Pregnancy among girls in the age range of 13 to 19 years old is defined as teenage pregnancy. The term can also refer to pregnancy of girls who have not reached the age of legal adulthood, which varies across the world (United Nations Children’s Fund 2008). Some Malaysian teenage pregnancies are the result of rape, and some are the result of consensual intimate relationships. It was reported that there were 2,419 cases of statutory rape in 2011 and 2,049 cases in 2009, which means that all the victims were 16 years old or younger (Abu Bakar et al. 2012). There were 70,430 illegitimate children, registered from 1999 to 2000 (Mat Zaib et al. 2008), some of whom were the children of the increasing number of unwed mothers. The increasing number of unwed teenage mothers has attracted the attention of the Malaysian government.

Teenage mothers are more likely to have no or low educational qualifications, as they normally drop out of school (United Nations Children’s Fund 2008). These unwed teenage mothers can become economically vulnerable, and might struggle to perform in the role of a single parent. According to the same United Nations Children’s Fund report, the children of unwed teenage mothers are vulnerable to abuse and neglect, and unwed teenage mothers are also significantly associated with sexual abuse (Saewyc et al. 2004). The challenging circumstances around unplanned teenage pregnancy, such as academic disruption, lack of preparedness for motherhood, and family conflict due to pregnancy, can make the life of unwed teenagers a stressful event (Geller 2004).

Research on Malaysian unwed teenage mothers indicates that fear of abandonment by parents and friends, as well as living with shame and disgrace, can force them to abandon their babies and sometimes even resort to infanticide (Badiah and Mohd Jamil 2006; Wan Ismail 2012). Most of the recent studies about unwed teenage mothers in Malaysia and neighboring countries focus on risk factors (Fatimah 2009; Hanafiah 1989; Jamaludin 2010; Khadijah et al. 2012; Md Zain 2002; Saim 2004; Saim and Fatimah 2011), romantic relationships among teenagers (Abd Ghadur and Abdul Kadir 2009; Sabran 2003), maternal and reproductive complications (Suryoputra et al. 2006), and the rights of illegitimate children and adoption (Mohd Awal 2009; Mohd Wahie 2004). The unwed teenage mother phenomenon is normally discussed from a moralistic perspective, such as the harmful and catastrophic effect on moral norms and bringing shame to the family (Azizi 2010; Fatimah 2009; Hj Bedu et al. 2008; Salimon 1998), abandoning babies or resorting to infanticide (Badiah and Mohd Jamil 2006; Mohamed 1993; Ong and Green 2003), or the prohibitions according to religion—Islam (Triwulan 2009) and Buddhism (Tedesco 1996).

Thus, although, unwed Malaysian teenage mothers have been a topic of investigation and debate as a social phenomenon, not much attention has been given to the voices, perspectives or experiences of unwed teenage mothers. As a result, not enough data is available to Malaysian society to provide an understanding of the phenomenon in a way that can provide the social support system needed to meet the needs of unwed teenage mothers. Other reasons compelling the researchers to conduct this investigation at the individual level are to enhance existing knowledge concerning this issue from a Malaysian perspective, and then to compare the results with other research findings. For instance, as numerous questions remain unanswered regarding the living conditions of unwed teenage mothers, this investigation focuses on the experiences of unwed teenage mothers concerning their pregnancies.

To give a clear picture of how unwed teenage mothers are treated in Malaysian society, a short description about the context of the study is given, followed by the norms and understanding of the phenomenon from the perspective of Malaysian society.

Social Context of Malaysian Unmarried Teenage Mothers

The study was undertaken in the central region of Malaysia; the State of Selangor and Kuala Lumpur. Kuala Lumpur is the capital of Malaysia, while Selangor is the most developed state in Malaysia. Malaysia, with a population of 28 million, is a multicultural society with four major ethnic groups; Malays, Chinese, Indigenous, and Indian (Department of Statistics Malaysia 2011).

