Background Each year between 14 and 15 million adolescent girls give birth, accounting for more than 10% of births globally. Motherhood is an exciting time for every woman and the society at large and also seen as a significant part of any woman’s identity but that is often not the case for the adolescent mother. Adolescent motherhood can be a time of mixed feelings as it occurs at a critical time of their lives. This study examined challenges adolescent mothers face during early motherhood and strategies to improve early motherhood for better social and health outcomes.

Methods Based on a phenomenological perspective, this qualitative study was conducted in the Hohoe Municipality where purposive sampling was used to recruit study participants. The process of data gathering included, 6 focus group discussions held with adolescent mothers, 20 in-depth interviews with pregnant adolescents, 6 in-depth interviews conducted with midwives and traditional birth attendants (TBAs). Using thematic analysis, recorded data were transcribed and manually coded inductively and deductively for themes.

Results A total participants of 60 teenage Junior High School dropouts were interviewed, out of which 10 mothers were in school after initial dropout. The average age of participants was 15 years. Other participants included 3 midwives and 3 TBAs. The findings revealed adolescents’ expressions of some positive side of motherhood, although they were confronted with some difficulties that affected their lives. Some adolescents posit coping with economic and financial constraints, opting for unsafe abortion to reduce stigma with unplanned pregnancy, managing the extra responsibility of taking care of the baby and the challenge of going back to school after delivery were major societal challenges for them. Some adolescents opined that positive support from family members assisted them manage difficulties despite community stigma associated with unplanned teenage pregnancies. Interviews with midwives and TBAs showed that adolescents were treated badly by health professionals, thereby significantly contributing to delays regarding their access to health services.

Conclusion We propose that health service providers and policy makers implement interventions that will support young mothers during motherhood. There is the need to build social capital among community members regarding their support to improve psychosocial well-being of adolescents during early motherhood. Adolescent friendly health services need to be strengthened to encourage adolescents to freely utilize services and health professionals need to be trained to deliver effective services to adolescents.