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Policy discussion of teenage sexual behaviour has been strongly influenced by a political agenda that characterises teenage pregnancy as a potential 'risk' of sexual activity. This presumed risk framework, however, depends upon an assumption of shared value judgements about the social undesirability of teenage parenthood, and the moral undesirability of teenage abortion. Drawing on three qualitative research projects undertaken in England between 2003 and 2009, this article looks at the complex processes of individual pregnancy decision making, in a context of competing values and moralities. It provides insights into, and understandings of, underlying tensions in the processes through which different degrees of personal autonomy may be experienced, and suggests that when autonomous decision making is compromised, often due to tensions in competing value systems, young women may experience ambivalence or regret about the decision they have made.