In Malaysia, pregnancy out of wedlock is considered a moral violation just as it is in the majority of other Asian countries, such as Korea (Herrmann and Kasper 1992; Jin et al. 2007), China (Nian et al. 2001; Zheng et al. 2001), Japan (Akiko 2005), India (Chhabra et al. 2009; Silk 2007), Thailand (Keown 1999), Indonesia (Butt and Munro 2007), and Singapore (Kurup et al. 1989; Rahman 2009). Malaysian society stigmatizes unwed teenage mothers (Abd Rahman 2000), most of whom are stereotyped by their communities, families and service providers, and are associated with delinquency such as practicing free sex, substance abuse or prostitution. The unwed teenage mothers are normally seen as girls with no shame, and their families are considered dysfunctional, as they were perceived as not being able to control their daughters (Nik Yaacob 2007). In addition, the child of an unwed teenage mother was previously called anak haram (a forbidden child), which has now changed to anak tak sah taraf (illegitimate child). Owing to their shame, most teenage mothers end their schooling prematurely, either by their own will or as a result of external force. From his research among students in Thailand, Prawatrungruang (2002) found that pregnancy could affect the decision to drop out of school. It is normal for unwed teenage mothers and their families to hide the pregnancy, which is kept as a high-priority secret that people rarely talk about in public (United Nations Children’s Fund 2008).

According to Section 312, it is illegal in Malaysia to perform abortion except for reasons of mental and physical health (Penal Code 2006). Although abortion pills might be available over the counter, unwed teenage mothers rarely ask for them out of shame (United Nations Children’s Fund 2008). Their other option is to purchase alternative medicines, such as herbal abortifacients or Chinese medicine (Abdullah and Wong 2010; Fatimah 2011). Some families encourage their teenage daughter to marry the baby’s father if he is her boyfriend; however, according to the Malaysian constitution, a couple has to be at least 18 years old to become legally married (Islamic Family Law 2006; Law Reform Marriage and Divorce 2006). If the couple’s age is below 18 years, the marriage can be voided. In addition, according to the Acts, a license granted from the Chief Minister or the Syariah Judge must be obtained if the bride’s age is below 16 years.

In some cases, the unwed teenage mother is sent to a shelter home to hide her pregnancy. Shelter homes are of three types—governmental, semi-governmental, and non-governmental—all of which are considered residential care centers, and adhere to the Care Centre Act of 1993 for placement or probation. The shelter homes function as a temporary protection for unwed teenage mothers, especially during their pregnancy (Dar Assaadah 2008), in addition to providing supervision, rehabilitation, and training (Care Centre Act 2006).

The following questions are addressed in this research: (a) What reactions do the unwed teenage mothers receive from significant others (e.g., parents and the father of their baby)?; (b) How do the reactions from significant others influence the experiences of unwed teenage mothers?

Method

Ethical Consideration

Formal ethical approval and administrative permission were obtained from the Economic Planning Unit, Prime Minister’s Department of Malaysia, the Social Welfare Department of Malaysia, and from the shelter homes involved. The respondents were apprised of the purpose of this study, their role and rights, and the data collection method. The participants were assured of confidentiality of the information they provided. Also, it was clarified that their participation was voluntary and that they could leave the investigation at any time. At the time of data collection, the respondents were in a vulnerable position through either being pregnant or being in the state of confinement. The main researcher was ready to provide help and support if necessary.

Participants

The respondents were selected from a group of unwed teenage mothers, aged between 10 and 18 years. Malaysian legislation defines the teenage period as starting at the age of 10 (Child Act 2006; Najmuddin 2007). The criteria for inclusion were that the respondents should be free from severe mental health disorders and drug abuse. The respondents were recruited assuming that they understood the principles of their involvement in the research process. After consenting to share their experiences and opinions (Reid et al. 2005), 17 respondents, aged 12 to 18 years, consented to engage with the interviewer. Twelve of them were residing in the governmental shelter home and five in the non-governmental organizations (NGOs) shelter homes.

Data Collection

The main researcher’s practical knowledge of the study area and the distance between shelter homes were the main reasons behind choosing convenient and purposive sampling (Marshall 1996; Miles and Huberman 1994) together with the variations in the data (Flick 2009). Four shelter homes were involved in this study; one was a governmental shelter home located in Kuala Lumpur, and the other three shelter homes were located in Selangor. No semi-governmental shelter home was involved in this study, because none were accommodating any unwed teenage mothers at the time of this study.

On average, the one-to-one interviews lasted 1 h. The main researcher introduced herself to the respondents as “kakak”, which means “sister”. According to the Malaysian culture, this is a common way of building rapport with the respondents and facilitating them to share their feelings and experiences freely with the researcher. Most of the interviews took place in a private room at the shelter homes, and, where no private room was available, they were conducted in the garden of the respective shelter home or in the car. All arrangements were undertaken to ensure that the respondents felt comfortable and that the interview proceedings remained confidential.

