The Impact of Sexual Imagery on Teenage Pregnancy in the UK

Chapter 1: Introduction
Sexual imagery in the society is on the increase with young people exposed from an early age to sexual concepts and behavior especially through media exposure and sex education in school. This has an effect on the conceptualization of sexual beliefs and behavior patterns as the young generation moves into adolescence and sexual maturity (Brown 2002). Further suggestions in literature indicate that teenage exposure to sexual imagery and its influence on sexual attitudes and behavior may also impact their reproductive health outcomes among them pregnancy (Chandra et al. 2008). This is because greater exposure especially to content that promotes teenage sexual activities may encourage engagement in sexual activities leading to unplanned pregnancies especially since the teenagers may not be aware of effective contraceptive methods. In retrospect, exposure to content discouraging early sexual activity or that promote accurate education on teenage sex could facilitate a decline in teenage pregnancy. This analysis considers the impact of presented sexual images such as in television programming, movies, advertisement, magazines, and school on teenage pregnancy in the United Kingdom (UK) through a review of literature.
Background Information
In Western Europe, the UK has the highest rates teenage birth rates (Fletcher et al. 2008), an aspect conferment by Teenage Pregnancy Factsheet published by Family Planning Association (FPA) (2010) for teenage pregnancy in England, Wales, Scotland and Northern Ireland. The factsheet presents policy and statistics in UK and presents that UK has the highest births and abortions in the Western Europe. Compared to Netherlands, the UK has a rater five times higher, and ten times more than France and more than that for Germany.
The groups most vulnerable to teenage pregnancy are teenagers in or leaving care, homeless, underachieving at school, children of teenage parents, some ethnic group members, and teenagers in the criminal justice system, and those living in socially deprived areas (FPA, 2011). In relation to attaining an abortion, teenage girls from socially disadvantages areas have a lesser likelihood attain an abortion if pregnant compared to those living in socially advantaged neighborhood. In this report abortion is considered a consequence of teenage pregnancy, which may also influence a decline in teenage births as some choose to terminate their pregnancies.
According to Chandra et al. (2008) the factors contributing to the high rate of teenage pregnancy are complex and interrelated among them individual, social, and environment related. Related to the individual are issues such as lack of attachment to school, while social factors include peer norms concerning sexual behavior. An example of environment related factor is availability of contraceptives. These factors serve to increase teenage vulnerability to pregnancy. Another factor associated with teenage pregnancy is exposure to sexual content such as through the media, although as Chandra et al. (2008) indicates, this arena is poorly explored. Furthermore, research available on exposure to sexual imagery and its link to teenage pregnancy seems to follow specific avenues of exposure such as television content or music content (Chandra et al. 2008; Martino et al. 2006) as opposed to considering a group of avenues.
In the book, The truth about sexual behavior and unplanned pregnancy, Kittleson et al. (2005), provides insight into the impact of sexual imagery on adolescents sexual interpretations and subsequent behavior. Fromm the book, it was noted that sexual images contributed to how young girls and boys perceived their sexuality and reacted. For example, the book noted that girls that saw commercials with an emphasis on sex appeal and physical attractiveness compared to those exposed to neutral advertisements considered beauty characteristics important to their self-image and attraction to men. Further, middle school students exposed to programming with sexual content were more likely to engage in sexual activities compared to students that did not view such programmes.
This finding extended to music videos where students watching sexually suggestive music videos were more permissive toward sexual activity compared to students that did light viewing. Permissiveness toward sex included seeing premarital sex as acceptable. An interesting note on the book is that adolescents noted that television content provided equal or more encouragement to sex compared to their friends (Kittleson et al. 2005). The related are findings to previous studies reviewed in the book, which provide an initial indication of the impact of sexual content on adolescents.
Various avenues exist from which adolescents can access sexual content among them media, peers, and teaching by teachers. The media presents a significant avenue to learn about sexual behaviors especially considering many youths are exposed to at least to six to seven hours of some form of media every day (Kittleson et al. 2005). These exposures help shape the teenagers attitudes toward sex, whether negative or positive. Depending on the types of exposure, the teenager will regard sex during adolescence as acceptable to unacceptable, and this informs their sexual behavior.
The sexual imagery has the potential to encourage teenage pregnancy or discourage it depending on content. For example, imagery that shows the potential risks associated with teenage sexual activity such as sexually transmitted diseases or unplanned pregnancies and their impact on the teenagers life may discourage teenage sexual activity (Kittleson et al. 2005). Similarly, if the imagery seems to edify sexual activities, then it will encourage acceptance and the possibility of teenagers engaging in sexual activities with the consequences of unplanned pregnancies. Notably, sexual imagery has the potential to contribute to a decrease or increase to teenage sexual activity and unplanned pregnancies depending on how the avenues providing the imagery are used. The connection between teenage pregnancy and sexual imagery emerge from the potential of sexual imagery to contribute to acceptance of sexual activity within teenage years.
