Abstract Objectives to explore and describe the experiences of teenage pregnancy among Xhosa families, and, depending on the results of the study, to recommend a strategy to assist midwives to enhance pregnancy outcomes. Design a qualitative, explorative, descriptive, phenomenological and contextual research design. In-depth face-to-face interviews were performed to collect data. Participants 10 pregnant teenagers, eight mothers, two fathers, seven grandmothers and three grandfathers from the same families were interviewed independently and privately. Findings pregnant teenagers experienced emotional turmoil as they strived to cope with their pregnancy, and experienced a change in their relationships with significant others due to expectations that were not met and role confusion which led to crisis. Parents experienced overwhelming emotions due to the unexpected pregnancy of their child, and loss of control as the pregnancy could not be reversed. Grandparents of pregnant teenagers experienced the pregnancy as a family disturbance, and acknowledged that healing should take place in the family. Key conclusions teenage pregnancy was experienced differently by different generations within the same family, but all the experiences culminated in anger that hampered the necessary parental support for the pregnant teenager. Lack of support during pregnancy can easily affected the well-being of the unborn child, as teenagers are not supervised and experience acute emotional stress. Intervention by a midwife could help to relieve the teenager's stress and optimise the pregnancy outcome.