Data Analysis

The interview proceedings were recorded and transcribed. NVivo 9 software (QSR International 2010) was used to determine the structure of the data material. Following the recommendation of Graneheim and Lundman (2004), the interviews were read through several times by the researchers to obtain a sense of the whole as well as the meaning units in words, phrases, and/or paragraphs in the transcriptions (Morse and Field 1995). Using the content analysis of Graneheim and Lundman (2004), the interviews were coded by the meaning unit and the condensed meaning of the manifest and latent contents of the four sessions of discussions between the three researchers. Each session took about 2 h to ensure the credibility of the findings. Subthemes and themes formed the final stage of data analysis, as suggested by Graneheim and Lundman (2004). In the section of “what reactions do the unwed teenage mothers receive from significant others (e.g., parents and father of the baby)”, 19 codes were developed and categorized into five subthemes and three themes (shown in Table 1). For the section of “how do the reactions from significant others influence unwed teenage mothers’ experiences of their pregnancies”, 30 codes were developed and coded with eight subthemes and four themes (shown in Table 2).

Table 1 Overview concerning the reactions of significant others toward the pregnancy of unwed teenage mothers
Full size table
Table 2 Overview concerning how the reactions of significant others influence unwed teenage mothers experiences of pregnancy
Full size table

Results

Secrecy

In the initial stage, when the girls became pregnant outside of marriage, they tried to hide their pregnancy from friends, siblings, families, and school personnel. They tried to do this in several ways, such as wearing loose shirts/dresses or simply by denying that they were pregnant when questioned. Some of the respondents said that as they put on weight they defined the change as being fat. Some avoided direct contact with their families to prevent them from noticing their body changes. Even when the parents noticed some changes, the teenagers were reluctant to discuss the issue:

“My father was suspicious, but he did not dare to ask. I used to watch TV with my mother, but, of late, I rarely watch TV with her and most of the time I confine myself to my room. That made my father suspicious.”

Repression

When the respondents’ parents or babies’ fathers learned about their pregnancy, either from the respondents or someone else, they tried to threaten and force the teenagers to abort their babies. More than half of the respondents were victims of statutory rape, while others were victims of false pretenses or rape. However, all the respondents were pressured to abort their babies by traditional methods (e.g., herbs, lay midwife), mostly with unsuccessful results, or by clinical abortion. The youngest unwed teenage mother, 12 years old, expressed her mother’s reaction as follows:

“My mother noticed that I ate a lot of tamarind [due to the craving during pregnancy]. She asked me, ‘Why do you eat a lot of it? Has something happened to you?’ I told her nothing has happened. Then she said, ‘Mark my words, if you are pregnant we will abort it.’”

This teenager ran away from home before her mother could take her to a doctor. She was terrified of her mother’s reaction.

Repression also took the form of physical violence, normally from the fathers of the babies, most of whom were the respondents’ boyfriends. The respondents who were seduced by their boyfriends and became victims of statutory rape turned to their boyfriends for help before their families knew about their pregnancies. However, the reactions from the fathers of the babies were not what they expected. The prospective mothers were beaten and pressured to effect self-induced abortion or take abortion pills. One of the respondents stressed that the father of her baby abused her because she refused to abort the baby. She further added:

“He wanted to capture me, but I ran and hid in a drain. Had he captured me, he would have surely hit me. I wanted to keep my baby. I was sad. He bought me a lot of pills [to abort the baby], but nothing happened.”

Rejection

As these respondents became pregnant out of wedlock, their families could not accept their pregnancy. The families reacted with shame and worry and were often anxious about what they should do to keep the pregnancy a secret. One respondent described, “Of course it [the pregnancy] was a shame. We can’t tell others. They [her parents] decided to ask [her to have an] abortion.”

The fathers of the babies also rejected the babies as theirs. Often, the respondents were accused of having had an affair with another man. The babies’ fathers, who refused responsibility for the pregnancy or for bearing its consequences, broke off the relationship. Some of them did so because of job restrictions or financial instability, often without giving any reason, even though both families consented to them marrying. When the family of the father came to know about the pregnancy, they normally asked the father of the baby to marry the girl. However, if he refused, his family just ignored the girl and did not offer any help. Several respondents were humiliated or even threatened by their boyfriends as a way to avoid marrying them. One participant shared her experience, “When my family asked him to marry me, he ran away. His family knew about this and asked him to marry me. But he sent a letter… He sent me a letter and said so many [bad] things.” The humiliation and threats from the fathers of the babies can be seen as ways of rejecting the pregnancies, as well as the respondents.

