While the world is making rapid strides to address the global deficit between the use of and need for maternal health services, pregnant adolescents remain a distinctly vulnerable and profoundly neglected group. In their Health Policy paper, Farnaz Sabet and colleagues report that an estimated 21 million adolescent girls (aged 15–19 years) become pregnant every year in low-income and middle-income countries, representing 97% of global adolescent childbirths. Irrespective of marital or socioeconomic status, pregnancy in adolescence is a strain on the health and development of teenage girls.