style=\"font-weight: 400;\">A </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">2013 report</span></a><span style=\"font-weight: 400;\"> for Partners in Sexual Health, an NGO focused on sexual and reproductive rights, outlines how implementing policies meant to protect girls is “filtered through people’s own views on teenage sexuality, and beliefs about ‘appropriate girls and boys norms’ – and this has led to many violations of these policies”.</span>\r\n\r\n<span style=\"font-weight: 400;\">So, although girls are not being expelled outright, the culture of stigma around sex and pressure to hide the pregnancy </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">force many to drop out</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">And it’s not only school staff who have to come around. </span>\r\n\r\n<span style=\"font-weight: 400;\">Says Moolikwe: “I thought that in school children will not judge each other. I thought they’ll just know that we can fall pregnant. But every time when there’s a girl who’s pregnant, they judge her – and most of the time it’s the girls. Sometimes I tell them that you may be judging her today, but tomorrow it could be you.”</span>\r\n\r\n<span style=\"font-weight: 400;\">That’s why creating a culture of support, at home and in schools, is an important part of helping young girls stay in class. Parents can be an important link in this system, says Réjane Woodroffe, director of the </span><a href=\"https://bulungulaincubator.org/\"><span style=\"font-weight: 400;\">Bulungula Incubator</span></a><span style=\"font-weight: 400;\">, an NGO that works to improve living conditions in the rural Eastern Cape. </span>\r\n\r\n<span style=\"font-weight: 400;\">Part of their strategy is having zero tolerance for dropping out – not just specific to teen pregnancies – and helping pupils to return to school.</span>\r\n\r\n<span style=\"font-weight: 400;\">Girls who have the backing of their mothers are more likely both to </span><a href=\"https://www.gov.za/sites/default/files/gcis_document/201409/dobeteenagepregnancyreport.pdf\"><span style=\"font-weight: 400;\">return to school and to complete their studies</span></a><span style=\"font-weight: 400;\">. Having a parent at home can also help </span><a href=\"https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01300-w\"><span style=\"font-weight: 400;\">relieve the pressure</span></a><span style=\"font-weight: 400;\"> on the teen mother, who has to </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">study while looking after the baby</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe explains: “I’m not the one who raised my child. He was raised by my parents… Sometimes my parents will tell me, ‘This is not your child; this is our last born. So you don’t have to stress yourself’.”</span>\r\n<h2>It’s cool to stay in school</h2>\r\n<span style=\"font-weight: 400;\">During the past few months of her pregnancy, Moolikwe’s world began to narrow down to her home. As her due date drew closer, she wasn’t able to attend class in person. </span>\r\n\r\n<span style=\"font-weight: 400;\">A </span><a href=\"https://zerodropout.co.za/wp-content/uploads/2022/01/ZERO-DROPOUT-PUBLICATION-2021_GenderMatters_digital.pdf\"><span style=\"font-weight: 400;\">2021 report from the Zero Dropout campaign</span></a><span style=\"font-weight: 400;\"> explains that pregnancy can interfere with a teenage girl’s education even before the baby is born. Young women are more likely to miss school during the pregnancy, because they have to take time off both before and after giving birth and need regular clinic check-ups. </span>\r\n\r\n<span style=\"font-weight: 400;\">The more a pupil misses school, the </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">harder it becomes to continue</span></a><span style=\"font-weight: 400;\"> studying and catch up. A </span><a href=\"https://sites.bu.edu/mvkarra/files/2020/11/Karra_Lee_2012_Human-Capital-Consequences-of-Teenage-Childbearing-in-South-Africa.pdf\"><span style=\"font-weight: 400;\">2012 study</span></a><span style=\"font-weight: 400;\"> from Cape Town found that teen moms were likely to lag behind their non-pregnant peers by more than half a year.</span>\r\n\r\n<span style=\"font-weight: 400;\">To undo this pattern “you have to support the school as well as the young women”, says Woodroffe.