Some background about the image (for those who are not looking more deeply on the Facebook page or around the web): it was used as a billboard by a church in Aukland, NZ, and subsequently vandalized. Their intent was to provoke thought and discussion, in which they seem to have been successful.

NZ Herald article

Huffington Post article

From Aukland Now (stuff.co.nz):

'In a statement, Vicar Glynn Cardy and priest associate Clay Nelson said Christmas was about "a real pregnancy, a real mother and a real child. It's about real anxiety, courage and hope".

"Regardless of any premonition, that discovery would have been shocking. Mary was unmarried, young, and poor. This pregnancy would shape her future. She was certainly not the first woman in this situation or the last."

The church said the billboard was aimed at provoking conversation and have asked people to submit their captions for the image.

Cardy told Auckland Now it was about highlighting the fact that Christmas was a tough time for many people who suffered through a lack of money, poor health or violence.

"The point is really to get the season focussed on Jesus and on the reality of his birth and some of the anxieties that his mother felt and the real situation of people who are in poverty like his family were."

He hoped it inspired people to be more generous. '

Another poster they used a few years back had similar issues. (Facebook link) It depicted Joseph and Mary in bed, with the caption, "Poor Joseph. God was a hard act to follow."

Here's the info on the church:

About        
St Matthew-in-the-City is working to be a church Jesus would belong to without embarrassment: Inclusive, welcoming, compassionate and fearless. Here you can be a fan without being religious.

General Information        
St Matthew-in-the-City is a progressive Christian congregation affiliated with the Anglican Diocese of Auckland. We have been a part of Auckland for over 150 years. We have played an important role in fighting for the marginalised and excluded in New Zealand and around the world

We are committed to being an inclusive, welcoming church on site and online. While we welcome all, our mission is to push the theological envelope to articulate a spirituality that goes beyond traditional Christian doctrine and dogma. Our liturgy is innovative and remarkably free of traditional Christian dogma and yet Anglican in flavour.

Our business is spiritual transformation not filling the pews. Our strategy is to ask questions, not give answers. Our dream is a world that is a little more just, a little more kind.

Our congregation is worldwide linked by our website, iGod podcasts, and OMG! e-magazine, and locally by our beautiful neo-Gothic stone church. We connect locally not only as a house of worship but as a venue for community activities, concerts, and corporate and private events.
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~ Becky in Long Beach