‘I Was Still a Child, but They Called Me a Mother’: Family, Culture and Psychological Wellbeing among Adolescent Mothers in Rural Pakistan

INTRODUCTION: Adolescent motherhood remains common in rural Pakistan, yet research has focused on obstetric and neonatal outcomes, leaving adolescent mothers' experiences within family and cultural contexts underexplored. Understanding these experiences is important because family relationships and social expectations shape psychological wellbeing and can inform family-sensitive nursing care. We explored how adolescent mothers experienced motherhood in Pakistan. METHODS: We used interviews, observations and artefact-based conversations in this ethnographic study with 25 mothers who experienced pregnancy between the ages of 15 and 19. Reflexive thematic analysis was used, with intersectionality as an interpretive lens after theme development. RESULTS: Three themes were identified: (a) marriage without choice and obligatory motherhood; (b) intergenerational advice on pregnancy and maternal practices; and (c) belonging within moral and material hierarchies shaped by age, child sex, caregiving and sacrifice. DISCUSSION: Findings show household authority, culture, child sex and hardship shaped psychological wellbeing and can guide culturally responsive, family-sensitive nursing support.