Teenage pregnancy among school-going youth is a concern worldwide, but in socially–economically challenged environments it is a result of, and contributory factor to, a complex web of social injustice. In South Africa, most of the school-based prevention interventions to date have been adult-designed and imparted, with the voice of the target audience – the youth – being ignored. The purpose of this participatory action research study was to involve school-going youth in the research and development of prevention interventions, tailored to meet their perceived needs. This article focuses on the first cycle where 24 high school participants interrogated their own and their peers’ narratives about teenage pregnancy so as to determine a way forward. Findings indicate that, although the youth perceive parenthood while they are still studying to have a negative impact on their future life goals, the prevention messages mediated by educators and other adults do not take into consideration the needs and lifestyle of teenagers within their specific social context. The implications of the three themes which emerged from the thematic analysis of the interviews, open-ended questionnaires and visual data are discussed to provide guidelines for the design of more youth-friendly prevention education to inform the next cycle of the research. Since teenage pregnancy is a global problem, the findings of this study have international relevance.