Social media use and postpartum body image dissatisfaction: The role of appearance-related social comparisons and thin-ideal internalization

Examination of the Feelings and Experiences of Postpartum Mothers Engaging with Social Media: A Qualitative Study

Purpose: This study examined how postpartum mothers experience social media within the context of mothering and their postpartum body.Methods: A subsample of 20 mothers (age 23-42) of infants aged 0-6 months who were exposed to body-focused social media posts as part of an experimental study designed to test social media's impact on body dissatisfaction took part in semi-structured interviews. We used thematic analysis to identify themes and subthemes generated from the data.Results: We identified three themes in the study: (i) Social media provides a sense of connection with family and friends as a source of support, and connecting with others to gather information related to mothering and child-rearing; (ii) social media led mothers to engage in comparison regarding their bodies, lifestyles, and baby's development; and: (iii) mothers do not always recognize the influence of social media on their feelings.Conclusions: Findings can help guide prenatal and postpartum interventions and equip healthcare professionals with the information needed to support postpartum mothers in maintaining a positive body image and mothering experience when engaging online.

Cultural Determinants of Body Image: What About the Menopausal Transition?

Body image is an important aspect of psychological well-being that is influenced by several biological and psychosocial risk factors. Cultural determinants of body image include the patterns of shared beliefs, values, practices, and social norms within a group that can act as a lens through which a person perceives, compares, and evaluates their body. Women tend to experience higher rates of body dissatisfaction than men, with reproductive milestones such as puberty, pregnancy, and postpartum being windows of vulnerability for body image concerns. The menopausal transition is another reproductive stage of women's lives that involves major physical changes, psychological challenges, and social pressures that can impact body image negatively. However, the literature on the influence of cultural determinants on the body image of menopausal women is limited. Therefore, this perspective review paper aims to discuss the potential role of cultural determinants in influencing body image satisfaction in women undergoing the menopausal transition. To this end, the relationships between different cultural perspectives and body image around the world are first discussed. Sociocultural influences on body image throughout women's lifespan and reproductive stages are then presented. Finally, cultural perspectives on menopause and aging and their potential influence on the body image of menopausal women are explored. This paper underscores the importance of considering culture and sociocultural factors when studying body image and highlights the need for further research on the cultural determinants of body image during the menopausal transition.

The trajectory of body image dissatisfaction during pregnancy and postpartum and its relationship to Body-Mass-Index

BACKGROUND

During pregnancy, women's bodies undergo rapid body weight and size changes within a relatively short period. Pregnancy may therefore, be associated with an increased vulnerability for developing body image dissatisfaction linked to adverse health outcomes for the mother (e.g., depression, eating disorders) and child (e.g., impaired self-regulation, childhood obesity). The present study aims to examine the prevalence and trajectories of body image dissatisfaction during pregnancy and postpartum and its relationship to pre-pregnancy BMI. This is the first study that investigates prevalence rates of body image dissatisfaction not only ante- but also postpartum, and that compares trajectories of women with normal weight and overweight.

METHODS

A prospective longitudinal design with a quantitative approach was applied. Healthy pregnant women (N = 136) answered paper-pencil or online questionnaires at four time points (18th-22nd and 33rd-37th week of gestation, 3 and 6 months postpartum). Body image dissatisfaction was assessed using the German version of the Body Shape Questionnaire (BSQ) and the Eating Disorder Examination Questionnaire (EDE-Q). Both questionnaires are considered reliable and valid measures of several aspects of body image, and the BSQ allows for calculating prevalence rates by providing cut-off values. Using not just one but two body image questionnaires, trajectories of body image dissatisfaction can be compared. Pre-pregnancy BMI was assessed retrospectively via self-reported weight and height.

RESULTS

The proportion of women reporting elevated levels of body image dissatisfaction was 6.6% (n = 9) in the second trimester, 2.9% (n = 4) in the third trimester, 11.0% (n = 15) three months postpartum, and 10.3% (n = 14) six months postpartum. Repeated measures ANOVA revealed that body image dissatisfaction significantly decreased from pre-pregnancy to pregnancy, remained stable during pregnancy, and returned to pre-pregnancy levels three to six months postpartum. Mixed between-within ANOVA showed that the overweight/obese group reported significantly higher levels of body image dissatisfaction at each measurement point except during the third trimester than women in the normal weight group. Significant but small interaction effects between time and pre-pregnancy BMI were found.

