This paper uses a rich longitudinal dataset to examine the relationship between teen fertility and both subsequent educational outcomes and mortality risk in rural South Africa. Human capital deficits among teen mothers are large and significant, with earlier births associated with greater deficits. In contrast to many other studies, we find no clear evidence of selectivity into teen childbearing in either schooling trajectories or pre-fertility household characteristics. Enrolment rates among teen mothers only begin to drop in the period immediately preceding the birth and future teen mothers are not behind in their schooling relative to other girls. Older teen mothers and those further ahead in school for their age pre-birth are more likely to continue schooling after the birth. Following women over a six year period we document a higher mortality risk before the age of 30 for teen mothers that cannot be explained by household characteristics in early adulthood.