Key Social Norms Take-aways The study emphasizes the need for gender-transformative approaches that do more than expand services—they must reshape the social and cultural context. Effective interventions should empower girls with knowledge and decision-making confidence, engage male partners and families as supportive allies, train healthcare providers to reduce stigma and bias, and implement whole-community initiatives to challenge harmful beliefs around adolescent sexuality, fertility, and abortion. Only by addressing the intersection of gender, stigma, and power can adolescent SRH outcomes and gender equality meaningfully improve in Mozambique.

Objectives This study investigates how gender norms shape adolescent girls’ and young women’s experiences with pregnancy and abortion in Mozambique, particularly following the country’s recent abortion law reforms. It aims to understand how cultural expectations, social stigma, misinformation, and gendered power relations influence young women’s knowledge, attitudes, practices, decision-making, and access to sexual and reproductive health (SRH) services.

Methods Using an exploratory qualitative approach, the research team conducted 19 triad interviews with adolescent girls and young women, 19 focus group discussions with male and female adult community members, and 15 in-depth interviews with young women who had experienced induced abortion. Participatory tools such as fictional narratives and community resource mapping were employed to facilitate open discussion of sensitive topics. Data were analyzed using the RinGs gender analysis framework, focusing on access to resources, cultural beliefs, roles and responsibilities, and power dynamics.

Results The study found that deeply entrenched gender norms significantly constrain young women’s reproductive autonomy. While motherhood and fertility are highly valued, premarital pregnancy is harshly stigmatized. Many girls lack accurate contraceptive knowledge or autonomy, facing male partner refusal, family opposition, and community judgment. For those who become pregnant, consequences can include abandonment, forced marriage, family expulsion, school dropout, and sometimes violence. Although abortion is legally permitted, abortion stigma, misinformation about legality and safety, and health provider bias lead many girls to seek unsafe or clandestine abortions. Decision-making is rarely in girls’ hands; male partners and family members often control whether pregnancies continue or end, with girls’ preferences frequently overridden by others’ expectations or demands.

Conclusions Legal reforms alone are insufficient to ensure safe, equitable access to abortion and SRH services for adolescents. Without addressing the underlying social and gender norms, girls and young women remain vulnerable to unsafe abortion practices, harmful social consequences, and constrained reproductive choices.