Where shame meets vulnerability: unintended adolescent pregnancy within the cultural context of the rural district of Rwandan Eastern Province

Unintended pregnancy has been a longstanding public health, social, and political issue in Rwanda, with a significant impact on the perinatal and maternal health outcomes of childbearing women, especially in the case of adolescents. Although studies have been conducted in Rwanda to address the issue of unintended pregnancies among adolescent girls, the sociocultural factors that contribute to the complexity of the risks have not been explored. Thus, this study aimed to understand the cultural and personal meanings of unintended adolescent pregnancy in the Rwandan context and examine the contextual factors that shape this issue from a multidimensional perspective. A critical ethnographical study was conducted in Rwanda framed by both critical and intersectionality theoretical lenses. By using purposive criteria and maximum variation sampling, a total of eight focus group discussions (FGDs) were conducted with 74 society members from the selected rural district of the Eastern Province of Rwanda, including adolescent mothers, parents of adolescents, men of varying ages, nurses, midwives, religious leaders, and staff members from non-government organizations (NGOs) that assist adolescent mothers. The data collected from FGDs were transcribed verbatim and translated into English, imported into Dedoose, and analyzed according to Braun and Clarke’s (2006) six steps for thematic analysis. The findings suggested that unintended adolescent pregnancy is associated with shame felt personally by young mothers, shame enacted interpersonally by family members, and societal cultural positioning of adolescent pregnancy as shameful. Additionally, the issue of adolescent pregnancies was associated with the broader sense of youth as deviant, the existence of poverty and vulnerability, exposing adolescents to trading sex for money, advancement, or opportunity, as well as violence and abuse. This critical ethnographic study sheds light on the complex cultural and personal meanings of unintended adolescent pregnancy in Rwanda, which goes beyond individual behaviors and involves social, cultural, and structural factors. Therefore, all efforts to prevent and address unintended adolescent pregnancy should incorporate the promotion of positive social norms and the reduction of stigma associated with it.