JMIR Publications

ABSTRACT

Background:

Caesarean section (CS) rates in Indonesia are rapidly increasing, for both social and clinical reasons. However, there is little understanding about the role social media plays in influencing preferences around mode of birth (vaginal or CS). Social media provides a platform for users to seek and exchange information, including information on the mode of birth, which may help to unpack social influences of health behaviour.

Objective:

This study aimed to explore how CS is portrayed on Indonesian Instagram.

Methods:

We downloaded Instagram posts from Indonesia containing CS #hashtags and extracted their attributes (image, text, #hashtags, as well as objects and texts within images). We used a mixed-methods approach to analysis, utilising text mining, descriptive statistics, and qualitative content analysis.

Results:

A total of 9,978 posts were analysed quantitatively, and 720 posts were sampled and analysed qualitatively. CS was portrayed on Instagram through advertisements, health messages, and birth stories. Instagram posts using CS #hashtags mostly advertised herbal medicine products to women for faster CS recovery. Services were advertised to offer women a clinical consultation to choose an auspicious day for childbirth – encouraging uptake for elective CS. Some private health facilities and providers explicitly promoted CS by giving discounts for CS on special events, such as mother’s day, and promoting clinical techniques (enhanced recovery after CS) claiming to improve comfort, provide a painless, and a faster recovery birth. There were mixed messages regarding the support for or promotion of CS, with some posts encouraged CS, while others were neutral or discouraged CS.

Conclusions:

This study highlights the need for enforcement of advertisement regulations around birth-related medical services, and more health promotion aims to provide accurate, balanced, and appropriate information for women regarding the mode of birth. Ongoing and proactive health information sharing from government organisations may also be needed to encounter bias in promoting CS over vaginal birth.