IT is not HIV, sexually transmitted diseases or babies that scare them most. Pregnant teenagers who are willing to talk about it, say it is their angry mothers they fear above all else.
"Most of the teenagers we see get rejected everywhere they go. Their parents, their school, the clinic sisters – nobody wants to help them.
"We try to break the cycle,” said Margreet Wibbelink, a registered midwife and sister at the Healthy Mom and Baby clinic in Jeffreys Bay.
It is a Wednesday afternoon and time for community worker Thandi Plaatjie’s teenage pregnancy support group at the clinic.
Here she tries to teach girls responsibility and accountability and help them deal with arguably the biggest crisis of their short lives.
"My mom chased me away. Maybe when I have had the baby I can go home and go back to school,” a 16-year-old says during a group session at the clinic.
"I just cannot talk about it yet. My parents were so hurt,” says another, reaching for the tissues.
A 17-year-old orphan who was chased away by her guardian when she became pregnant says: "At least now I have a baby, which means I have someone to love. He is my whole life now.”
None of the teenagers in the group consistently used contraceptives. "Now we use them,” two girls said. Only one of the 10 admitted to having had an HIV test beforehand.
"The day we first had sex, it just happened,” a 16-year-old added. "We did not plan it.”
"Girls have sex for money. We are teaching our daughters to be prostitutes. They are doing it for shoes and for airtime,” Jean Downey, the director of New Life Crisis Pregnancy Centre in Uitenhage, said.
"We see girls who have been raped and when we talk to them they are astonished when we tell them that they can say no.
"When we tell the girls they can say no, it is your body, boys cannot demand sex from you, it is not a prerequisite to love, they are completely surprised and almost shocked.
"This makes us wonder: are they brought up believing that they are nothing but toys to be played with? Most rapes are not even reported,” Downey said.
She echoed others’ concerns over "sugar-daddy syndrome”, saying they often saw girls aged 13 or 14 with men in their 20s and 30s.
Plaatjie said most of their young teenagers, aged around 13, fell pregnant because of coercive sex. "We do not promote abortion, but we tell them to come back if they have one, so that we can talk about it.
"One of my patients is 13 years old and pregnant. Her mother brought her here for contraceptives. Then we found out that she was already pregnant. She had sex with a man for airtime and again for hair relaxant.”
Downey is part of a team which goes to schools and talks to teenagers about pregnancy.
"We do not only talk about sex. We talk about values. We try to explain what it means – respecting and loving yourself, choices to have sex and the consequences.
"Parents today seem to tell their children that it is okay to live a promiscuous lifestyle and that it is in order to do whatever you want.
"Instead we try to talk about sexual integrity – something everybody should practice. We explain that sexual wholeness and purity is about loving and respecting yourself.”
Plaatjie said it was often difficult to get through to teens. "They are not even scared of HIV. They will look me in the eye and say: ‘I don’t mind about that. I can live with that’. They are more afraid of disappointing their parents. They do not believe that they will get HIV.”
Downey said her team believed the boyfriend and his family needed to be involved.
"He must also be made accountable for the pregnancy, as much as she, because her whole life changes. There is no accountability or responsibility when it comes to the boys,” Downey said.
"These boys do not go to school anymore. They sit around, they get bored. They have sex and make babies. I ask them for their CVs and send them to get a job. We show them love first and then they start to love their kids,” Plaatjie said.
She said they often saw pregnant teenagers as young as 13 at the clinic. "We have seen about six in the past four months from the primary school. We see many more from high school. Having sex is a peer pressure thing. It is almost like a fashion trend at the moment. They talk about babies like shoes.
"‘My friend has a child’, they will tell me. ‘I also want one’.”
Plaatjie said lack of access to contraception was not the cause of teenage pregnancy.
"There is no problem with access to contraceptives. These girls are clued up. They are just curious and then end up with the consequences of a stupid decision.”
She said even when the teenagers gave birth, the biggest challenge was to get them to bond with their babies.
She does not change nappies or give bottles during her support group sessions. Instead she is very quick to point out to teenage mothers that their child needs to be attended to, and then she makes sure that they do.
"Teenagers battle to connect with the baby after birth. Very often their mother or granny will take over.
"Lots of the pregnant teenagers become dropouts,” says Wibbelink.
"Many teenagers never go back to school once they get pregnant. We try to get them back on track. We look at the person and teach them to choose life for themselves.”