CONCLUSIONS

The results revealed that approximately every tenth woman is affected by body image dissatisfaction after childbirth. Women with a higher BMI level before pregnancy are particularly at risk of experiencing body image dissatisfaction. Healthcare providers should screen for body image dissatisfaction, in particular after childbirth, and inform affected women about possible adverse health outcomes and treatment options. Study limitations concern the drop-out rate of 51.4% and the retrospective and self-reported assessment of pre-pregnancy BMI. Future studies should include additional assessment points in the first trimester and more than six months postpartum and try to include a matched control group of non-pregnant women to compare prevalence rates and trajectory of body image dissatisfaction.

In search of the 'like-minded' people: pregnant women's sense-making of their physical activity-related social experiences

AIMS/BACKGROUND

Social factors are increasingly recognised as influential on antenatal physical activity. While pregnant women describe the people and support they require to remain physically active, little is known about how pregnant women select and make sense of their social experiences throughout pregnancy. This study followed pregnant women's sense-making of their physical activity-related social experiences as pregnancy progressed, and physical activity declined.

DESIGN/METHODS

This study used a qualitative design. Four pregnant women were recruited in their second trimester, participated in three individual semi-structured interviews and submitted diary entries throughout trimesters two and three. Data were analysed using longitudinal interpretative phenomenological analysis.

RESULTS

To facilitate physical activity, pregnant women were 'searching for the "like-minded" people who motivate, share and understand', namely pregnant women and prenatally trained exercise professionals. When making sense of social experiences, pregnant women were 'grading and critiquing the quality and paucity of "active pregnancy" information', and'cherry-picking social experiences necessary for "nesting", obtaining support and protecting self-esteem as physical activity declined'. This involved disengaging from social experiences, and consequently, some pregnant women found themselves 'lamenting interactions with the "like-minded" people, contending with grief and inner conflict'.

CONCLUSION

Pregnant women proactively seek and make sense of social experiences to facilitate physical activity. In an increasingly digitalised society, interventions should support pregnant women to utilise social media constructively and safely to access 'like-minded' people, provide in-person and virtual networks to meet individual support needs throughout pregnancy and encourage health professionals to demonstrate interest in the 'active pregnancy' to maximise influence.

Mothers' experiences living with diastasis recti abdominis - an interview study

BACKGROUND

Diastasis recti abdominis (DRA) is a common postpartum condition. Knowledge is scarce on how mothers perceive living with DRA. The interaction between healthcare providers and patients plays a significant role in shaping the healthcare service experience. Women suffering from typical women's diseases tend to experience not being taken seriously or listened to when seeking healthcare. The aim of this study was to explore mothers' experiences living with DRA.

METHODS

Semi-structured individual interviews were conducted with six Norwegian mothers, age 32-41, presenting with a clinically significant DRA. Topics discussed were how the condition is experienced, how it affects different aspects of day-to-day life and experiences with healthcare services. The data was analyzed using systematic text condensation.

RESULTS

DRA had an impact on everyday life among the mothers included in this study. Three major themes emerged: (I) The path to obtaining knowledge and understanding of DRA, (II) DRA - intertwined with health issues and physical limitations and (III) A changed belly - on self-image & social interactions. The mothers experienced uncertainties and frustration when trying to learn about DRA. The limited knowledge of the condition made it hard to differentiate if the experienced symptoms were caused by presence of DRA or from other health issues. Several mothers felt misunderstood.

CONCLUSION

DRA is a multifaceted condition affecting many aspects of day-to-day life in various dimensions, like physical, emotional, and social. This study contributes to a wider understanding of living with DRA, which might guide healthcare professionals in providing support for mothers with this condition.

Sociocultural pressures and body related experiences during pregnancy and the postpartum period: A qualitative study

Sociocultural pressures to pursue unrealistic appearance expectations and control body shape and weight during pregnancy and postpartum periods have been increasing. Little is known about messages from different sources that may constitute unhelpful or protective influences. The aim of this study was to qualitatively examine messages women received from the sociocultural environment during pregnancy and postpartum and their association with experiences of living in their bodies and body change behaviors. Twenty women, mean age (SD)= 31.85, (2.3) years, 95% White, 60% with a Master's degree or higher, participated in individual interviews and completed online surveys. Women described appearance pressure from multiple sources during and after pregnancy, that increased their concerns related to their weight and shape. For a small number, these concerns were associated with efforts to control weight. Others described protective influences from friends and family that promoted body attunement, functionality appreciation, and positive body image. Findings highlight the importance of sociocultural influences during the peripregnancy period yet how many women derive elements of positive body image from this period. These findings have implications for interventions to support body image among women during the peripregnancy period and positive outcomes among mothers and infants.

