Key Social Norms Take-aways Motherhood under age 15 in Uganda is constructed as a violation of moral and social norms—“crossing the line”—through intertwined religious and cultural discourses that stigmatize young mothers and regulate their sexuality. These norms shape not only community attitudes but also policies and service provision, resulting in restricted access to sexual and reproductive health (SRH) services. Critically, the study shows that stigma, moral judgment, and “social age” (rather than chronological age alone) determine whether young mothers are seen as deserving of care, highlighting how norms actively produce inequities in health access.

Objectives The study aims to explore how motherhood under 15 years is socially constructed in an urban poor community in Kampala, Uganda, and to examine how these constructions influence access to and utilization of SRH services among very young mothers.

Methods The study uses a qualitative collaborative ethnography design, engaging young mothers as peer researchers. Data were collected through life histories, ethnographic conversations, and focus group discussions with young mothers, caregivers, and community leaders. Data were audio-recorded, transcribed, translated, and thematically analyzed, with a focus on discourse and governmentality frameworks to understand how norms shape behavior and service access.

Results Findings show that young mothers under 15 experience intense stigma, being labeled immoral, “too young,” or even compared to “wolves,” which reflects social exclusion and family shame. Cultural norms position premarital motherhood as non-normative, while religious beliefs frame it as sinful, reinforcing restrictive attitudes toward SRH services such as contraception and abortion. These discourses influence policies, provider behaviors, and family responses, often leading to denial of services, coercion in decision-making (e.g., forced marriage or abortion), and avoidance of care due to fear of judgment. Even when services exist, stigma, cost, and provider attitudes limit access, and young mothers’ voices are often dismissed due to assumptions about their age and capacity.

Conclusions The study concludes that dominant religious and cultural norms construct motherhood under 15 as morally deviant, and these constructions are institutionalized through policies and practices that restrict SRH access. Addressing the needs of very young mothers requires a paradigm shift toward rights-based, equity-driven SRH approaches that recognize the structural drivers of adolescent pregnancy and challenge stigmatizing norms that currently govern service provision and social support.