Although not all of the measures of gender inequity were associated with unplanned and unwanted pregnancies in this study, there is evidence that inequitable gender power relations and low socioeconomic status do increase risk. Interventions to prevent teenage pregnancies need to be tailored by socioeconomic status because some teenagers may see having a pregnancy as a way to have a more secure future. Interventions that engage with teenagers’ relationship dynamics are essential for effective preven- tion of unwanted and unplanned pregnancies. There is also an unmet contraceptive need among the young women in the Eastern Cape.