The dialogue doesn't get more real: A pregnant teenage girl pushes her boyfriend in a parking lot, screaming, "I hate you, I hate you!"
Another boy, sitting in a living room with his pregnant girlfriend, says coldly, "So you realize if we weren't having a baby, I wouldn't be here, right?" "No, I did not realize that," she replies in a small voice.
These are the voices of "16 and Pregnant," a hugely popular reality-TV program that follows several young mothers through their pregnancies and deliveries.
Their stories are so heart-rending that "one could make the argument that these are the best teen-pregnancy-prevention public service announcements ever made," said Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy.
But "16 and Pregnant" — which starts its third season Oct. 26 — is not a documentary series on some sober news station. It is the brainchild of MTV, the cable network that is also home to sexually charged music videos, sex-laden reality shows and all-but-explicit "Spring Break" coverage.
The show also inspired a spinoff, "Teen Mom," which follows some of the pregnant girls into the early years of caring for their babies.
Mr. Albert's view of the show was backed up last week by a survey to find out what teens really thought of "16 and Pregnant."
The poll, which the National Campaign commissioned, found that out of more than 1,000 teens, six in 10 had seen the show. Of those teens, 82 percent thought the show helped teens understand the challenges of childbearing much better, while only 15 percent thought it glamorized having a baby in high school.
The phone survey of 1,008 people aged 12 to 19, taken Aug. 12 to Sept. 12, also found that youths overwhelmingly said watching TV shows made them think harder about how to avoid teen pregnancy themselves, though there was a major gap between the sexes.
Among girls, 46 percent "agree strongly" and 34 percent "agree somewhat" that seeing TV shows and characters they like dealing with teen pregnancy makes them consider themselves how to avoid it. Among boys, the numbers were 27 percent "agree strongly" and 40 percent "agree somewhat."
But the juxtaposition of virtual celebration of casual sex on some MTV channels and cautionary tales about teen pregnancy on other MTV channels elicits eye-rolls from groups like the Parents Television Council (PTC).
"It's hard for me to believe that they are really sincere [about fighting teen pregnancy] when they produce and distribute so many programs that really glamorize irresponsible behavior," said Melissa Henson, director of communications for the nonprofit media-watchdog organization.
MTV has only gotten coarser over the years, she said. When the "Real World" reality show debuted, it seemed to be more focused on "young people getting started with their new lives, getting internships, embarking on their careers," she said.
"These days, it's almost entirely focused on kids going out, getting drunk, hooking up with strangers they meet at the bar and fighting with their housemates when they get home."
As for sexually charged programming aimed at youth, MTV is close to the top, if not the top network, Ms. Henson said.
In 2004, PTC examined a week of MTV's "Spring Break" programming. They found 3,056 depictions of sex or various forms of nudity, plus 2,881 verbal sexual references, which broke down to about 18 instances an hour. In comparison, prime-time "adult hour" network programming has fewer than six instances of sexual content an hour, the group said.
In a statement to The Washington Times, MTV said it "has always reflected and been a source for our audience on the issues that affect them most — our job is to air a balance of what is culturally relevant to our audience and produce shows that reflect issues and interests that are important to our viewers."
For more than a decade, it added, MTV has worked with the Kaiser Family Foundation on a public-information partnership called "It's Your (Sex) Life," to "encourage young people to make responsible decisions about their sexual health. Both '16 and Pregnant' and 'Teen Mom' are extensions of this campaign."
In other statements to the press, MTV officials have been unabashedly upbeat about their programming, mixed messages and all.
MTV "is the dynamic, vibrant experiment at the intersection of music, creativity and youth culture," its "16 and Pregnant" press materials said. "For over 28 years, MTV has evolved, challenged the norm, and detonated boundaries — giving each new generation a creative outlet and voice."
MTV's popular reality shows "Jersey Shore" and "Teen Mom" are "authentic realities" and "that is what's resonating much more today," Van Toffler, president of MTV Networks Music and Logo Group, recently told the Associated Press.
According to MTV publicist Melissa Barreto, in-house data suggests that "Teen Mom" has 4.1 million viewers in the coveted youth audience — between the ages of 12 and 34.
Mr. Albert at the National Campaign is well-versed in the sticky subject of whether the nation's top youth-oriented cable channel is part of the solution or part of the problem in teen sexual health.
"MTV is not in the teen-pregnancy-prevention business, they're in the entertainment business," Mr. Albert began.
There are many things throughout all the entertainment media that parents and advocates don't like, he said. But the bottom line is that, given the reach and influence of the entertainment media, "we are probably unlikely to make any progress without them."
"A show like '16 and Pregnant' reaches millions and millions of teens. We just simply can't do that in sex-education classes," he said.
So instead of ignoring or criticizing the media, the National Campaign has worked with media leaders, educating them, offering resources and support.
With "16 and Pregnant" and "Teen Mom" — both sole creative projects of MTV — "our two worlds have collided," said Mr. Albert. The National Campaign, which has MTV officials on its boards though it has no role in MTV's programming decisions, supplies discussion guides with every "16 and Pregnant" episode.
The National Campaign's recent survey results are music to its ears.
Said Mr. Albert: "Our feeling all along has been that if you can get kids thinking about this issue, and if you can even make that next step — talking to friends and parents — then you are probably on the right road for behavior change."
"And at the time when the teen-pregnancy rate has flattened out" — it's hovered around 72 pregnancies per 1,000 teens for three years, he said, "we need to search for and embrace bold and new ways to address this issue. And from our standpoint, '16 and Pregnant' and 'Teen Mom' do just that."
Still, MTV's new teen-mom reality shows have drawn yet another line of criticism — that they are glamorizing teen motherhood.
In an item called, "I Took a Nap and the Teen Moms Became Celebrities?" Popeater.com writer Jo Piazza wondered how she "missed out on the moment when teenage mothers … turned into famous people."
After MTV teen moms Maci, Farrah, Amber and Catelynn turned up on the cover of Us Weekly, Ms. Piazza asked senior editor Ian Drew how that happened. His answer was that they sell magazines.
These girls are not "glam," he said. "Everyone knows someone in the situation like this."
The National Campaign contests the idea that the MTV shows do not "glamorize" teen motherhood. Of the 600 teens surveyed on "16 and Pregnant," only 15 percent thought that it glamorized teen parenthood.
"16 and Pregnant" is "gritty, not glamorous; sobering, not salacious," noted Sarah Brown, chief executive of the National Campaign.
But Ms. Henson of PTC still shakes her head with disbelief.
"Certainly when you see the stars of that program being featured on teen magazines, it turns from cautionary tale into something that looks almost glamorous to the outside observer," she said.
Added Ms. Piazza: It won't be long before the "regular-people" teen moms start acting like celebrities — "Amber" has already done "her very starlike weight-loss unveiling, and it's only a matter of time before someone starts dating 'The Situation.'"
Note to readers over a certain age: "The Situation" is the hot male star of "Jersey Shore."
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