</span>\r\n\r\n<p><img loading=\"lazy\" class=\"size-full wp-image-1229992\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2022/04/Bhek-NW_1.jpg\" alt=\"\" width=\"720\" height=\"433\" /> A study in the 'South African Medical Journal' showed that nationally the number of births to girls between 10 and 14 years old had increased by close to 50% between 2017 and 2021. For those between 15 and 19 years, births increased by about 18%. (Photo: Media24 / Gallo Images)</p>\r\n\r\n<span style=\"font-weight: 400;\">Rather than just introducing a policy that says girls must be allowed to remain in school while pregnant, training should be available to teachers and staff to help them get on board with this decision, she explains.</span>\r\n\r\n<span style=\"font-weight: 400;\">Woodroffe says some teachers are worried that by accommodating expecting mothers “you’re encouraging young women to fall pregnant while still in school and that this sends a negative message to other learners”. </span>\r\n\r\n<span style=\"font-weight: 400;\">Schools also need support in handling potential emergencies and health problems pregnant pupils face. For example, if a student were to give birth at school, there should be a plan for getting her to a healthcare facility and keeping her safe.</span>\r\n\r\n<span style=\"font-weight: 400;\">But these strategies can’t be left just to the school – it should be a team effort between the school, the pupil and her family, Woofroffe says.</span>\r\n\r\n<span style=\"font-weight: 400;\">During the later stages of school pregnancies, the Incubator has family members accompany girls all day in case they go into labour – specifically because there are no hospitals close to the rural school the Incubator runs or an ambulance service in the area.</span>\r\n\r\n<span style=\"font-weight: 400;\">“But it does place a burden on the girl’s family, as they have to sacrifice their time to be with her,” says Woodroffe.</span>\r\n\r\n<span style=\"font-weight: 400;\">Woodroffe and her team try to keep teen moms in class for as long as possible, because studying at home isn’t always possible. In the part of the Eastern Cape where she works (the Elliotdale district), online study “isn’t really an option”.</span>\r\n\r\n<span style=\"font-weight: 400;\">“We don’t even have electricity. You have to find a way to charge the device and even if a learner has a cellphone, there isn’t a signal everywhere.”</span>\r\n\r\n<span style=\"font-weight: 400;\">Ultimately, Woodroffe realised that distance learning was possible only if it could be done with textbooks and worksheets.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe’s school took a similar approach. “After school, my friend used to bring me books and assignments,” she says. “My mother used to take me to school so I could write my exams and then bring me back home afterwards.”</span>\r\n\r\n<span style=\"font-weight: 400;\">This support and hands-on help from her teachers allowed Moolikwe to stay on top of her classwork.</span>\r\n\r\n<span style=\"font-weight: 400;\">She was considering taking a gap year after matriculating. 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"name": "The South African Medical Journal (SAMJ) study showed that nationally the number of births to teen girls between 10 and 14 years had increased by close to 50% between 2017 and 2021. For those between 15 and 19 years, births increased by about 18%. Teenage pregnancy can have serious health complications, such as the risk of developing very high blood pressure that can cause seizures and young girls being more susceptible to bacterial infections that can enter the bloodstream and lead to death if not treated in time.\n(Photo: Media24/Gallo Images)",
"description": "<span style=\"font-weight: 400;\">In her school uniform and sitting in a classroom with rows of wooden desks and blue plastic chairs, Otlotleng Moolikwe (18) looks just like any other Grade 12 pupil. It’s hard to imagine she’s the mother of a four-year-old boy.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe says she was 13 when she and her boyfriend first had sex. They had grown up as next-door neighbours and were both in Grade 7. They hadn’t planned on having sex that day, she recounts. “It just happened.”</span>\r\n\r\n<span style=\"font-weight: 400;\">The two found themselves home alone, and what started simply as making out quickly turned into clothes being shed.</span>\r\n\r\n<span style=\"font-weight: 400;\">They had both had the abstinence talk – at home and at school – and also knew about using a condom. But in the rushed reality that theoretical knowledge came to naught, Moolikwe says: “The condom slipped off during sex.”