Teenage pregnancy has become a major policy issue, for which young people are often publicly held solely responsible. However, a combination of factors substantially increases the risks of conception faced by young people engaging in early sexual activity. This article reports the main findings of a study of teenage pregnancy in linked seaside and rural areas, focusing on the experiences and perceptions of young people living in rural localities. They identify the issues of immobility, visibility and attitudes of stigma as affecting their ability to access sexual health services. The young people highlighted issues for service and policy development and the behaviour of professionals, both within schools and from sexual health services. Education, social and health services and the voluntary sector have important roles to play in responding to their needs.