JMIR Publications

ABSTRACT

Background:

Caesarean section (CS) rates in Indonesia are rapidly increasing for both sociocultural and medical reasons. However, there is limited 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 on health behaviour.

Objective:

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

Methods:

We downloaded public Instagram posts from Indonesia containing CS #Hashtags and extracted their attributes (image, text, #Hashtags, and objects and texts within images). Posts were divided into two periods: "before COVID-19" and "during COVID-19" to examine changes in CS portrayal during the pandemic. 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. The use of text (527/5193, 8.91% vs 242/4065, 5.95%; P<.05) and advertisement materials (411/5913, 6.95% vs 83/4065, 2.04%; P<.05) increased during COVID-19 pandemic compared to before the pandemic, indicating growth of information-sharing on CS over time. Posts with CS hashtags primarily promoted herbal medicine for faster recovery and services for choosing auspicious childbirth dates, encouraging elective CS. Some private health facilities offered discounts on CS for special events like Mother’s Day and promoted techniques like Enhanced Recovery After CS (ERACS) for comfortable, painless, and faster recovery after CS. #Hashtags related to comfortable or painless birth (2358/5193, 39.88% vs 278/4065, 6.84%; P<.05), ERACS (124/5193, 2.09% vs 0/4065, 0.0%; P<.05), Feng Shui services (110/5193, 1.86% vs 56/4056, 1.38%; P<.05), name of healthcare providers (2974/5193, 50.30% vs 304/4065, 7.48%; P<.05), and name of hospitals (1460/5193, 24.69% vs 917/4065, 22.56%; P<.05), were more prominent during compared to before the pandemic.

Conclusions:

This study highlights the necessity of enforcing advertisement regulations around birth-related medical services in the commercial and private sectors. Enhanced health promotion efforts are crucial to ensure women receive accurate, balanced, and appropriate information about birth options. Continuous and proactive health information dissemination from government organisations is essential to counteract biases favouring CS over vaginal birth.