</span>\r\n\r\n<span style=\"font-weight: 400;\">Three months later – and after taking three pregnancy tests – Moolikwe had to accept that she was having a baby.</span>\r\n\r\n<span style=\"font-weight: 400;\">She recalls: “My mother noticed because she would buy me sanitary pads and then just see them in my wardrobe – unused.”</span>\r\n<h2>Let’s talk about sex</h2>\r\n<span style=\"font-weight: 400;\">Moolikwe grew up in Majankeng in rural North West, just under an hour’s drive from Potchefstroom. The road to her home (she lives with her parents, brother and cousin) runs past farms dotted with cows, goats and chickens. </span>\r\n\r\n<span style=\"font-weight: 400;\">Teen pregnancies are frowned upon here. But they happen.</span>\r\n\r\n<span style=\"font-weight: 400;\">There was a 25% increase in the number of girls between 10 and 14 years old who gave birth in public healthcare facilities in North West from 2017 to 2021, according to an </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/13549\"><span style=\"font-weight: 400;\">April study published in the </span><i><span style=\"font-weight: 400;\">South African Medical Journal</span></i><span style=\"font-weight: 400;\"> (</span><i><span style=\"font-weight: 400;\">SAMJ</span></i><span style=\"font-weight: 400;\">)</span></a><i><span style=\"font-weight: 400;\">.</span></i>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe shuffles on the blue plastic chair, staring at the cracks in the plaster of the classroom wall. A breeze blows through the open window, which looks out over a clump of trees and a mountain.</span>\r\n\r\n<span style=\"font-weight: 400;\">“I knew there was a chance I could be pregnant. But still, when I found out, I was scared,” she says.</span>\r\n\r\n<span style=\"font-weight: 400;\">In Moolikwe’s community, the default approach to sex education is “just don’t have sex”. But that approach isn’t working.</span>\r\n\r\n<span style=\"font-weight: 400;\">More than 80% of girls in rural KwaZulu-Natal had some sexual experience by the time they were 13, a </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/8925/6640\"><span style=\"font-weight: 400;\">2015 survey found</span></a><span style=\"font-weight: 400;\">. About one in five were having sex before the age of 15.</span>\r\n\r\n<span style=\"font-weight: 400;\">Sex itself is not the problem, but rather that children are having sex without contraception. </span>\r\n\r\n<span style=\"font-weight: 400;\">According to the </span><a href=\"https://dhsprogram.com/pubs/pdf/FR337/FR337.pdf#page=103\"><span style=\"font-weight: 400;\">2016 Demographic and Health Survey</span></a><span style=\"font-weight: 400;\">, one in six girls between 15 and 19 years old have had a child. In 2020, close to </span><a href=\"http://www.statssa.gov.za/?p=14902\"><span style=\"font-weight: 400;\">34,000 births in South Africa</span></a><span style=\"font-weight: 400;\"> were from mothers younger than 18 – and more than 600 of them were between 10 and 13. </span>\r\n\r\n<span style=\"font-weight: 400;\">The </span><i><span style=\"font-weight: 400;\">SAMJ </span></i><span style=\"font-weight: 400;\">study showed that nationally the number of births to teen girls between 10 and 14 years had increased by </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/13549\"><span style=\"font-weight: 400;\">close to 50%</span></a><span style=\"font-weight: 400;\"> between 2017 and 2021. For those between 15 and 19 births increased by </span><a href=\"http://www.samj.org.za/index.php/samj/article/view/13549\"><span style=\"font-weight: 400;\">about 18%</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">Teenage pregnancy can have serious </span><a href=\"https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\"><span style=\"font-weight: 400;\">health complications</span></a><span style=\"font-weight: 400;\">, such as the risk of developing very high blood pressure that can cause seizures and young girls being more susceptible to bacterial infections that can enter the bloodstream and lead to death if not treated in time.