Purpose of the Review
This review will consolidate available research on influence of sexual imagery on teenage pregnancy in the UK by considering various avenues of exposure including school and media. This will provide a holistic outlook on teenage pregnancy and exposure to sexual imagery, and the way the exposure will influence sexual decision thus leading to teenage pregnancy. The review will emerge from research article selected based on the criteria presented in the subsequent section. The review will show lessons on relationships and feelings emerging from the sexual imagery and decisions on safety and sexual decisions emanating from the content. A consideration in the review is whether the influence is similar for boys and girls or differs between the genders.
The discussion will consider the two sides of sexual imagery presented in relation to teenage pregnancy, where it can facilitate an increase in teenage pregnancy through promotion of acceptance of teenage sex, or promote a decline by teaching about sexual responsibility. When considering sexual imagery and teenage pregnancy emerging from preliminary research presented in the background is that exposure to sexual imagery through the media, peers, and school has the capacity to influence teenage pregnancy.
Chapter 2: Methodology
This section presents the sampling process in the review, article selection criteria including database search strategy, article inclusion and exclusion criteria, data abstraction, data synthesis, research limitations and delimitations. It also provides the themes and categories that will form the basis of the discussion chapter. Another aspect included in the chapter is the search phrases utilized when searching for the incorporated articles.
Research Sample
The review brings together 14 articles on teenage pregnancy, sexual imagery, and the influence of sexual imagery on teenage pregnancy. The articles included are from EBSCOhost, and Proquest Social Science databases. During the data collection process, it was noted that considerable information is available on teenage pregnancy and factors contributing to the high rates even in relation to sexual imagery. However, articles used were selected for their relevance to the topic and presentation of a primary research. Relevance to the topic was in terms of sexual imagery such as videos, television, magazines, advertisements, school, songs, and internet, and the way these influenced teenage pregnancy within the UK.
Design: Literature Review
The presented discussion in this report emerges from a review of literature, a research strategy involving reading, analyzing, and synthesis of scholarly materials (Garrard 2010). When conducting a review, the researcher focuses on those materials concerned with the topic under discussion considering their presentation and relevance to the topic, and determines whether they meet the agreed criteria. For example, when looking for primary materials, a consideration would be focus on hypothesis presentation, valid use of research measurements and procedures, interpretation of results and derived conclusions.
These materials come from various sources including journals, reference books, textbooks, policy publications, government and organization or institutional publications and other relevant and credible sources presenting theory, practice, and results in scientific research (Garrard 2010). These materials form the source documents for the research. In the current discussion, the source documents are articles published in peer-reviewed journals, thus providing credible sources.
Peer-reviewed journals publish articles judged after submission for quality of research conducted and conclusions drawn by the researcher instead of relying on the researcher’s general reputation to determine publication (Dawidowicz 2010). Using peer-reviewed articles provide an opportunity to focus on articles agreed on by the academia and professionals, since they have read and agree with the presented findings. This offers credibility to secondary sources. The discussion focuses on empirical articles, a form of peer-reviewed articles reporting on new data or giving results on a research (Friesen 2010). These articles give a background on research and works published on the topic under discussion. It can also show existing gaps in literature if the research has such an interest, although this is beyond the scope of the current review.
Databases and search strategy
Databases utilized in the article search were SAGE Journals Online that has full-text collections in various topics, EBSCOhost that provides periodicals including peer-reviewed journals in full-text, and ProQuest Social Sciences that provides articles in full-text including visuals where applicable. Using the three databases provides variety to the research process, although some of the articles are repeated in the databases since they may contract from same journals.
The search was conducted using various search phrases that included impact of sexual imagery on teenage pregnancy in UK, influence of sexual imagery on teenage pregnancy in UK, teenage pregnancy in UK, influence of sexual content on television on teenage pregnancy in UK, and influence of sexual content on internet on teenage pregnancy in UK.  Other phrases were mass media influence on teenage pregnancy in UK, movies/internet/television/magazine influence on teenage pregnancy in UK, and impact of sexual imagery teaching on teenage pregnancy. Additional phrases were teenage exposure to sexual imagery in the UK, sexual imagery targeting teenagers in the UK, sexual imagery in the UK, and sexual content targeting youth in the UK.
When conducting the search, applied limitations included selection of full-text and peer-reviewed options for the three databases. This ensured all articles attained would be accessible and from peer-reviewed journals. Secondly, Boolean/phrase categories were used in search modes for EBSCOhost. At the initial search, a time limit was not established, but in subsequent search, a time limit between 2005 and 2011 was established to bring the focus on recent materials. The reason for establishing a limit within the last six years was to ensure data was current since the discussion does not depend on a historical setting but contemporary data.
The initial search on EBSCOhost gave 6967 results for impact of sexual imagery on teenage pregnancy in the UK and 23 articles on ProQuest, and zero for SAGE. The phrase was the initial one utilized to gain a survey of the topic. The results were somewhat disappointing especially since adherence to the area of relevance was minimal. The second search was for how media influences teenage pregnancy providing another null return in SAGE at which point the database was disregarded in the search leaving EBSCOhost and ProQuest. The results in the remaining two databases were positive in the second phrase, with ProQuest generating 1486 articles and EBSCOhost more than 8000. The articles continued to be narrowed down from these databases using the other search phrases leaving 15 articles. Many come from ProQuest Social Science that proved most useful in selection of relevant articles within the applied time limit.
