Teen childbearing varies sharply with cognitive skill. In a nationally representative cohort of U.S. women born in the late 1950s and early 1960s, 28% of women in the bottom quartile of an adolescent cognitive test had a first birth by ages 14–17, compared with 3% in the top quartile, and mean age at first birth differs by 5.4 years. I estimate a dynamic life-cycle model of schooling, work, marriage, and contraceptive effort to ask whether standard opportunity-cost channels can explain this gap. They cannot: matching the teen-birth gradient requires that cognitive skill also raises the effectiveness of contraceptive effort in reducing pregnancy risk. Counterfactuals imply large policy effects: giving low-skill teens the same access to effective contraception as high-skill teens lowers pregnancies before age 18 by about 53% and raises college attendance by about 20%; combining improved contraception with improved schooling opportunities lowers pregnancies before age 18 by about 60% and raises college attendance by about 45%. Welfare gains are concentrated among low-skill women.