</span>\r\n\r\n<span style=\"font-weight: 400;\">Also, because their bodies may not yet be fully developed, adolescent girls are </span><a href=\"http://apps.who.int/iris/bitstream/handle/10665/43368/9241593784_eng.pdf;jsessionid=97843C7A472EC6F7033A50E41C89E076?sequence=1\"><span style=\"font-weight: 400;\">more likely to have complications</span></a><span style=\"font-weight: 400;\"> during labour and mothers between 15 and 19 are </span><a href=\"https://apps.who.int/iris/bitstream/handle/10665/43368/9241593784_eng.pdf\"><span style=\"font-weight: 400;\">twice as likely to die</span></a><span style=\"font-weight: 400;\"> during childbirth than those who have babies in their twenties. </span>\r\n\r\n<span style=\"font-weight: 400;\">A pregnancy at a young age can also be </span><a href=\"https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\"><span style=\"font-weight: 400;\">bad for the baby</span></a><span style=\"font-weight: 400;\">. The foetus is likely to </span><a href=\"https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy\"><span style=\"font-weight: 400;\">develop slower</span></a><span style=\"font-weight: 400;\"> when the mom is in her teens and the baby could be born too early, which could raise the risk of the infant dying from </span><a href=\"https://www.who.int/medicines/areas/priority_medicines/Ch6_23Neonatal.pdf\"><span style=\"font-weight: 400;\">complications</span></a><span style=\"font-weight: 400;\"> such as its lungs not being fully developed.</span>\r\n\r\n<span style=\"font-weight: 400;\">But kids often don’t know how to broach talking about sex and pregnancy – something Moolikwe experienced. Even when she was worried about the chance that she might be pregnant, she wasn’t sure how to bring up the taboo topic with her family.</span>\r\n\r\n<span style=\"font-weight: 400;\">She recalls: “I couldn’t talk to my parents. I always talked with my friend or my cousin. I’m more comfortable talking with them, because they always listen to me.”</span>\r\n<h2>The tangled relationship of teen pregnancy and school dropouts</h2>\r\n<span style=\"font-weight: 400;\">The worry about teen pregnancies is about more than health risks since it can also disrupt young girls’ education and cause them to </span><a href=\"https://journals.sagepub.com/doi/abs/10.1177/1090198119831755\"><span style=\"font-weight: 400;\">drop out of school</span></a><span style=\"font-weight: 400;\">. This can jeopardise their chances of </span><a href=\"https://www.opensaldru.uct.ac.za/bitstream/handle/11090/920/1-s2.0-S0167629616301977-main.pdf?sequence=1\"><span style=\"font-weight: 400;\">finding a job later</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">There were 3,449 young people who were unemployed and didn’t finish school in the </span><a href=\"http://www.nids.uct.ac.za/images/papers/2019_11_NIDSW5.pdf\"><span style=\"font-weight: 400;\">2019 National Income Dynamics Study</span></a><span style=\"font-weight: 400;\">. Of these, 81% are women. The most common reason for not looking for a job is responsibilities at home, and one in five said having a baby or being pregnant was the reason they stopped going to school.</span>\r\n\r\n<span style=\"font-weight: 400;\">“Pregnancy is both a cause and a consequence of school dropout,” the authors of a </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625926/\"><span style=\"font-weight: 400;\">2019 paper</span></a><span style=\"font-weight: 400;\"> published in </span><i><span style=\"font-weight: 400;\">Health Education & Behaviour </span></i><span style=\"font-weight: 400;\">showed.</span>\r\n\r\n<span style=\"font-weight: 400;\">The study found that girls who fell pregnant while still in school were </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625926/\"><span style=\"font-weight: 400;\">twice as likely to drop out</span></a><span style=\"font-weight: 400;\"> than their peers who didn’t get pregnant. Similarly, pupils who left school before completing their studies had a </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625926/\"><span style=\"font-weight: 400;\">four-times greater risk of falling pregnant</span></a><span style=\"font-weight: 400;\"> than girls who stayed to finish school.</span>\r\n\r\n<span style=\"font-weight: 400;\">Given South Africa’s </span><a href=\"https://dhsprogram.com/pubs/pdf/FR337/FR337.pdf#page=103\"><span style=\"font-weight: 400;\">high teenage pregnancy rate</span></a><span style=\"font-weight: 400;\"> and the disruptive effect on girls’ schooling, the Basic Education Department introduced a </span><a href=\"https://www.gov.za/sites/default/files/gcis_document/202112/45580gen704.pdf\"><span style=\"font-weight: 400;\">new policy</span></a> <span style=\"font-weight: 400;\">in December to help keep teenage moms in school.</span>\r\n\r\n<span style=\"font-weight: 400;\">This </span><a href=\"https://www.gov.za/sites/default/files/gcis_document/202112/45580gen704.pdf\"><span style=\"font-weight: 400;\">document</span></a><span style=\"font-weight: 400;\"> says all pupils should have access to sex education and pregnant girls should be allowed to carry on attending classes as long as they can and then be encouraged to return after giving birth.