Exploring young women’s reproductive decision-making, agency and social norms in South African informal settlements
Outcomes: Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways This study highlights that focusing solely on individual agency overlooks the powerful role of social norms — particularly the expectation that young women should prove their fertility early. Programs aiming to reduce early, unplanned pregnancies must challenge these community and family pressures, while also supporting women’s increasing desire for reproductive control as they mature. Tailoring interventions to life stages and social realities is essential to improving reproductive health outcomes.
Objectives This study explored how young women living in South African informal settlements make reproductive decisions, examining the roles of personal agency and social norms, particularly regarding early motherhood, contraceptive use, and fertility control.
Methods Researchers conducted a qualitative case study involving 15 young women aged 18–30, using in-depth semi-structured interviews, participant observation, and photovoice over an 18-month period. Data were analyzed inductively to identify themes related to reproductive decision-making, contraceptive use, and the influence of social pressures.
Intervention Details Participants were part of the broader “Stepping Stones and Creating Futures” intervention — a randomized controlled trial aimed at reducing intimate partner violence and HIV risk, though this paper focused only on the qualitative research arm exploring reproductive decision-making.
Results The study found that most young women did not actively plan or think about pregnancy during their teenage years, with social norms encouraging early motherhood and proving fertility. As they grew older or after having a first child, some women began asserting more reproductive agency, seeking to delay further pregnancies. However, even when they desired to prevent conception, barriers such as inconsistent contraceptive use, misinformation, limited healthcare access, and partner dynamics often undermined their efforts. Importantly, many young women accepted pregnancies passively, with decisions often shaped by broader family, partner, and community expectations.
Conclusions Social norms heavily shape young women’s reproductive behaviors early in life, while personal agency becomes more influential as they age or after their first birth. Effective reproductive health interventions must recognize these shifting influences, addressing both social expectations and individual empowerment across women’s life stages.
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