Effect of social media on body image of pregnant and postpartum women in India

In the present times, there is a high influence caused by social media platforms in case of body image issues faced by an individual. Pregnancy is a stage for women where they go through several mental and physical changes. Realizing the inseparable role played by social media in this aspect, it is an attempt here to determine the effect caused by social media on the body image of pregnant women as well for those in their post-partum stages. The PRISMA method is used by the authors to arrive at 55 research papers from the Scopus databases that are systematically reviewed. The authors' review reveals that social media can have both negative and positive effects on women's perception of body image during pregnancy and the postpartum period.

A prospective study on body image disturbances during pregnancy and postpartum: the role of cognitive reappraisal

Background

During pregnancy, body size rapidly modifies over a relatively short period. Literature emphasizes the need to identify the factors that influence body image during peripartum as the extent of women's adaptation to these changes has significant repercussions on both mother's and newborn's health. Emotion regulation strategies (i.e., expressive suppression and cognitive reappraisal) were linked to body image in the general and clinical population, but no studies were conducted in the peripartum. The present study aims to investigate the longitudinal impact of prepartum body image disturbances on postpartum body image disturbances and to evaluate the mediational role of emotional regulation strategies.

Methods

A total of 133 pregnant women completed a three-phase longitudinal study. Women answered online questionnaires during the second (T1) and the third (T2) trimesters of pregnancy, and at about 6 months postpartum (T3).

Results

Findings indicated that body image disturbances at T1 were a significant predictor of body image disturbances in the postpartum (1 year after the first assessment). Moreover, cognitive reappraisal measured at T2 partially mediated this relationship: body image disturbances in the second trimester of pregnancy were linked to less use of cognitive reappraisal in the third trimester of pregnancy, and this, in turn, was associated with worse body image disturbances at 6 months after birth.

Conclusion

Findings of this longitudinal study highlight the importance of assessing body image disturbances during pregnancy to early identify women at risk, and suggest cognitive reappraisal as a possible target intervention.

Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum

PURPOSE

Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity.

METHODS

In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake.

RESULTS

Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy.

DISCUSSION

The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies.

LEVEL OF EVIDENCE

Level I-Evidence obtained from: systematic reviews and meta-analyses.

#Fitmom: an experimental investigation of the effect of social media on body dissatisfaction and eating and physical activity intentions, attitudes, and behaviours among postpartum mothers

BACKGROUND

Research has shown that body dissatisfaction is higher during the postpartum period compared to other periods of life, and strongly associated with disordered eating behaviours, which can lead to adverse health outcomes. While results from cross-sectional studies suggest that social media may play an important role in body dissatisfaction among postpartum mothers, causal inference is limited due to the observational nature of the existing research. The objective of this study is to experimentally test the effect of body-focused social media on the body dissatisfaction and eating and physical activity intentions, attitudes, and behaviours of postpartum mothers.

METHODS

Postpartum mothers of infants 0-6 months (n = 132) were randomly assigned to view either body-focused social media posts (n = 65), or a control set of infant feeding tips (n = 67). ANCOVA was used to examine differences between the intervention and control group on levels of body dissatisfaction, eating and physical activity intentions, attitudes, and behaviours. There were two follow-up time points, immediately post intervention and 1-month post intervention to measure potential sustained effects of intervention.

RESULTS

Exposure to body-focused social media posts resulted in higher levels of body dissatisfaction, mean difference 1.54 (p = 0.002); poorer body image, mean difference 0.41 (p = 0.007); eating attitudes, mean difference 2.26 (p = 0.025); and higher levels of restrained eating behaviours, mean difference 0.39 (p < 0.001) among the intervention group post intervention. Mothers in the intervention group also reported higher levels of inspiration to be active, mean difference 0.48 (p = 0.021) post intervention. A sustained effect was found for restrained eating, mean difference 2.03 (p < 0.001) and poorer eating attitude, mean difference 0.29 (p = 0.001) at 1-month follow-up. No sustained effects were found for any other outcomes at 1-month follow-up.

