Teenage pregnancies accounted for 6.0% of confinements and 24.8% of legal abortions in South Australia in 1986-1988. The teenage pregnancy rate has declined by 28.5% since the early 1970s, associated with a 52.6% decline in the confinement rate. The abortion rate rose in the 1970s but fell slightly in the 1980s; nearly half the teenage pregnancies now end in legal abortion: abortion was a more likely pregnancy outcome for younger teenagers and for teenagers resident in metropolitan areas. Compared with women confined in their twenties, confined teenagers were more likely to be single, primigravid and Aboriginal, to have few antenatal visits and to have a medical or obstetric complication during their pregnancy. They were less likely to have an induction of labour or an elective Caesarean section. They had higher frequencies of preterm deliveries (8.9%) and low birth-weight babies (9.3%). The youngest teenagers had the most risk factors and the worst outcomes. In the small group of Aboriginal teenagers aged 16 years and under, about a third of the babies were low birth-weight or premature and one in 12 babies was a perinatal death. Comparison of singleton pregnancies of teenagers with women in their twenties all of whom were single, Caucasian and primigravid, with 7 or more antenatal visits, showed similarity in outcomes. This suggests that being teenage is not in itself a risk factor. Continued support and extension of teenage counselling and antenatal care services is essential.