Article Inclusion and Exclusion Criteria
To qualify for inclusion in the study, the article must be reporting on a primary study conducted using qualitative, quantitative research methods or a mixed design. Data collection must have been with identifiable techniques including surveys, interviews and with specified participants and area of study. However, content analysis of media was considered as credible research for inclusion in this research especially since sexual imagery within the media require evidence from advertisements, newspaper articles, or programming. Therefore, studies that conducted a content analysis for media sexual presentation were considered especially when responding to the issue of sexual imagery in the UK.
The second qualification was the population focus to be between ages 12 to 19 years. The definition of adolescence or an agreement on the age of adolescence ranges from 12-21, 12-20, 12-18, or 13-20 (Laser, Nicotera and Jenson 2011).  The reason for choosing 12 to 19 years is that this falls within the age group attending secondary education in the UK. The third factor in the criteria was that the article report on specifically UK. Fourth consideration was the article to report on aspects relating to impact of sexual imagery on teenage pregnancy. This could be on sexual imagery from television, internet, movies, songs, or from teaching, and then indicate a relation to teenage pregnancy. Further, the article must be peer-reviewed, published between 2005 and 2011, and fully accessible. When running the articles through the criteria, some articles were relevant to the discussion but not included because they were literature reviews, meta-analysis, or systematic review. As shown in the graphic presentation of the exclusion and inclusion, these were discarded. Others excluded were those relevant to the topic, with in the specified years of publication but were policy papers or based on theoretical conceptions.
Based on the five aspects mentioned, the articles were first narrowed down to 365 depending on year of publication and accessibility. This was then reduced to 50 articles depending on participants, and research techniques. The final placement for 14 articles emerged from area of study, where selections were done depending on the article’s focus on sexual imagery as a topic or specific concentration on identified sources of sexual imagery including television, movies, internet, school, advertisements, or songs.
The included materials emerged in the following design:

Data Abstraction
After selection of the articles, the researcher considered the materials in terms of the study, location, dates, study design, sample and testing, description of the study, and then identifying the features of the discussion specific to the article. Other considerations in data abstraction were checking for quality and relevance. Quality checks included data collection techniques, length of study and participant characteristics and then ensuring the findings reflected accurate application of procedures and processes. Despite the articles being peer-reviewed, it was important to ensure quality checks that would increase the quality of the review, since it could be easily compromised by poor article selection. Relevance was maintained through checking the findings related to the topic under discussion.
Data Synthesis
Conducting a literature review gives a large amount of data that requires the reviewer’s attention in reading, analyzing, and interpreting the work then writing a report. As advised by Matthews and Matthews (2008) it is important to have a system to handle all the information converging on the reviewer. Following this advice, data analysis followed thematic coding using themes emerging from the topic under discussion. These include sexual imagery, sexual imagery impact on teenage sexuality, sexual imagery impact on teenage pregnancy, and intervention to reduce the impact of sexual imagery. The same themes form the basis of the discussion section each representing a chapter. As will become evident in the discussion, some articles will be useful within more than one theme, while others will have greater significance under one theme.
Review Limitations and Delimitations
In the process of collecting materials for the review, the emerging challenge was that using published works limits the possibility of generalization to the entire population. This is because published works are specific to the context selected by the research and thus may not apply across another group outside the context. This discussion considers persons aged 12 to 19 years, and includes articles that bring together this age group within differing categories such as 12-15 or 16-18 years. This leaves the reviewer to bring together the different groups to make one group representing the population. Irrespective of the noted limitation, the reviewer remained confident that the materials collected would provide the information needed to complete the discussion effectively.
This chapter gives insight into the review process describing the literature review and the data collection process. Included is an in-depth analysis of the database search, and inclusion and exclusion criteria for the 15 selected articles. These came from EBSCOhost and ProQuest Social Science as the third electronic database Sage Journals Online was disqualified for failing to produce results on two broad search phrases. The chapter also outlines the data abstraction and analysis process indicating the themes used in bringing together the information collected.
Chapter 3: Sexual Imagery in the UK
Fundamental development tasks during adolescence include exploring and understanding ones sexuality (Plakoyiannaki and Zotos 2009). This may include physical and emotional development of a sexual identity and learning to formulate healthy relationships, develop values and attitudes toward sex. Encouraging sexual development are various social influences among them adolescent exposure to sexuality content from various sources. These include schools through sex education and peers, television, movies, music, and the internet (Zurbriggen and Morgan 2006). These sources play a significant role in acquisition of sexual information among adolescents. Sources of sexual imagery present topics that convey the pleasure or displeasure of sexual relations through sexual references, jokes, and innuendos that have the capacity to influence sexual attitudes and behavior (Zurbriggen and Morgan 2006). Sexual imagery emerge from the way various sources present sexual content either in relation to women or male sexuality.