</span>\r\n<h2>One plus one makes another one</h2>\r\n<span style=\"font-weight: 400;\">However, keeping pregnant girls in school is an uphill battle.</span>\r\n\r\n<span style=\"font-weight: 400;\">In 2021, </span><a href=\"https://cramsurvey.org/wp-content/uploads/2021/07/11.-Shepherd-D-_-Mohohlwane-N.-2021.-Changes-in-education-A-reflection-on-COVID-19-effects-over-a-year.pdf\"><span style=\"font-weight: 400;\">an update</span></a><span style=\"font-weight: 400;\"> of the earlier National Income Dynamics Study showed that, compared with 2018, </span><a href=\"https://cramsurvey.org/wp-content/uploads/2021/07/11.-Shepherd-D-_-Mohohlwane-N.-2021.-Changes-in-education-A-reflection-on-COVID-19-effects-over-a-year.pdf\"><span style=\"font-weight: 400;\">triple the number of students</span></a><span style=\"font-weight: 400;\"> between the ages of seven and 17 were no longer in school.</span>\r\n\r\n<span style=\"font-weight: 400;\">And although it doesn’t specify how teen pregnancies have been affected, a report by </span><a href=\"https://www.samrc.ac.za/sites/default/files/attachments/2021-07-27/HERStory2%20Process%20Evaluation%20Report%20Overview.pdf\"><span style=\"font-weight: 400;\">the South African Medical Research Council</span></a><span style=\"font-weight: 400;\"> noted that teenage girls struggled to access contraceptives during Covid-19 lockdowns, which, they say, could be part of the reason for the rise in teen pregnancies during the first year of the pandemic. </span>\r\n\r\n<span style=\"font-weight: 400;\">That’s a pattern seen at Matsukubyane Secondary School, which Moolikwe attends. </span>\r\n\r\n<span style=\"font-weight: 400;\">Tinyiko Rakobela of the HIV prevention organisation </span><a href=\"https://showmeyournumber.org.za/about-us/\"><span style=\"font-weight: 400;\">Show Me Your Number</span></a><span style=\"font-weight: 400;\"> has been working with pupils at Matsukubyane since 2019. In the past year there have been 16 pregnancies at the school (the school has 1,018 pupils) – a definite spike since pupils started returning after lockdown. Typically, the school saw only one or two pregnancies a year, she says.</span>\r\n\r\n<span style=\"font-weight: 400;\">“During Covid, kids were at home most of the day, so they had lots of free time and little supervision,” explains Rakobela.</span>\r\n\r\n<span style=\"font-weight: 400;\">Rakobela says their organisation helps with clinic referrals, offers financial assistance and creates a space for young moms when they need to talk. She helps to answer questions about their relationships and sex, what type of protection to use, where to get contraceptives and how giving consent to sex works.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe says: “Without the support of my friends at school and my family, I’m not sure I would have stayed in school.”</span>\r\n\r\n<span style=\"font-weight: 400;\">She speaks to Rakobela about her relationship with her boyfriend or problems at home, but she also relies on the network of teen mothers at the school.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe says: “We can support each other. The others will always come to me and ask me about what kind of things they should be doing when their child is crying.”</span>\r\n<h2>Parental guidance advised</h2>\r\n<span style=\"font-weight: 400;\">When Moolikwe gets home from school, she is greeted by her mom, who takes care of her son. He’s across the street spending the afternoon with his father and paternal grandparents.</span>\r\n\r\n<span style=\"font-weight: 400;\">When he returns, he heads straight for the floral couch and his grandma immediately pulls him onto her lap.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe is preparing to apply to university and is doubling down on studying. </span>\r\n\r\n<span style=\"font-weight: 400;\">Her biggest help? Her mom.</span>\r\n\r\n<span style=\"font-weight: 400;\">“My parents insisted that they would look after the baby so that I could finish school,” she says. “Dropping out was not an option.”</span>\r\n\r\n<span style=\"font-weight: 400;\">But many girls don’t have a good support system.