Teenage pregnancy--need a child bear a child?

International and local evidence suggests that the incidence of unplanned pregnancy in teenage girls is unacceptably high. Obstetrical concerns centre around insufficient antenatal care; paediatric on small babies vulnerable to neglect from child-mothers and burdened grandmothers; and psychiatric and social on the trap for ill-educated, unskilled, immature child-mothers, poorly equipped to face the demands of the modern world. The experience of assessing local teenagers for therapeutic abortion on psychiatric grounds is presented. Of the 187 girls of 16 years and younger who were seen, 67 (35.8%) were granted an abortion: the remainder were counselled about alternatives. A variety of interventions are discussed: medical, educational, social and legal. These need to be comprehensive in order either to prevent pregnancy or to promote the health of a child-mother and her vulnerable infant. The role of the psychiatric services in this context needs revision.