To illustrate the development of sexual imagery in the UK society, two analysis conducted using magazines in the UK to show the social construct of sexual images provide needed examples. A content analysis conducted by Farvid and Braun (2006) on male and female sexuality as presented in Cleo and Cosmo offer insight into the form of sexual imagery presented in the UK media to young people. The magazines target market is 18-34 years old women; however, the authors of the content analysis agree that it starts with girls as young as 14 years, hence its ideal use in the current research. Emerging from this analysis was that sexual imagery presentation was relentlessly heterosexual with a liberal image of sexuality among women (Farvid and Braun 2006). This means that women are empowered and independent, with the right to desire sexual relations and pursue pleasure. However, the independence was tampered with a needing nature in women, where they want a man in their life within a monogamous and long-term relationship. The sexual image emerging from the content analysis of the two magazines is that female sexuality is heterosexual with their happiness and fulfillment underlined by the right man ready to commit to a long-term relationship.
Expounding more on sexual imagery in the UK society, Plakoyiannaki and Zotos (2009) begin by stating that the UK is mainly a patriarchal society but is increasingly recognizing gender role portrayals with an empowered woman that also enjoys personal freedom. However, the authors recognize that the reality is different from the social understanding since women’s sexuality and sexual role continued to be defined by gender stereotypes of physical attraction and being sexual objects or decorations. Furthermore, appearances of dependence continue to inform portrayals of women in the UK society. The authors concluded from the indication of findings from British consumer magazines that the women portrayals show the concept of ideal femininity being the perfect provocateur. This is a woman displaying the expect image of sexual seductiveness, desire, and physical attraction.
Emerging from the above results on sexual imagery is that the form of imagery the teenagers find in the society is one that promotes the woman’s need for the man even as she explores her independence, and this is within a heterosexual setting (Plakoyiannaki and Zotos 2009; Farvid and Braun 2006). Further, women are encouraged to pursue the ideal image of seductiveness, desire, and physical attraction. Additionally, sexual pleasure emerges as an acceptable social ideal even for women considering the UK is a patriarchal society and thus the male person has greater advantage in making sexual decisions and pursuing the decision. The next chapter looks into how the constructed sexual imagery influences teenagers, considering whether they pursue the same formulations or divert from social expectations.
Chapter 5: Influence of Sexual Imagery on Teenage Sexuality
This chapter looks at the male and female construction of sexuality among teenagers emerging from sexual imagery. Discussed in the previous section is exposure to sexual imagery especially in the media, although as is apparent in the subsequent discussion, the media is not the only avenue for sexual imagery but it is the most obvious avenue. Other avenues considered are sex education, and sexual interpretations by nurses, teachers and peers.
Forrest (2010) conducted a research to find out boys response to sex education in England and determine whether the framework for sex education contributed to gender stereotyping. The study also sought to determine whether the learning and experiences in sex played a role in development of sexual identity and influenced beliefs about gender and sexuality. This provides a perspective on male construction of sexuality compared to the female construction that has been the focus of research as seen in the previous chapter in the works of Plakoyiannaki and Zotos (2009) and Farvid and Braun (2006).
In his opening statement, Forrest (2010) noted that school sex education is source of tension for boys and girls in relation to gender stereotyping. In these classes, girls and boys argue about the values and meaning attached to sexual behaviors and instead of promoting understanding of sexuality, sex classes can become a ground for promoting gender stereotypes. This is because boys tend to argue for masculinity while girls seek independence or women power, opening up a discussion that can degenerate into a sex battle.
Unfortunately, within this environment boys do not get to learn much about sexuality since they are perceived as problematic in sex education and thus teachers and trainers may avoid engaging them in serious sex talk, especially if they are unaware of ways to control the boys. As Forrest (2010) found out this makes sex education for teenage boys incompatible with their experiences. It does not address the stresses and strain they are undergoing as they move into masculinity. Further, lack of concrete information in sex education makes it alright for the boys to experiment and formulate their own constructs about sexuality. The constructs emerge from ritualized bullying, hectoring, and showing off. Additionally, the boys get into trouble with teacher for their problematic behavior since it is not understood that the behavior acts as a cover for their confusion, ignorance or doubt about sexuality.
Factors contributing to the boys behavior in sex education classroom is the need to fit within social constructs where behaviors related to shame and embarrassment are discourage among boys as they show a lack of control (Forrest 2010). To this end, boys may distance themselves from behavior showing weaknesses that may them the point of ridicule by their peers. The problem noted in sex education in relation to boys raises a need to consider ways to encourage boys to verbalize their fears without fearing ridicule, thus encourage accuracy in learning about sexuality.
The lesson emerging from the research by Forrest (2010) is that sex education as one of the sources of sexual imagery has been supporting continued existence of gender stereotyping in the constructs of masculinity and femininity. Masculinity sex-stereotype is for a person that does not show fear or keeps from factors that will lead to embarrassment. Further, lack of understanding of the factors driving boys behavior in their participation in sex education classes have made the classes have poor contribution to accurate learning about sexuality for boys. It promotes the need for accuracy in sexual imagery for both boys and girls.
Rahimi and Liston (2009) research is specific to influence of sexual imagery on girls sexuality. It considers assumptions by teachers and the way these influence adolescent girls sexuality. This study recognizes that sexual imagery also includes sexual labeling by peers, the society, and school staff including teachers, administrators, and school nurse, which also has an impact in the way teenage girls understand their sexuality. Ramihi and Liston (2009) also bring to the forefront the impact of this on promoting gendered role within a heterosexual society.