Detachment

As any pregnancy without marriage is considered dishonorable and shameful in Malaysian society, the respondents mentioned how this resulted in them remaining detached from their babies. Some of them described how they experienced emotional numbness toward their babies, while others suppressed their feelings. One respondent expressed her feelings, “I don’t have any feelings yet for the baby. I just feel pain when the baby moves [in my tummy] or when it stays still.”

The detachment between the respondents and their babies made some respondents constantly attempt to effect self-induced abortion in dangerous ways. One of the respondents, who tried to abort her baby, described her experience, “Err…I was so stressed. I kept thinking how to get rid of this child, this baby. I purposely did…I lived in a double story house, so purposely I made myself fall.”

Trapped

Almost all of the respondents considered the pregnancy to be like a trap; they found themselves in a condition where all options seemed to be wrong and impossible to apply. Even though they were experiencing shock from their pregnancies, they also received threats from significant others. They were first shocked when they noticed that they did not have their regular menstrual cycle and worried about consequent body changes. One respondent said, “When the doctor told me I was pregnant, I couldn’t believe it at all, I felt like I was dreaming. Is it real I’m pregnant? It seemed like I was dreaming.”

To deal with the shocking situation, most respondents informed their families themselves or obtained help from professionals, such as teachers, school counselors, doctors, or social workers. Some informed their families through someone they could trust, such as a close friend. The respondents were stunned by their pregnancies as they had not planned to become mothers at that young of an age, and most of them were still attending secondary school and obliged to follow school regulations. One participant said, “Since I knew I was pregnant, I didn’t go to school. I was afraid my school will know about it and I will be expelled from school.”

Unworthiness

The respondents stressed that they felt guilty about their bad behavior by becoming pregnant out of wedlock. The majority of them felt their pregnancy was a punishment for breaking religious and cultural rules. They believed that their pregnancies were a lesson well learned. One of the girls who felt unworthy because of her pregnancy stated, “Before this, I disgraced people who committed adultery. For me it is so humiliating. But now I did the same. I learnt from that. If we don’t like it, don’t despise it.”

Overcome by a feeling of extreme guilt, most of the respondents decided not to make any decision by themselves concerning the future. Feeling unworthy made them think that they were incapable of making the proper decisions, and, hence, they preferred that their parents decide what to do about the babies. The respondents were afraid that they might make things worse if they decided by themselves. One respondent expressed her feelings, “I made a mistake. I don’t want to add another. I hurt my parents; if I make my own decision it will hurt them again. I made them suffer enough.”

Ambiguity

The respondents were also in a dilemma about whether to continue or to terminate their pregnancies and about their own futures, as well as that of their babies. They were undecided on whether to follow their parents’ decision to give up their babies for adoption or to take care of the babies by themselves, although they were aware that they would not have any support if they chose the latter option. Some of them wished that they had a chance to take care of their baby by themselves, at least for some time, knowing very well that they could not do so without support from their families. One respondent narrated as follows:

“Actually, I love my baby, but I am not sure. I just follow what my father wants to do. I could take care of the baby, but how am I going to answer if people asked me? I am still young. I can’t say that the baby belongs to my sister. [I wish] I could take care of the baby for a month and then I will give her for adoption.”

The respondents were also unsure as to what they should do about their education and how they should deal with the reactions from family and others after leaving the shelter homes. They were highly uncertain about almost everything concerning their pregnancies.

Discussion

This research was based on a content analysis of the interviews with 17 unwed teenage mothers during their placement or probation period in shelter homes because of pregnancy out of wedlock. Among them, 13 were victims of rape or statutory rape. Generally, pregnancies among teenagers are rarely understood as a consequence of violence or victimization (Jacoby et al. 1999). As the respondents were under-age, the majority of them were seduced by their partners. Such seductions were also reported in India (Chhabra et al. 2009) and Indonesia (Butt and Munro 2007). Nevertheless, most of the respondents received no support from their families. They also lost their social support from their significant others. As a result, the attempts to repress their pregnancy left them traumatized and rejected. These findings are similar to those of Butt and Munro (2007) who reported how unwed teenage mothers in Papua, Indonesia, constantly tried to hide their pregnancies from public view because of the stigma attached to pregnancy out of wedlock.

