MacKenzie Douthit is a 16 year old cheerleader from Miami, Oklahoma who is pregnant by her boyfriend, Josh McKee. On September 12, 2011, Douthit gives birth a baby boy, Gannon Dewayne McKee via C-section. The episode focuses on the hard decisions Douthit and McKee must both make as parents, with Douthit having to give up cheerleading and McKee being pressured to give up bull riding.
When Briana finds out she's pregnant, her boyfriend breaks up with her and she must decide whether she's ready to be a single mom. To make matters worse, her sister Brittany finds out she's pregnant as well but decides not to continue with her pregnancy.
Lindsey has always fought to get ahead in everything she attempts to do. However, when she unexpectedly gets pregnant, she struggles to find a stable living situation with her inconsistent boyfriend, and to be able to follow through with her dreams.
Alex has always had dreams to open her own dance studio one day, but finding out she's pregnant at 16 puts everything on hold. Her boyfriend Matt is also growing increasingly unreliable, and Alex considers whether adoption might be the best choice.
Jordan's mother has never been her boyfriend Tyler's biggest fan, and the tension between the two only gets worse when Jordan gets pregnant. Even though Tyler is white and an outcast, Jordan wants to make it work.
Myranda finds that love isn't the answer to everything when she gets pregnant. As she watches her own mom's battle with substance abuse spiral out of control, Myranda and boyfriend Eric struggle with preparing for a baby on their own.
Formerly a party girl, Hope gets pregnant after losing her virginity to Ben, a guy she barely knows. Absent at first, the two try to make a go of their relationship in order to provide a good family for their baby.
Sabrina used to be a cool California girl, with a star athlete boyfriend and a large group of friends. But when she gets pregnant, she must move to her grandparent's house in Tennessee to start a brand new life. Sabrina hopes her boyfriend will come too.
Sarah and Blake were high school sweethearts, until an unexpected pregnancy begins to pull them apart. Blake wants to move away and work on a shrimp boat, but Sarah needs him to stick around for their baby, despite tension in the household.