Teachers have a continued contact with students and see them dressed to suit what they perceive as the appropriate outfitting. Adolescent girls develop in a world with numerous sources of contradictory sexual messages including church, parents, music, movies, and peers (Rahimi and Liston 2009). These groups promote either abstinence or a hypersexualized context, and leave the teenager to pick the side that is most influential. The media and peers provide a substantially influential side especially on dressing, and girls will choose to dress within the images presented in these groups to fit in with the crowd. While the teenager may not be dressed in the manner as evidence of being hypersexualised, the dressing leads to teachers presuming the teenage is as hypersexualised as their models in the entertainment industry. This puts a barrier and conflict between teachers and students due to arising misunderstanding.
Emerging from this research is that while girls note the images presented in the various sources of sexual imagery they should refrain from actualizing them and instead toning down their sexuality in relation to sexual desire (Rahimi and Liston 2009). Hypersexualised dressing translates to showing sexual desire in this context, which is presumed to be poor behavior by the girls. Stifling one’s desire for girls emerges as desirable, and teaching on sexuality should be focused on silencing desires. Unfortunately, this makes teenage girls fear voicing issues relating to their sexuality. Again this study notes the importance of stereotyping on sexual constructs, where sexual imagery merge with social and individual constructs of gendered roles to define the way boys and girls should behave and understand their sexuality. For boys sexual imagery promote the need to maintain masculinity also an aspect of social understanding of masculinity, while girls need to retain their femininity while protecting themselves from hypersexualised images in the media and society.
Exploring further the role of others in the school setting and their capacity to  influence sexual imagery, Westwood and Mullan (2009) studied the perceptions of teachers and students of the school nurse identifying whether the nurse was an effective source of sexual health education. The teachers’ perception is positive indicating they feel the school nurse can positively contribute to development of effective sexual health education. However, students are more skeptical especially among the older and male students showing their role may not be as effective as considered by teachers. Female students are more agreeable on the positive role of the nurse as providing support, sympathy, knowledge, and being approachable in regard to sex health education. However, this points out the emerging gap in practice where boys and girls do not seem to receive similar or equal attention in sex education. Girls seem to receive greater attention compared to boys (Forrest 2010; Westwood and Mullan 2009). This makes teenage boys sexual education basically ignored.
This chapter continues to show that the impact of sexual imagery on teenagers operates within social constructs, where the people around the teenager and their reaction to sexuality will influence a teenager’s appreciation or lack of appreciation for sexual imagery. Within this constructs, teenagers develop their sexuality, remaining within their understanding of femininity and masculinity and the way those around them define the constructs. For girls, constructs of femininity are defined either by groups calling for a conservative expression of sexuality or by the media and peers that lean toward hypersexuality. For boys, the scale tips towards retaining masculinity expressions where issues leading to embarrassment or shame are discouraged. The differences in sexual constructs that boys and girls pursue also emerge from differences in helping them discover the meaning and understand their sexuality. Girls seem to receive greater attention, while boys receive less leading to poor learning about sexual imagery and their influence on boys compared to girls. Nevertheless, a need for greater learning for both boys and girls is evident if they are to overcome gender stereotypes and develop their own sexual identities within a stereotypes society that has various sources of sexual imagery.
Chapter 6: Influence of Sexual Imagery on Teenage Pregnancy
Historically, teenage pregnancy in the UK was condemned and considered morally wrong as an extension of pre-marital sex that was wrong (Macvarish 2010). However, in the last decade, premarital sex has become normalized as part of newer constructs in sexual imagery. The relaxation on morality surrounding pre-marital sex emerges from the risk discourse surrounding teenage sexuality, where teenagers are between adult and child and may thus not be considered liable for their sexual outcomes. Instead, the blame falls on lack of information that would help in making informed choices about sex and use of contraceptives. Additionally, teenagers may not have adequate skills required to negotiate sexual skills.
Other factors also counting into the excuse of teenage pregnancy is that they are feckless, ignorant, and immature, which are just prejudices against teenage parents (Macvarish 2010). Those that plan to have babies are considered naïve or their need attributed to dysfunctional families, or needing to fulfill their gender roles. However, this relaxation in pre-marital sex does not mean the society has become more acceptable of teenage pregnancies. To prove the lack of acceptance continues, various models for intervention have risen and the society is creating and popularizing ways to prevent pregnancy.
A contemporary message in regard to teenage pregnancy is the challenges and problems it creates for the young parent. The child born of a teenage mother represents some form of future problem and to discourage it, peer education programmes invite teenage mothers to speak on the problems child bearing including the discomfort of pregnancy, labor pains and the burden of baby care (Macvarish 2010). This has moved sex education to deterrence policy, where the child is a product of unprotected sex, and the teenagers are encouraged to recognize the challenges that will emerge from unprotected sex and having a baby.
The challenge of teenage pregnancy is not only emphasized to girls but boys are being included due to teenage fatherhood. According to Ngu and Florsheim (2011) boys are required by the young mother to embrace their paternal functioning; however, many of teenage fathers are at risk of failing in paternal roles based on dropping out of school, psychopathology, and repeat fatherhood. To promote better fatherhood, those that become teenage parents may undergo classes to assist them adapt to their new status while fulfilling other aspects of their teenage lives such as schooling.
