Stress from pregnancy disclosure and its impact on teen mothers’ identity in Rwanda: a qualitative study

Teen motherhood is often accompanied by a range of emotional and psychological challenges, which are further intensified by social and familial responses. Understanding these experiences is critical for developing effective support mechanisms. This study aimed to explore the multifaceted experiences of teen mothers, from pregnancy disclosure through early motherhood, with a focus on their emotional and behavioral reactions, the sources of stress, and the impact of stress on identity development. Twenty-seven semi-structured qualitative interviews were conducted with teen mothers selected from Burera district. The interviews were transcribed and analyzed using thematic analysis within Nvivo 14 software to identify key themes and subthemes. Five interrelated themes described how stress arising from pregnancy disclosure shaped teen mothers’ subsequent experiences and identity. First, reactions of teen mothers captured intense emotional responses to pregnancy and early motherhood, including disappointment, sadness, fear of physical changes, shame, loss of self-esteem, and isolation. Second, the relationship between reactions and stress showed that emotional distress translated into behavioral responses such as refusal of food, suicidal ideation, insomnia, as well as working hard to counteract societal stigma. Third, sources of stress sources included a lack of social and family support, economic difficulties, and emotional challenges. Fourth, the influence of stress on identity development was reflected in identity conflicts and persistent emotional disturbances. Fifth, preventive measures highlighted the perceived importance of counselling and psychoeducation, social and economic support, and community education to reduce stigma and support positive identity development. The study underscores the complex challenges faced by teen mothers and the critical need for comprehensive support systems to mitigate stress and promote positive identity development. Culturally relevant mental health interventions, along with ensuring access to healthcare, education, and financial assistance, are vital for improving the well-being of teen mothers and their children, while also addressing societal stigma and maladaptive coping strategies.