The respondents also spoke about having been threatened and pressured to terminate their pregnancy either by medical or traditional methods. Most of the attempts to terminate pregnancy were done without any concern for the safety of the girls. Having been in a vulnerable situation, they were sent by their families to shelter homes to hide their pregnancy. Some of the families perceived the shelter homes as the last solution for the girls to hide the pregnancy and some as a place for repentance and/or punishment.

Using secrecy and silence (Herman 1992) as a strategy, the parents and babies’ fathers tried to protect themselves from shame and responsibility. But, when they could no longer maintain secrecy, the girls faced rejection and repression.

The majority of the respondents were found to have felt powerless owing to rejection and repression; they also showed signs of ‘surrender’, which was associated with numbness, detachment, shock, feeling of being unworthy, and dilemma. These reactions are examples of what Herman (1992) termed repetitive trauma. The present results indicate that the respondents were reluctant to make any decisions for the future, as they were afraid that they could risk their fragile relationship with significant others. The respondents also thought that they were incapable of making wise decisions as they were afraid they might compound their mistake if they made decisions by themselves. In addition, the respondents often associated their pregnancies with feelings of disgrace, humiliation, guilt, and shameful failure that decreased their self-value (Nathanson 1994). The respondents thought that termination of the pregnancy might restore their “value” and remove the cause of their turmoil. The resulting dynamic of detachment on the part of such mothers might be the main reason for the abandonment of babies and infanticides in Malaysia (Badiah and Mohd Jamil 2006; Ong and Green 2003).

A potential negative outcome of the traumatic events surrounding the respondents’ out of wedlock pregnancies can be a loss of trust in the social environment, thereby leading the traumatized girls to believe that they were alone, abandoned by family, community and religion as they had broken norms and religious beliefs. According to Herman (1992), traumatized victims feel a sense of alienation and disconnection, which exposes them to great risk of mental health problems (e.g. post-traumatic stress disorder, depression and suicide) (Foa and Rothbaum 1998; Ghazinour et al. 2003). Having mental health problems can affect the future by enhancing the victim’s risk of being abused, and neglected, besides failing in school and more likely engaging in criminal behavior (Barnet et al. 2009; Omar et al. 2010). Re-victimization of sexual assault in adulthood (Sandberg et al. 1994) could be another possible risk.

Conclusions and Implications

The research findings suggest that the Malaysian government should take the issue of unwed teenage pregnancy seriously. The authors strongly encourage every shelter home to engage qualified social workers and psychologists who are equipped to meet the teenage mothers’ psychological and social needs and provide the necessary interventions. This recommendation is very important because unwed teenage mothers in shelter homes have to bounce back to join the mainstream of life and need to be able to develop trust in the community again. Having been exposed to rape or psychological abuse, as reported by the respondents, there is a strong need to create a place of safety and security where the girls can recover from repression and rejection. To achieve this goal, psychologists and social workers should have specialist qualifications and competence that enable them to effectively handle human psychological responses to traumatic life events.

In addition, to reduce the psychological impact on traumatized teenagers, it is suggested that the Malaysian authorities organize micro- and macro-level psycho-educative programs to educate families and society. Shelter homes should be considered as a place to help unwed teenage mothers that support the reconstruction of the perception by the teen and their significant others, as well as of society, to see unwed teenage mothers as “good” girls; thereby restoring them in the eyes of all from deviant girls to innocent girls who made a mistake (Rains 2009). The family should not see the shelter home as a place of punishment as this view can only increase the girls’ vulnerability and inflict on them unhealthy shame, which, together, constitute a negative development for teens who already consider themselves worthless. It is also suggested that health-related units be created for the young and the adolescents within the health care system, to help unwed teenage mothers deal with their pregnancies and meet their psychosocial needs.

Community and school-based programs should be organized to provide education and guidance to teenagers about boyfriend-girlfriend relationships, health information, sex and reproduction, and current laws concerning these issues. Finally, Malaysian authorities, at every level for the provision of care and protection to unwed teenage mothers, must be respectful to them, hear their voices, and be more sensitive to their stories and their experiences. Malaysian society must realize that most unwed teenage mothers did not consciously choose to put themselves in this traumatic situation, but are victims who need help to heal.