Exploring further the issues of parenting and the girls expectation of the father, Whitehead (2008) noted in a research exploring relationship in teenage pregnancy that the relationship between the two depends on three factors. The first is the age of the father, their level of education and employment status, and third their ability to provide financially. The study also noted differences in demographic and cultural background, where teenage parents from south-east are likely to maintain the relationship, while those from north-west are less likely to pursue the relationship. The reason for this difference could be that in north-west teenage pregnancy is more common compared to the south-east.
While identifying the need for the father to be part of the parenting process, Whitehead (2008) recognizes that the reality has removed the father from the scene. The focus is largely placed on the mother, even when watching programmes about teenage pregnancies and parenting the dominant figure is the mother. This is understandable since many of the girls separate from the fathers or leave further from them. Teenage fathers mostly appear as absent fathers, and this is the picture constructed in sexual imagery.
Sexual imagery presented in the groups mentioned in the previous chapter, namely school, parents, then media and peers has constructed a double impact on teenage pregnancy where it either promotes or discourages behaviors related to sexual activity and subsequent pregnancy. Current constructs in sexual imagery are working toward discouraging teenage pregnancy by discouraging teenage sexual behavior. Showing the implications of engaging in sexual activities this early in life could act as a deterrence; however, evidence exist that teenagers are increasingly engaging in sexual activities at an early age a factor contributing to high pregnancy rates (Yu 2010). Therefore, messages are developing to counter this in sex education and highlighting the use of contraceptives.  
The major sources of sexual imagery are also becoming important in presenting the contraceptive message as part of sexual imagery. Among these are the media, such as through radio, magazines, internet, and television programming considering these are already significant sources of information on sex, abortion, and relationships (Yu 2010). A comment on the internet is that this is a growing medium with important attraction to teenagers and thus an effective tool of communication and facilitating education. Concerns continue to exist on sexual presentations in the media; however, within the same train in which it provides for information on sex, it can offer information on preventing pregnancy.
Another source of sexual imagery is interaction with peers. Teenagers share more details about sexual experiences and hopes with their friends compared to parents thus making friends an important source of information (Yu 2010). Friends can encourage use of contraceptives, abstaining, engagement in unusual sex behaviors, or encourage usual sexual activities. Peer consideration in promoting messages on sexual imagery, sexuality, teenage pregnancy, and contraceptive use is significant.
The school as a source of sexual imagery connects with sex education, which is a source of information for many children by providing sexual knowledge and skills. Sex education does not lead to a significant decline in sexual activity; however, it contributes to fewer pregnancies through comprehensive education in which teenagers are helped to understand the implications of their decisions (Yu 2010). The role is to provide information even if it may not change a teenager's beliefs and attitude toward sex.
Part of current education on contraceptives and reducing teenage pregnancy is use of emergency contraceptive. In a study conducted by Bayley, Brown and Wallace (2009), teenagers aged 13 to 16 years remain positive about emergency contraceptive recognizing the benefits it gives in avoiding teenage pregnancy. However, issues such as access, confidentiality, and anticipation of a negative reaction from others influence its use. The afore mentioned avenues of sexual information can be useful in providing accurate information in access, confidentiality, and use of emergency contraceptives among teenagers.
The impact of sexual imagery on teenage pregnancy is both on encouraging and deflecting. Supposed encouragement emerges from imagery promoting sexual activities such as encouragement from peers and media without taking precautions. Discouragement does not seem to emerge from abstaining from sexual activities but from use of precautionary measure prior or after engaging in sexual intercourse. To facilitate this, a need exists to educate in contraceptive use. An aspect noted in this chapter is the need to address pregnancy, an aspect that is emerging by showing the challenges associated with having unprotected sex and in turn becoming pregnant. Child bearing is not considered an added advantage to the teenage parents, including the absent father, but instead it is highly discouraged.
Chapter 7: Interventions to Sexual Imagery on Teenage Pregnancy
Emerging from the review is that sexual imagery has the capacity to influence conception of sexuality and lead to poor sexual decisions thus pregnancy. Following this finding is the recognition that teenage pregnancy may negatively affect an individual’s life for both teenage mothers and fathers, denying them the opportunity to enjoy their growing up and destroying their future prospects. This leads to the need to develop measures or interventions to undermine the negative impact of sexual imagery on teenagers, and instead develop a positive influence. Within research, there exist studies looking at various interventions for boys and girls that can promote positive influence of sexual imagery on teenage pregnancy. Among these is sex education, where teachers help students learn about sex, their growing bodies, contraceptives, and sexual decision-making. This also forms another form of exposure to sexual imagery. This review considers whether it has been able to achieve a positive influence on teenage pregnancy.
In their research, Henderson et al. (2006) assessed the impact of an intervention called sexual health and relationships (SHARE), a school based sex education intervention to facilitate sexual health education in teenagers. SHARE targets secondary school students, and was tested on ages 13-15 years with the target of reducing unwanted pregnancies, unsafe sex, and improve the quality of teenage sexual relationships. Trained teachers facilitated the programme through a 20 session pack divided in two groups begin with ages 13-14 years and then 14-15 years each group taking 10 sessions.
