{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:03:43Z","timestamp":1784120623465,"version":"3.55.0"},"reference-count":38,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"African Regional Office of the Swedish International Development Cooperation Agency, Sida","award":["12103"],"award-info":[{"award-number":["12103"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early pregnancy is associated with poor mental health outcomes, but little is known about the extent to which stressors contribute to mental health challenges among pregnant or parenting adolescents. Informed by Meyer\u2019s minority stress theory, this study examines how generalised distal and proximal stressors affected adolescents\u2019 mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This explanatory qualitative study drew data from in-depth interviews with 22 adolescents (2 pregnant and 20 parenting) and 10 caregivers of pregnant or parenting adolescents in an urban informal settlement in Nairobi, Kenya. We used purposive sampling. The data were analysed using both inductive and deductive thematic analysis, guided by Meyer\u2019s minority stress theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Pregnant and parenting adolescents faced generalised, distal and proximal stressors, including the burden of childcare, financial struggles and social rejection from partners, family, peers and the community. These experiences often led to internalised feelings of shame, disappointment, embarrassment, worthlessness, self-doubt and self-isolation. The combined impact of these stressors resulted in emotional distress, isolation, low self-esteem, emotional numbness, hopelessness, anxiety, depression and suicidal thoughts. Social support from family, peers and community groups played a protective role by reducing stress and helping pregnant and parenting adolescents cope more effectively with their challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early childbearing is associated with generalised, distal and proximal stressors that negatively impact the mental health of pregnant and parenting adolescents. It is crucial to recognise the complex interplay of these stressors and the resulting emotional distress, isolation and low self-esteem that these adolescents face. There is a need for a comprehensive support system that not only addresses emotional, social and economic needs but also reduces stigma surrounding adolescent childbearing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003637","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T12:05:15Z","timestamp":1784117115000},"page":"e003637","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Silenced, stigmatised and struggling<\/i>\n                    : early childbearing, minority stress and mental distress among pregnant and parenting adolescent girls in an urban informal settlement in Kenya \u2013 an explanatory qualitative study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5397-0924","authenticated-orcid":false,"given":"Vallery Auma","family":"Obure","sequence":"first","affiliation":[{"name":"Sexual, Reproductive Maternal Newborn Child Adolescent Health Unit, African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally Atieno","family":"Odunga","sequence":"additional","affiliation":[{"name":"Sexual, Reproductive Maternal Newborn Child Adolescent Health Unit, African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1188-289X","authenticated-orcid":false,"given":"Beryl Nyatuga","family":"Machoka","sequence":"additional","affiliation":[{"name":"Sexual, Reproductive Maternal Newborn Child Adolescent Health Unit, African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0735-9839","authenticated-orcid":false,"given":"Caroline","family":"Kabiru","sequence":"additional","affiliation":[{"name":"Sexual, Reproductive Maternal Newborn Child Adolescent Health Unit, African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6004-3972","authenticated-orcid":false,"given":"Anthony Idowu","family":"Ajayi","sequence":"additional","affiliation":[{"name":"Sexual, Reproductive Maternal Newborn Child Adolescent Health Unit, African Population and Health Research Center, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"2026071505050639000_4.3.e003637.1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s40609-017-0102-8","article-title":"Adolescent Pregnancy and Challenges in Kenyan Context: Perspectives from Multiple Community Stakeholders","volume":"5","author":"Kumar","year":"2018","journal-title":"Glob Soc Welf"},{"key":"2026071505050639000_4.3.e003637.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-018-0480-0","article-title":"Values clarification workshops to improve abortion knowledge, attitudes and intentions: a pre-post assessment in 12 countries","volume":"15","author":"Turner","year":"2018","journal-title":"Reprod Health"},{"key":"2026071505050639000_4.3.e003637.3","unstructured":"UNESCO . 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