<p>Pregnant adolescents often face social, emotional and physical challenges, compounded by inadequate support. Drawing on a Straussian grounded theory approach, we explored the social processes and perspectives that influence adolescent pregnancy experiences in Zambia. Semi-structured interviews were conducted with adolescents (<i>n</i> = 26), partners (<i>n</i> = 8), parents/legal guardians of adolescents (<i>n</i> = 8), healthcare workers (<i>n</i> = 6), and key stakeholders (<i>n</i> = 5). Data were subjected to open, axial and selective coding, and a core category <i>‘Support me like a child, respect me like an adult’</i>, generated. Bronfenbrenner’s socio-ecological framework was also used as a theoretical lens to aid understanding of the social interactions between three interlinked categories <i>feeling vulnerable and alone</i>, <i>age discrimination</i>, and <i>lack of agency and autonomy</i>. Narratives highlighted social disapproval, influenced by cultural values, beliefs and social norms. Trying to navigate systems and spaces in which adolescents (and others) believed they did not belong, was illuminated. The need for an inclusive and supportive environment in which adolescents can feel cared for whilst also being respected for their own positionality and decisions, is critical.</p>