Births driven by statutory rape in South Africa: an analysis of birth records 2003–2023

South Africa continues to grapple with high rates of adolescent pregnancies, many of which stem from exploitative sexual relationships where there are significant differences that relate to age, power, and socio-economic status. The study aims to estimate the distribution and prevalence of statutory rape and to examine the spatial clustering patterns at the district level of statutory rape in South Africa. The study uses descriptive statistics and the Pearson Chi-Square Test of Independence to assess differences in the prevalence of statutory rape. To explore spatial patterns, Global Moran’s I was applied to test for spatial autocorrelation, and Local Moran’s I was used to identify hotspots of statutory rape. Of 7,058,458 recorded births, 21,396 recorded births over the past two decades were identified as statutory rape driven births. Highest levels of statutory rape driven births were in Mpumalanga (0.6%, p < 0.001), KwaZulu-Natal (0.5%) and Limpopo (0.4%). Participants with births classified as statutory rape driven birth were significantly more likely to have delayed child’s birth registration (1.8%, p < 0.001). The global Moran’s I indicated a strong and statistically significant spatial clustering (p < 0.0001). A high-high cluster was observed in northern KwaZulu-Natal, while low-low clusters spanned across Gauteng and Limpopo. These findings highlight the urgent need for policies that strengthen enforcement of statutory rape laws and ensure clearer protocols for identifying and responding to such cases within health and civil registration systems. Thus, the study calls for integrated data systems across key departments, improved mandatory reporting, and encourages community programmes that respect local cultures.