The results were interesting, finding that the programme did not show any benefit on rates for conception or termination compared to normal sex education (Henderson et al. 2006). However, the findings for conceptions or termination correlated to socioeconomic and cultural influences. This emerged in differences noted in schools across Scotland. Note the results indicated were in comparison to conventional sex education programmes. However, the authors agreed that sex education in schools did have a benefit to reducing conceptions, unsafe sex and decision-making. Emerging from the SHARE programme was that students gained practical knowledge on sexual health, had less regrets about sexual activity, and though at a minimal level benefitted in alternate beliefs to sexual intercourse and intentions to resist unwanted sexual activities. It also encouraged discussion on use of condoms with partners but did not affect sexual experiences and use of contraceptive.
Gained from the study by Henderson et al. (2006) was that a sex education has the potential to discourage unsafe sex and reduce the age at which teenagers engage in sexual intercourse, thus agreeing with previous knowledge on the topic. It nevertheless, noted the need for adding complementary and longer term interventions to existing sex education. This would address factors such as socio-economic inequalities and cultural influence that have an influence on teenage sexual behavior.
Apart from school based sex education programmes, the government has also taken the initiative to reduce early motherhood through the teenage pregnancy initiative launched in 1999. By 1998, teenage pregnancy in the UK was at a peak hence the strategy. The countries in UK, namely Wales, Scotland, Northern Ireland and England defined their own strategies. An example is the England strategy that comprised of national media awareness targeting youth magazines and radio encouraging teenagers to rests peer pressure in sexual activity, contraceptive use, giving advice on sex and relationships, and availability of confidential contraceptive (Wilkinson et al. 2006). Second was having a joint venture between local and national agencies coordinating statutory and voluntary activities. Third was improvement on sex and relationship education as well as improving on access to sexual health services. The fourth component was encouraging teenage parents to return to education, training, and employment. Support for the programme is provided in a helpline proving details for services and support websites.
Wilkinson et al. (2006) undertook a geographic study analyzing under-18 conceptions, births, and abortions between 5 years before and after the implementation of the strategy. After the implementation of the strategy, the researchers note that the pregnancy rate declined by 2.0% annually between 1998 and 2003. The findings also followed others findings (Henderson et al. 2006) that socio-economic and home background played a part in conception rates. The researchers found conception rates were higher among teenagers from deprived and rural areas as well as among those with poor educational attainment. The findings also showed areas receiving strategy-related resources had greater change in the decline.
National strategy shows that the four components have a positive influence on teenage pregnancy since decline in conception and birth were greatly realized in those areas with strategy related funding (Wilkinson et al. 2006). However, the authors recognize that the evidence on decline is limited, and thus recommend longer-term observation to look at further progress. This will be useful in showing whether the UK position on teenage pregnancy improves on an international level.
A third strategy proposed to bring down teenage pregnancy in UK is a model used in Leicester, which focuses on incorporating youth involvement into teenage pregnancy prevention programmes (Fleming, Chong and Skinner 2009). The research conducted by Social Action Researchers in collaboration with Youth Affairs Unit worked with peer evaluators to ensure that the people that would be most affected by the findings are part of the process. The researchers conducted an evaluation of Teenage Pregnancy Prevention Strategy in Leicester. Although the report is dedicated to the process of having peer evaluators participate in the evaluation process an important emerging lesson is the potential benefit in having peers as part of teenage pregnancy prevention strategies. Peers as recognized by Fleming et al. (2009) are able to draw out the young people since they can relate. The feeling that the other person understands the feelings and emotions behind the teenagers actions can promote education and knowledge transfer in educating teenagers about sex and the images they are exposed to that related to sexual activities.
The knowledge on preventing teenage pregnancy agrees on the possibilities of supporting young people and providing information that would work toward reduced pregnancy rates and birth rates among teenagers in the UK (Henderson et al. 2006; Wilkinson et al. 2006). Among possible strategies are sex education programmes in school, strategies derived from the national teenage pregnancy prevention programme that comprises of media campaign, school based education, agency partnerships, and parent-teenager support, as well as utilizing peer campaigns. These strategies have the capacity to offer teenagers information useful in interpretation of sexual imagery, making right decisions on their sexual activities including refrain from sexual intercourse until a later age, or using contraceptives. The noted factor is that the strategies are a source of information that can be helpful in guiding teenagers on use of information gained through various sources of sexual imagery.
Chapter 8: Conclusion
The purpose of the review was to consolidate available research on influence of sexual imagery on teenage pregnancy in the UK. It considered the various sources of sexual media as a way of providing a holistic outlook on teenage pregnancy and exposure to sexual imagery, and the way the exposure will influence sexual decision thus leading to teenage pregnancy. The review considers sexual imagery in relation to teenage boys and girls identifying the difference in presentation and expectations. Considered in the review are the two sides of sexual imagery presented in relation to teenage pregnancy, where it can facilitate an increase in teenage pregnancy through promotion of acceptance of teenage sex, or promote a decline by teaching about sexual responsibility.
