Teenage pregnancy remains a persistent phenomenon in North Macedonia, particularly in the context of low use of modern contraception and limited access to early, reliable, and trustworthy health services. Data from the State Statistical Office show that during 2024, mothers under the age of 15 gave birth to 12 children in North Macedonia. Meanwhile, according to UNICEF data, the adolescent birth rate declined to 13.4 births per 1,000 women aged 15–19 in 2023, down from 14 in 2022 and 16 in 2018. Despite this downward trend, the rate remains significantly higher than the European Union average and slightly above the average for the Western Balkans. According to the same data, urban areas account for 58.1 percent of these births.
The Head of the Sexual and Reproductive Health Program at the organization HERA, Olivera Stojkovska, told Mollëkuqja that teenage pregnancy in North Macedonia remains a serious problem, although some improvements have been observed in recent years. She noted that many of these pregnancies occur in silence, accompanied by feelings of shame and fear of judgment, which makes it more difficult for young people to seek timely support.
“Early pregnancy is most often the result of a combination of several factors, among which the lack of adequate educational programs in schools—such as comprehensive sexuality education—stands out. Young people often enter sexual relationships without sufficient knowledge about their bodies, methods of protection, and the consequences of unprotected sex, while information is frequently obtained from informal and often inaccurate sources. In addition, limited access to contraception—whether due to financial barriers or fear of stigmatization when seeking health services—significantly increases the risk of unplanned pregnancy. Social and economic conditions, such as poverty, low levels of education, and early school dropout, also play an important role, particularly for girls living in environments where gender roles are strictly defined and early motherhood is considered a ‘normal’ life path,” Stojkovska said.
According to her, the situation differs between urban and rural settings, as well as among different communities. In urban areas, young people generally have better access to information and services related to sexual and reproductive health, which contributes to the prevention of early pregnancies. In contrast, in rural areas and smaller settlements, services are limited or entirely absent, while topics related to sexuality remain taboo, increasing the risk of unplanned pregnancies.
“Moreover, there are significant differences among communities. In parts of the Roma community, for example, child marriages and early pregnancies are still present and are often linked to poverty, social exclusion, and early school dropout. In such circumstances, early pregnancy is not an isolated individual case, but rather part of a broader cycle of structural inequalities and limited life choices,” she added.
In addition to a lack of information, young people often face other barriers, including stigma related to sexual and reproductive health, which discourages them from seeking timely information or assistance. Fear of judgment by family members, health professionals, or the wider community often results in delays or complete avoidance of health services.
“Furthermore, the cost of contraception and the lack of free and confidential services represent a real barrier, particularly for young people from low-income families. Based on field experience, a major issue is also the lack of accurate and understandable information, as formal education provides little to no systematic and comprehensive knowledge on these topics. All of these barriers together create an environment in which young people are left to face the consequences of insufficient support on their own,” Stojkovska stated.
According to experts, early pregnancy has profound and long-term consequences for the education and overall well-being of young girls. In many cases, pregnancy leads to interruption or complete abandonment of the educational process, significantly reducing opportunities for further education and employment. This, in turn, increases the likelihood of economic dependence and lifelong poverty. In addition to educational consequences, early pregnancy carries heightened health risks for both the young mother and the child, particularly when the pregnancy is not accompanied by adequate health care. The psychological burden, feelings of isolation, and social stigmatization further undermine the emotional well-being of girls, leaving lasting effects that are often felt many years later.