</span>\r\n\r\n<span style=\"font-weight: 400;\">Even though the </span><a href=\"https://www.justice.gov.za/legislation/constitution/SAConstitution-web-eng-02.pdf\"><span style=\"font-weight: 400;\">law</span></a><span style=\"font-weight: 400;\"> protects girls’ right to remain in school while pregnant and after giving birth, schools are not obliged to go to extra lengths to make that happen. </span>\r\n\r\n<span style=\"font-weight: 400;\">A </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">2013 report</span></a><span style=\"font-weight: 400;\"> for Partners in Sexual Health, an NGO focused on sexual and reproductive rights, outlines how implementing policies meant to protect girls is “filtered through people’s own views on teenage sexuality, and beliefs about ‘appropriate girls and boys norms’ – and this has led to many violations of these policies”.</span>\r\n\r\n<span style=\"font-weight: 400;\">So, although girls are not being expelled outright, the culture of stigma around sex and pressure to hide the pregnancy </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">force many to drop out</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">And it’s not only school staff who have to come around. </span>\r\n\r\n<span style=\"font-weight: 400;\">Says Moolikwe: “I thought that in school children will not judge each other. I thought they’ll just know that we can fall pregnant. But every time when there’s a girl who’s pregnant, they judge her – and most of the time it’s the girls. Sometimes I tell them that you may be judging her today, but tomorrow it could be you.”</span>\r\n\r\n<span style=\"font-weight: 400;\">That’s why creating a culture of support, at home and in schools, is an important part of helping young girls stay in class. Parents can be an important link in this system, says Réjane Woodroffe, director of the </span><a href=\"https://bulungulaincubator.org/\"><span style=\"font-weight: 400;\">Bulungula Incubator</span></a><span style=\"font-weight: 400;\">, an NGO that works to improve living conditions in the rural Eastern Cape. </span>\r\n\r\n<span style=\"font-weight: 400;\">Part of their strategy is having zero tolerance for dropping out – not just specific to teen pregnancies – and helping pupils to return to school.</span>\r\n\r\n<span style=\"font-weight: 400;\">Girls who have the backing of their mothers are more likely both to </span><a href=\"https://www.gov.za/sites/default/files/gcis_document/201409/dobeteenagepregnancyreport.pdf\"><span style=\"font-weight: 400;\">return to school and to complete their studies</span></a><span style=\"font-weight: 400;\">. Having a parent at home can also help </span><a href=\"https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01300-w\"><span style=\"font-weight: 400;\">relieve the pressure</span></a><span style=\"font-weight: 400;\"> on the teen mother, who has to </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">study while looking after the baby</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe explains: “I’m not the one who raised my child. He was raised by my parents… Sometimes my parents will tell me, ‘This is not your child; this is our last born. So you don’t have to stress yourself’.”</span>\r\n<h2>It’s cool to stay in school</h2>\r\n<span style=\"font-weight: 400;\">During the past few months of her pregnancy, Moolikwe’s world began to narrow down to her home. As her due date drew closer, she wasn’t able to attend class in person. </span>\r\n\r\n<span style=\"font-weight: 400;\">A </span><a href=\"https://zerodropout.co.za/wp-content/uploads/2022/01/ZERO-DROPOUT-PUBLICATION-2021_GenderMatters_digital.pdf\"><span style=\"font-weight: 400;\">2021 report from the Zero Dropout campaign</span></a><span style=\"font-weight: 400;\"> explains that pregnancy can interfere with a teenage girl’s education even before the baby is born. Young women are more likely to miss school during the pregnancy, because they have to take time off both before and after giving birth and need regular clinic check-ups. </span>\r\n\r\n<span style=\"font-weight: 400;\">The more a pupil misses school, the </span><a href=\"https://www.hst.org.za/publications/NonHST%20Publications/Teenage%20Pregnancy%20in%20South%20Africa%20Final%2010%20May%202013.pdf\"><span style=\"font-weight: 400;\">harder it becomes to continue</span></a><span style=\"font-weight: 400;\"> studying and catch up. A </span><a href=\"https://sites.bu.edu/mvkarra/files/2020/11/Karra_Lee_2012_Human-Capital-Consequences-of-Teenage-Childbearing-in-South-Africa.pdf\"><span style=\"font-weight: 400;\">2012 study</span></a><span style=\"font-weight: 400;\"> from Cape Town found that teen moms were likely to lag behind their non-pregnant peers by more than half a year.