Pregnancy and child

Television and teen pregnancy

The Times reported that a study has found that "teens that watch sexual scenes on television are twice as likely to get pregnant". It said the US study looked at pregnancy rates among teenagers and their viewing of shows such as Friends and Sex and the City. The researchers behind the study say they have found a “compelling link between a high exposure to sexual content on television and teen pregnancies.”

However, the factors contributing to teenage pregnancy are complex, and it is too simplistic to blame teenage pregnancy on television viewing. In addition, the design of this study means it cannot prove that televised sexual content is responsible for teenage pregnancy.

Where did the story come from?

Dr Anita Chandra and colleagues from RAND Corp (a non-profit research organisation in the USA) carried out this study, which was published in the peer-reviewed medical journal Pediatrics. Sources of funding were not reported for this study.

What kind of scientific study was this?

This was a cohort study which looked at the relationship between teenagers viewing sexual content on television and the likelihood of becoming or making someone pregnant. It analysed data from a national survey of 12 to 17 year-olds in the US with follow-up surveys one and three years later.

For the initial survey, in 2001, researchers telephoned  households that were likely to have people aged 12 to 17 living there. The interviewers confirmed whether a young person did live there, and asked if they and their parents would agree to them being surveyed.

A total of 2,003 young people agreed to participate and completed the first survey, and of these 73% completed another survey three years later, when they were aged 15 to 20 years. Young people were encouraged to complete the survey in private. The survey included questions about demographics, social and pyschological characteristics, television watching (amount and content), and sexual behaviour, attitudes and knowledge.

The young people were asked how frequently they watched a selection of 23 programmes popular amongst teenagers during the previous television season, using a four point scale ranging from ‘never’ to ‘every time it was on’. These 23 programmes included sitcoms, dramas, reality shows, animated and live action shows that were shown on a range of channels. The shows were selected as they had high levels of sexual content.

The researchers watched three episodes of each programme and counted how many scenes focused mainly on sexual behaviour (from flirting to intercourse) or talking about sex, and then calculated an average per episode to give an indication of the level of sexual content.

The researchers then calculated how much exposure to sexual content each young person had by multiplying how often they watched a programme by its average sexual content rating, and adding up these values for all 23 shows.

The survey also included questions about whether the young person had ever been pregnant or got anyone else pregnant. If they answered yes to these questions, they were then asked to give the year and month of their most recent pregnancy.

For this current study, researchers selected those young people who provided complete information about their sexual behaviour and pregnancy at the final interview and had reported having begun sexual activity, totalling 718 participants. Five young people had experienced a pregnancy before the first survey, and they were included in the analyses.

The researchers then looked at whether the level of exposure to sexual content on television at the first survey predicted the likelihood of pregnancy during follow-up. The researchers took into account factors that might affect results including the participants’ ages, gender, race/ethnicity, academic achievement, whether they reported wanting to have children before age 22, family life, difficult behaviour and parental education level.

What were the results of the study?

A total of 91 participants (around 14%) reported being pregnant, or getting someone pregnant between the first and final survey, three years later. After adjusting for other factors that might affect results, researchers found that young people who were exposed to more sexual content at the time of the first survey were more likely to report a pregnancy.

Based on their findings the researchers estimated that if all young people aged 16 watched a low level of sexual content on TV, 5% would be expected to report a pregnancy by age 19, compared to 12% if they all watched a high level of sexual content on TV.

What interpretations did the researchers draw from these results?

The researchers concluded that their study was the first to show a prospective link between viewing sexual content on television and teenage pregnancy. They suggest that the risk of teen pregnancy could be reduced by “limiting adolescent exposure to the sexual content on television and balancing portrayals of sex in the media with information about possible negative consequences”. They also suggest that parents may be able to counteract the effect of sexual content by watching and discussing these programmes with teens.

What does the NHS Knowledge Service make of this study?

This study cannot prove that watching sexual content on television is directly responsible for the pregnancies that occurred. As the authors themselves note, “The factors that contribute to teen pregnancy are complex and interrelated”.

Additionally, while this study did collect data in a prospective fashion, there are still a number of limitations:

  • Although the authors tried to take into account many of the complex factors known to be related to teen pregnancy these, and other unknown factors, may still have influenced the results of the study.
  • It is difficult to fully assess exposure to sexual content on television. The questionnaire used assessed only 23 programmes, which were rated on the basis of three episodes only, and this may not have been representative of the young people’s overall viewing or of the content of the selected shows.
  • Sexual content was not graded according to the messages contained, and some messages may have been positive (such as the importance of having protected sex).
  • This study did not itself look at whether reducing a young person’s viewing of sexual content would reduce their likelihood of pregnancy, nor whether accompanying such viewing with parental commentary would have a similar effect, therefore it is not possible to draw conclusions about the effect these actions would have.
  • The results rely entirely on teens self-reporting their television viewing, pregnancy status, and other characteristics, without independent validation. This may affect reliability of results.
  • This analysis included only individuals who were sexually active by the final survey at age 15 to 20 years. Inclusion of those teens who were not sexually active may have affected results.
  • This study was carried out in the US, and so the results may not be representative of what would be found in other countries.

This study provides us with more information about the characteristics of those who experience teenage pregnancy.

The complexity of this issue is enhanced by the fact that the authors report that teenage pregnancy in the US has reduced “remarkably” since 1991, while it seems unlikely that teenage viewing of sexual content on television has similarly decreased in this period.

Teenage pregnancy rates will be affected by a affected by a range of complex social factors, and it is too simplistic to blame television viewing alone. Instead parents, teachers, healthcare professionals, and policy makers should to continue to work together to ensure young people are well educated about sex, the risks of teenage pregnancy and sexually transmitted infections.

Sir Muir Gray adds...

It's still unclear whether this is a direct cause or just a sign of the teenagers' interests, but the findings are unsurprising.

NHS Attribution