Exploring the lived experiences of adolescent mothers and the factors affecting their access to antenatal care services in Rwanda

Background Teenage pregnancy remains a significant health challenge globally, with adolescents facing increased risks of complications during pregnancy and childbirth. In Rwanda, despite efforts to improve maternal health services, adolescent mothers continue to experience barriers to accessing antenatal care (ANC) services. Social stigma, cultural norms, and limited awareness contribute to delayed or missed visits. This study aimed to explore the ANC experiences of adolescent mothers in Burera District and propose solutions to mitigate barriers hindering their access to ANC services. Methods This qualitative, phenomenological study was conducted at two health centers, Rwerere and Kinyababa. Data were collected through in-depth interviews (IDIs) with adolescent mothers from Rwerere and Kinyababa sectors, selected via purposive and snowball sampling. The study compared participants enrolled and not enrolled in the Adolescent Sexual Reproductive Health (ASRH) program. IDIs, lasting approximately 40 minutes, were recorded and transcribed for thematic analysis with the aid of Dedoose software to identify key themes related to the barriers hindering access to ANC services. Results The study revealed several key barriers hindering adolescent mothers' access to ANC services in Burera District. Social stigma and judgmental attitudes from community and healthcare providers was a significant factor discouraging many teen mothers from seeking timely ANC services. Cultural norms and misconceptions about pregnancy care further exacerbated the issue, with some adolescents delaying ANC visits due to a lack of understanding of their importance. Additionally, logistical challenges, including long distances to health facilities and financial constraints, were frequently reported. Despite these challenges, participants highlighted the supportive role of peer educators and community health workers in encouraging ANC attendance, suggesting their potential as critical agents in mitigating barriers. Conclusion The study revealed that adolescent mothers face multiple interconnected barriers including limited knowledge about ANC services, fear of judgment, and practical challenges like transportation costs and long wait times. While healthcare providers were generally supportive, the current ANC service model requires adaptation. Integrating mental health screening into ANC services, revising the community-based health insurance system to accommodate adolescent mothers, and providing specialized training for healthcare providers will improve ANC service accessibility for teen mothers in Rwanda.