</span>\r\n\r\n<span style=\"font-weight: 400;\">To undo this pattern “you have to support the school as well as the young women”, says Woodroffe.</span>\r\n\r\n[caption id=\"attachment_1229992\" align=\"alignnone\" width=\"720\"]<img class=\"size-full wp-image-1229992\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2022/04/Bhek-NW_1.jpg\" alt=\"\" width=\"720\" height=\"433\" /> A study in the 'South African Medical Journal' showed that nationally the number of births to girls between 10 and 14 years old had increased by close to 50% between 2017 and 2021. For those between 15 and 19 years, births increased by about 18%. (Photo: Media24 / Gallo Images)[/caption]\r\n\r\n<span style=\"font-weight: 400;\">Rather than just introducing a policy that says girls must be allowed to remain in school while pregnant, training should be available to teachers and staff to help them get on board with this decision, she explains.</span>\r\n\r\n<span style=\"font-weight: 400;\">Woodroffe says some teachers are worried that by accommodating expecting mothers “you’re encouraging young women to fall pregnant while still in school and that this sends a negative message to other learners”. </span>\r\n\r\n<span style=\"font-weight: 400;\">Schools also need support in handling potential emergencies and health problems pregnant pupils face. For example, if a student were to give birth at school, there should be a plan for getting her to a healthcare facility and keeping her safe.</span>\r\n\r\n<span style=\"font-weight: 400;\">But these strategies can’t be left just to the school – it should be a team effort between the school, the pupil and her family, Woofroffe says.</span>\r\n\r\n<span style=\"font-weight: 400;\">During the later stages of school pregnancies, the Incubator has family members accompany girls all day in case they go into labour – specifically because there are no hospitals close to the rural school the Incubator runs or an ambulance service in the area.</span>\r\n\r\n<span style=\"font-weight: 400;\">“But it does place a burden on the girl’s family, as they have to sacrifice their time to be with her,” says Woodroffe.</span>\r\n\r\n<span style=\"font-weight: 400;\">Woodroffe and her team try to keep teen moms in class for as long as possible, because studying at home isn’t always possible. In the part of the Eastern Cape where she works (the Elliotdale district), online study “isn’t really an option”.</span>\r\n\r\n<span style=\"font-weight: 400;\">“We don’t even have electricity. You have to find a way to charge the device and even if a learner has a cellphone, there isn’t a signal everywhere.”</span>\r\n\r\n<span style=\"font-weight: 400;\">Ultimately, Woodroffe realised that distance learning was possible only if it could be done with textbooks and worksheets.</span>\r\n\r\n<span style=\"font-weight: 400;\">Moolikwe’s school took a similar approach. “After school, my friend used to bring me books and assignments,” she says. “My mother used to take me to school so I could write my exams and then bring me back home afterwards.”</span>\r\n\r\n<span style=\"font-weight: 400;\">This support and hands-on help from her teachers allowed Moolikwe to stay on top of her classwork.</span>\r\n\r\n<span style=\"font-weight: 400;\">She was considering taking a gap year after matriculating. But her father put his foot down.</span>\r\n\r\n<span style=\"font-weight: 400;\">She smiles: “He said no child of his will take a gap year, ‘you’re going to varsity’.” </span><b>DM/MC</b>\r\n\r\n<i><span style=\"font-weight: 400;\">This story was produced by the</span></i><a href=\"http://bhekisisa.org./\"> <i><span style=\"font-weight: 400;\">Bhekisisa Centre for Health Journalism</span></i></a><i><span style=\"font-weight: 400;\">. Sign up for the</span></i><a href=\"http://bit.ly/BhekisisaSubscribe\"> <i><span style=\"font-weight: 400;\">newsletter</span></i></a><i><span style=\"font-weight: 400;\">.</span></i>\r\n\r\n<img src=\"https://syndicate.app/st.php\" />\r\n\r\n<script async=\"true\" src=\"https://syndicate.app/st.js\" type=\"text/javascript\"></script>\r\n\r\n \r\n\r\n[hearken id=\"daily-maverick/9317\"]",
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"summary": "Otlotleng Moolikwe fell pregnant after having sex with her boyfriend when she was 13 years old. And she’s not the only one. One in six South African teenagers between 15 and 19 years old have had a child. This article explores interventions that help them stay in school.",
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