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Melissa Gilliam, MD, MPH, first started to see the bigger ecosystem of teen pregnancy during a study on ways to reduce the number of teens who become pregnant again within a year of delivery. As a resident, she worked on a small trial testing an intervention to remind teenage African American mothers to take their birth control pills. A later five-year study, which involved interviewing postpartum adolescent mothers in their homes over two years, highlighted other issues - such as difficulty getting medical appointments, misinformation and ignored requests for birth control - within this vulnerable population. The result: greater susceptibility to repeat pregnancies.