Background: Utilization of family planning services among teenagers in resource constrained settings is faced with challenges in regard to proximity to the health facility which is prevalent in rural Uganda. Evidence on the contextual challenges and bottom-top interventions with regard to teenage mothers is limited. This study identified major health related challenges teenage mothers face in a dire need to access family planning services and proposed areas of interventions in rural underserved context of south western Uganda. Methods: Data was obtained from a cross-sectional study involving an exploratory qualitative approach using a combination of in depth interviews, Key informant interviews and a Focus Group Discussion. Data was collected from September to December 2017. Framework analysis sequentially combining content and thematic analyses was used to synthesis emerging themes. Findings: Inadequate knowledge, fear of negative effects and reliance on traditional herbs as alternatives to modern family planning limited utilization of family planning services among teenage mothers. Participants presumed that upon sensitization of teenage mothers and engaging their male partners were major interventions to improve utilization of family planning services in Bugoye Sub-county. Conclusions: Mainly individual level factors influence the practices of teenage mothers towards accessing FP services. Interventions should be tailored to address these factors that limit access to FP services by adolescents.