Teenagers want sex education and access to contraceptives. The government agrees in principle—but progress is slow, and teenage pregnancy is rising. As a midwife, I often see very young girls admitted to the maternity ward for childbirth or abortion care. One recent case shook me deeply: a 9-year-old nearly died from childbirth complications in a semi-urban Rwandan hospital. Teen pregnancy is rising across the country, affecting girls as young as 12 and 13—and I am worried. The causes are many: inadequate sexual education, limited access to adolescent sexual health services, poverty, sexual violence, and conservative views on sex. But the truth is clear—teenagers in Rwanda are becoming sexually active at young ages, and many are left without the tools or support to protect themselves. Pregnancy at a young age has devastating consequences. Girls under 16 are far more likely to face complications during childbirth or even die. Each teen pregnancy costs the healthcare system around $3,200. Many of these girls drop out of school, and teenage motherhood often leads to lifelong poverty and poor health outcomes—for both mothers and their children. In contrast, preventing teen pregnancies could save Rwanda an estimated $72 million annually. When girls are educated and empowered to choose when to become mothers, everyone benefits. The Rwandan government has acknowledged the issue. A legal amendment now allows teenagers to access contraception without parental consent. But policy change is not enough—implementation is lagging, and teen pregnancies continue to rise. One major study on sexual behavior among Rwandan youth revealed that 28 percent of 15-year-old girls had already had sexual intercourse. Of the 1,320 participants who shared their age of first sexual activity, over half said it occurred by age 12. Meanwhile, adolescent pregnancies rose from 19,701 in 2021 to 22,454 in 2024, according to the Ministry of Gender and Family Promotion. Traditional efforts to enforce abstinence and suppress sexual education are not working. We need to face the reality: young people are sexually active, and they need access to accurate information, contraceptives, and judgment-free health services. I’ve seen the hunger for change firsthand. I recently organized discussions around Rwanda with young people, educators, church leaders, media figures, and government officials. The message was loud and clear: young people want safe, private, and friendly spaces to access contraceptives and sexual health advice. They also want schools, families, and communities to engage in open, non-judgmental conversations about sexual and reproductive health. We must follow the legal progress with real action: youth-friendly, school-based centers that offer access to contraception, emergency care, STI testing, mental health support, counseling, and menstrual hygiene—free or at very low cost. These services should also include legal support and safe, respectful abortion and post-abortion care. I understand that some parents, church leaders, and community members fear that educating young people about sex will lead to promiscuity. But in my experience, the opposite is true: the more teenagers understand about sex, the more likely they are to make safe, responsible choices. I am calling for a national coalition of young people, parents, educators, health workers, community leaders, media voices, and government officials to deliver a comprehensive, coordinated response. This must include: Comprehensive Sexual and Reproductive Health Education: Age-appropriate, evidence-based education in schools and communities. Access to Contraceptives: Confidential, affordable access in friendly, non-judgmental spaces. Support for Teen Parents: Social and economic support to help them continue school and build a future. Community Engagement: Building broad understanding and support through open dialogue. If we fail to act, the cycle of teen pregnancy, poor health, and poverty will continue to harm future generations—and cost us all. But imagine a Rwanda where tens of thousands of girls can finish school, grow into confident adults, and become mothers only when they are truly ready. That future is within reach—if we choose to make it real, together. The writer is a midwife and is the health services coordinator at the University for Global Health Equity (UGHE) and Aspen Advanced Advocacy Fellow Class 2025.
