At 16, Pulane Mothebesoane was too afraid to attend antenatal clinic sessions after falling pregnant—fearing that nurses in Mokhotlong district would judge and interrogate her for becoming pregnant as a teenager. Her experience reflects the daily struggles faced by many pregnant adolescents across Lesotho.

4 August 2025 by Limpho Sello

Est. Read Time: 6m

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“I was too scared to go to the clinic,” Pulane Mothebesoane said in a voice just above a whisper.

At 18, Mothebesoane’s story is a single voice in the wider crisis of teenage pregnancy in Mokhotlong district.

In this mountainous district, at least 21 in every 100 adolescents become pregnant — four percent higher than Lesotho’s national average. Pulane delayed going to the clinic until she was six months pregnant, held back by fear and shame.

“I thought nurses would question why I was pregnant at such a young age. I felt ashamed carrying that blue pregnancy booklet,” she said.

Her story mirrors the reality faced by many pregnant teenagers across the country — girls afraid of motherhood and the judgment that often comes with seeking care.

“I didn’t go to my first antenatal appointment until six or seven months,” she said quietly.

Compounding Mothebesoane’s experience is the long distance to health facilities, which most residents must reach on foot.

“We have one hospital and a few clinics scattered across the mountains,” Mokhotlong District Medical Officer Dr. Mosa Tlahali said, adding “Some people walk two hours or more to reach care.”

For young mothers like Mothebesoane, these walks often feel like a walk of shame — a public parade of their pregnancies, exposed to the judgmental eyes of passersby and curious neighbours in surrounding villages.

Dr. Tlahali spoke about these very challenges — both geographical and social — when she opened the 2025 World Population Day event on July 11. The event was jointly organised by the Ministry of Health and the United Nations Population Fund (UNFPA).

Shifting focus on young people

In Mokhotlong, official statistics indicate that the population modestly exceeds 100, 000 people. 65 percent of that population are youth under the age of 25. Having 65 in every 100 people young people under the age of 25 has forced the district medical office to strengthen its focus on young people.

“We have a high fertility rate here, the highest in the country, and 21 percent of our youth become pregnant early—higher than the national average of 17 percent. Many pregnancies are unplanned, and this impacts maternal health and education,” Dr Tlahali said.

She added that violence compounds these challenges. “Forty percent of those surveyed reported abuse in the past year, compared to 25 percent nationally.”

Dr. Tlahali further explained that the emotional trauma associated with early pregnancy often leads to school dropouts, early marriages, and delays in seeking antenatal care — as many girls hide their pregnancies out of fear and shame.

For Mothebesoane, that fear came at the cost of her education. “I was studying at a vocational school, but I had to drop out. Having a child changed everything. I was angry with myself and felt like a burden on my parents. But I have accepted it, and now I want to work to support myself,” she said.

She also spoke candidly about the pressure she faced to marry young — pressure driven by stigma surrounding early and unintended pregnancy. “I want to get a job and earn an income before I think about marriage or starting a family,” she added.

In an effort to equip young people with the skills to navigate challenges like teenage pregnancy and intergenerational relationships, UNFPA organised a three-day training in Mokhotlong ahead of the July 11, 2025, World Population Day. Mothebesoane was among the young people who participated in and benefitted from the training from July 8-10, 2025.

“I learned from our three days training here at Mokhotlong High School on Comprehensive Sexuality Education that we must say no to unprotected sex and avoid relationships with older men because we do not know their health status. It’s hard to ask them to use a condom because they are older, and sometimes we feel powerless.”

UNFPA National Programs Analyst, Maseretse Ratia, explained that: “We held a three-day training for 30 adolescents before World Population Day, focusing on comprehensive sexuality education. We taught them about healthy habits, contraception, emergency contraceptives, and how to recognise and report sexual violence.”

Ratia stressed the importance of youth understanding their rights. “Some girls are forced into marriage after rape and end up raising children they did not want at that time. We encourage them to seek birth control services at local facilities free of charge.”

Addressing attendees at the World Population Day, UNFPA Country Representative Innocent Modisaotsile highlighted two reports launched alongside the event: the State of World Population Report 2025, titled The Real Fertility Crisis: The Pursuit of Reproductive Agency in a Changing World. This report shifts the focus from declining birth rates to the right to choice and dignity. Another report, Turning Points: Stories of Young Lives Interrupted by Early Parenthood and Marriage, features girls as young as 12 whose childhoods have been cut short by early marriage and their fundamental right to choose their partners and their timing of their families.

“Lesotho continues to bear a heavy burden from HIV, which disproportionately affects adolescents and young women,” Modisaotsile said. 

He added: “This epidemic worsens existing inequalities, impacting health, economic prospects, and well-being. Addressing it requires prevention, treatment, and tackling the social drivers of vulnerability.”

As a response to challenges faced by the Mokhotlong youth and the entire country, Minister of Environment, Letsema Adontši, detailed government efforts to support youth.

“We are strengthening access to education through free school meals and free primary education,” he said, adding “in partnership with UNFPA and others, youth-friendly services have been established, including youth corners in hospitals such as here in Mokhotlong.”

In an interview with Uncensored News, the Mokhotlong District Medical Officer, Dr. Mosa Tlahali, argued that previously, adolescents and young people were reluctant to visit health facilities for sexual and reproductive health (SRH) services and information.

He indicated that many pregnant girls did not attend antenatal care (ANC), and there was no platform to engage with young people and understand the issues leading to school dropouts and other challenges.

He said adolescent corners have proven to be very helpful in addressing these gaps:

“Adolescent corners help young people overcome the fear of being seen by family members at health facilities. Our adolescent corner is fortunately located outside the hospital premises, which gives them the freedom to seek services more comfortably.”

He added that they are now beginning to see a decline in adolescent pregnancies, even though the rates remain high.

“The rate has started to stabilise; it’s no longer increasing sharply. I believe this is largely due to the presence of adolescent corners. Besides that, our youth are also becoming wiser now.”

Meanwhile, Minister Adontši highlighted the Dual Learning Model, which combines classroom education with practical workplace experience, empowering youth with skills for the job market.

“The government of Lesotho is not standing still; we have taken swift action to empower young people and support them in all their endeavors.”

As the event closed, Pulane remained a symbol of the urgent need for change. “I didn’t speak today just for me,” she said softly, cradling her child. “I spoke for every girl who has been silenced.”