The review findings show that sexual imagery in the UK in relation to teenagers revolve around construction of gender stereotypes ensuring that even as teenagers from their sexual identity these are within the bounds of society. The expectations are for boys to exist within the confines of masculinity, while girls recognize femininity and the call for controlling sexual desires while maintaining physical attractiveness and desirability. The attendance to masculinity makes boys difficult to teach in sex education class, since they fear looking confused or doubtful, which would be embarrassing, while the constructs of femininity and physical attraction defined in hypersexuality for girls give room to misinterpretation.
Within this sexual imagery, teenage boys and girls develop their sexuality, identifying with behaviors as expected of their gender. This connects to gender stereotypes in masculinity and femininity. Furthermore, the development happens in reflection to the sexual imagery attained from the complex environment comprising of expectations from peers, comments from teachers, and help from other avenues. As adolescents identify with sexual imagery, a possibility exists for attraction toward sexual activities leading to pregnancy. Pregnancy in the UK is recognized as a significant problem and teenagers are discouraged from getting pregnant and having children. The discouragement emerges from presenting messages about the difficulties of teenage parenthood, and to avoid such an event use of contraceptives is encourage.
Amidst this development is need for strategies to help prevent pregnancy, within the school and national level. At the school level, use of school based sex education augmented with contemporary factors provides a possible avenue. While noting the potential use behind sex education it is important to not current failures in teaching boys and address this aspect. Findings from the review note differences in teaching boys and girls, where more emphasis is placed on girls. Boys sex education should also be encouraged. Another strategy is to encourage peer training, where peers talk to each other and offer advice on sexual activities. The third strategy emerges from the national responsibility in reducing teenage pregnancy through strategies such as media campaigns.
Post Script: Reflection
The process of conducting the review was a highly informative one, comprising of extensive research into the issues discussed. Learning gained from the experience was being able to appreciate the process of a literature review beginning with identification of a topic, carrying out preliminary research, and then pursuing the actual review. It was important to especially conduct a preliminary research as this provided a background on the issue making it easier to identify materials needed to proceed further. Working through impact of sexual imagery on teenage pregnancy in the UK also provided an opportunity to appreciate the plight of teenage pregnancy in the UK and the factors leading to the aspect.
The process was not as simple as it sounded when beginning, the process of identifying articles for the actual review is tiresome, cumbersome, and complex in formulation of themes. Reading through a large amount of literature to identify the articles required dedication especially when looking at materials from different databases. Nevertheless, application of the article exclusion and inclusion criteria made it easier to peruse through the thousands of articles. Further, identifying search phrases early helped develop some idea on the possible themes that would emerge from the reading, and having a preliminary search was also helpful.
The limitation noted in the review was lack of an extensive number of research directly linking sexual imagery to teenage pregnancy. Instead the research available took aspects of the topic instead of the whole. Nevertheless, the research was able to bring together the disjointed works to make a consolidated effort. This leads to the literature's contributions to the body of knowledge. This work recognizes materials published in credible peer-reviewed journals. It brings together these literatures to form one outlook on sexual imagery on teenage pregnancy in UK. This gives a holistic outlook derived from different sources thus making the picture complete. From the consolidated literature it becomes easier to form a debate on the topic, as this emerges from the flow of the presentation instead of pursuing disjointed discourse.
Prior to conducting the review, the learning was to explore sexual imagery and its impact on teenage pregnancy in UK and considering whether teenage boys and girls received similar lessons from the imagery about relationships and feelings, and safety. The learning outcomes were to identify the impact sexuality had on teenage pregnancy, understand teenage pregnancy in the UK better, and look into ways to reduce the high rate of pregnancy in the UK. In preliminary research, it was evident that UK had a very high teenage pregnancy rate compared to other regions. Having identified this, the next step was identifying factors contributing to the high rates of pregnancy. Sexual imagery offers an explanation showing the way sexual portrayals influence the actions of young people. It has the capacity to encourage a more permissive attitude toward sexual activity among the youth especially when presented with information to facilitate better decision-making and avoid pregnancy.
Part of the learning process included looking at differences in gender in lessons boys and girls gain from sexual imagery. It was noted that both operated within expectations of the society in relation to pursuing ideals of femininity and masculinity as provided in the sexual imagery. Further, interpretations of others contributed to the teenagers interpretation of sexual imagery such as the contribution of teachers and school nurse. Access to information also seems to contribute to the potential impact of sexual imagery on adolescents.
Deriving from the issues emerging from the learning outcomes, the review was able to meet the target by raising information on teenage pregnancy in the UK and the impact of sexual imagery. It also clearly indicated that male teenagers were at a disadvantage in learning about sexual imagery and its impact on their life. For example, in learning processes facilitated in sex education programmes the teachers perceive them as problematic and instead of encaging participation they discourage them. The problem is in gendered requirements of a male child that reflect in their learning and hinder them from pursuing that which interest them. Additionally, lessons related to pregnancy concentrated on girls or the mothers. Although evidence rose in boys being trained into parenthood, much focus has been on motherhood.
The review responds to the question of what is the impact of sexual imagery on teenage pregnancy in the UK. However, it was noted that some aspects of the analysis were more noticeable compared to others. Part of sexual imagery considered was in adverts, television, magazines, school, internet, radio, and movies. It was easy to identify imagery consequences in relation to magazines, adverts, and schools while the others took more time. To some extent each element is mentioned in research, which assisted in formulating the answers to the question.

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