Physicians providing preventive and primary health care for schoolaged patients are frequently confronted with difficult problems that stem from premature sexual activity among these young people. In this paper a brief description of the scope and potential costs, both human and societal, of these problems is given as background for discussion of the pediatrician's role as counselor and educator in their prevention and management. The high frequency of sexual experience among school-aged girls and boys and the potential devastation that may result from the emerging epidemic of acquired immunodeficiency syndrome (AIDS), in combination with the pattern of multiple sex partners among adolescents, lend added urgency to the consideration of preventing these problems. PROBLEMS ASSOCIATED WITH ADOLESCENT PREGNANCY, ABORTION, AND CHILDBEARING The problems associated with pregnancy and childbirth among adolescents have attracted public concern and controversy since the middle 1970s when the number of births to American teenagers reached its peak. However, even though the number of births in this age group has declined as a result of the legalization of abortion and a decline in the number of teenagers in the population, the likelihood of pregnancy has declined much less, particularly among adolescents, younger than 18 years, and among the youngest teenagers. Among girls 15 years of age and younger, the pregnancy rate has been fairly stable and, among those who are white, it has continued to increase.