CONCLUSION

Social media exposure to body-focused social media posts negatively affect postpartum mothers' body dissatisfaction and health behaviours. Further experimental research that includes an interactive social media component is needed among this population.

TRIAL REGISTRATION

NCT05181280, Study ID Number: 054798. Registered 06/01/2022. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05181280 .

Course and prediction of body image dissatisfaction during pregnancy: a prospective study

Background

During pregnancy, women`s bodies undergo rapid changes in body weight and body size within a relatively short period of time. Pregnancy may therefore be associated with an increased vulnerability for the development of body image dissatisfaction that has been linked to adverse health outcomes for mother and child. The present study aims to examine changes in body image during pregnancy as well as predictors of body image dissatisfaction. This is the first study using a tailored, multidimensional measure of body image especially developed for the pregnant population.

Methods

A prospective longitudinal design with a quantitative approach was applied. Healthy pregnant women (N = 222) were assessed using standardized instruments at two time points (T1: 18th-22th week of gestation, T2: 33th-37th week of gestation). The impact of demographic, weight- and health-related, behavioral, and psychological factors assessed at T1 on body image dissatisfaction at T1 and T2 was examined using stepwise linear regression analyses.

Results

T-tests for paired samples revealed that dissatisfaction with strength-related aspects of body image, dissatisfaction with body parts, and concerns about sexual attractiveness increased significantly from the middle to the end of pregnancy. In contrast, preoccupation with appearance, dissatisfaction with complexion, and prioritization of appearance over function were significantly reduced over time. Stepwise linear regression analyses revealed that factors influencing body image depend on the component of body image investigated. Overall, a low level of self-esteem and a high level of pregnancy-specific worries were risk factors for several components of body image dissatisfaction. Besides these, poor sleep quality, low levels of physical activity, disturbed eating behavior, and higher levels of BMI and weight gain were significant predictors.

Conclusions

The results highlight the multidimensional nature of body image and show positive as well as negative changes during pregnancy. Overall, modifiable psychological, behavioral, and weight-related factors appear relevant to the extent of body image dissatisfaction.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-05050-x.

Operationalizing Whole-Person Postpartum Care: Health Care Provider-Level Strategies

Postpartum mothers report feeling unsupported and unprepared by their health care providers to meet the challenges of the postpartum period. This gap perpetuates a cycle of disappointment with and disengagement from postpartum care services. The need to revamp postpartum care has been recognized at the population level but implementing changes at the health care provider level is challenging without practical guidance. The needs of new mothers are broad in scope and variable between individuals, requiring a whole-person care approach that is comprehensive yet nimble. Presented here are provider-level strategies to promote care that both elicits and is responsive to the unique care goals of this population.

Partner influences, breastfeeding, and body image and eating concerns: An expanded biopsychosocial model

BACKGROUND

Recent research among postpartum women has considered body image and eating attitudes as well as exclusive breastfeeding within common theoretical models. However, these efforts have so far neglected to include partner-related constructs, which constitutes an important gap. Thus, the aim of this study was to examine an integrated model of body image and eating concerns, and exclusive breastfeeding among mothers of infants six months and younger, that included partner appearance influences as well as general postpartum support.

METHODS

A sample of new mothers (N = 156), aged 20-47 years, mean = 32.7 (SD = 4.7) years, reported on postpartum partner support and appearance pressures, thin-ideal internalization and body dissatisfaction, symptoms of disordered eating, depression, breastfeeding self-efficacy and exclusive breastfeeding. Path analyses were conducted to test the hypothetical model.

RESULTS

Findings revealed that the final model was a good fit to these data. Postpartum partner support was associated with lower depression and higher breastfeeding self-efficacy, through which it was related to higher reports of exclusive breastfeeding and lower eating disorder symptoms. In addition, partner appearance pressures and thin-ideal internalization were associated with higher body dissatisfaction, and thin-ideal internalization was also related to lower breastfeeding self-efficacy.

CONCLUSIONS

Partner influences may be important to account for in models of body image and eating concerns among postpartum women, and exclusive breastfeeding, and further research on ways in which they can support mothers of young infants is warranted.