“Bouncing back”: How Australia's leading women's magazines portray the postpartum ‘body’

An exploration of pregnancy and postpartum content on Instagram: A content analysis of health and exercise focused accounts

PROBLEM

Although social media can be an accessible option for women to receive support, there is increasing awareness of the negative mental health impacts of social media use during the postpartum period. Idealistic portrayals on social media have been shown to lead to body dissatisfaction and low mood.

BACKGROUND

The beginning of a child's life is a period of significant physical, mental and social adjustment for a mother. Women often resort to online sources of information to navigate this time period.

AIM

This study explored the content featured in prominent health and exercise Instagram account posts targeting pregnant and postpartum women.

METHODS

Popular individual health and exercise focused accounts targeting pregnant and post-partum women were identified on Instagram. Data about the account holder and content of posts were extracted. Data were analysed using inductive content analysis.

FINDINGS

Most included accounts belonged to American women aged 35-44 who were slim. Content analysis of 317 posts from 43 Instagram accounts unveiled six themes: reasons to exercise, weight management, guidance on doing exercise, eating well or not so well, fitting it all in, and comparison of body image.

DISCUSSION /CONCLUSION

Content analysed was not representative of the general population. Included posts could shape beliefs that may lead to intrapersonal weight stigma. Consideration must be given to actions that could promote individuals of all body sizes being represented in the media relating to pregnancy and the postpartum period.

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.

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.

A single group trial (before - after) on impact of physiotherapeutic intervention package on relief from low back pain of pregnant women

Introduction

More than half of the women have low back pain (LBP) at some point during pregnancy; the intensity of back pain increases as the pregnancy progresses. Such changes increase their risk for musculoskeletal disorders and fall injuries.

Aim and Objective

Our study's objective was to estimate the prevalence of LBP in antenatal and postnatal cases of pregnancy in PGIMER, Chandigarh and to ascertain impact of a training intervention on incidence and severity of LBP in the study subjects.

Methodology

A single group trial (before and after) on impact of physiotherapeutic intervention package on relief from LBP in pregnant women in between 20 and 35 years of age group were selected. The study duration was one year. The numeric pain rating scale was taken for measuring pain intensity at different levels. Where 0 indicates no pain, 1-3 indicates mild pain (which may be nagging, annoying, and interfering little with activities of daily livings (ADLs)), 4-6 indicates moderate pain (interferes significant with ADLs), and 7-10 indicates severe pain (Disabling, unable to perform ADLs). As per available time, it was decided to include at least 30 subjects in the study.

Results

Initially 45 patients were enrolled. Of those, 30 patients were suffering from backache, that is, 67% of the total and 33% did not have any backache. There were no backaches reported in the first trimester, five cases were in the second trimester, and 18 cases were in the third trimester. Of 30 patients, 11 were less than 25 years of age and remaining 19 patients were in the age group of 26-35 years.

Content Analysis of #Postpartumbody Images Posted to Instagram

Understanding the imagery on social media targeting postpartum women is an important step in determining the utility of Instagram as a potential avenue for targeting public health messages to this group. This study (1) describes the content of images on Instagram tagged with #postpartumbody and; (2) compares images from ‘Top’ posts (‘trending’ or ‘popular’) with ‘Recent’ posts. 600 images tagged with #postpartumbody (300 ‘Top’ and 300 ‘Recent’) were systematically captured from Instagram and coded using a predefined framework. Images of women were coded for adiposity, muscularity, pose and attire. Chi-square tests were used to compare ‘Top’ and ‘Recent’ posts. Most (n = 409) images were of a woman who generally had low/average adiposity (91%) and little-to-none/some visible muscle definition (93%). Most women (52%) were posing in a non-specific manner, 5% were posing to accentuate a postpartum body feature and 40% were wearing fitness attire. Compared with ‘Recent’, ‘Top’ posts were less likely to be text-focused (p < 0.001), photos of food (p < 0.001) or linked to a product/program (p < 0.001). Women of lower adiposity are more likely to post images of themselves on Instagram tagged with #postpartumbody than women of higher adiposity, which may reflect increased body pride in this group, but could reduce body satisfaction for some viewers. Conveying health information on Instagram may be necessary to interrupt potentially harmful content.

The role of body dissatisfaction and self-compassion in pregnancy-related anxiety

BACKGROUND

Women undergo significant physical, physiological, and psychological changes during pregnancy. They are also exposed to sociocultural pressure to meet appearance-related ideals. These pregnancy-related changes and sociocultural appearance-related pressures may place pregnant women at greater vulnerability to developing body dissatisfaction and psychological distress. To date, however, little is known about how sociocultural pressure may influence pregnancy-related anxiety, or factors that may protect against such distress during pregnancy. This study examined whether body dissatisfaction mediated the relationship between appearance-related sociocultural pressure and pregnancy-related anxiety, and whether this relationship was moderated by self-compassion and/or self-criticism.

METHOD

A cross-sectional sample of 253 pregnant women (M_age = 26.28, SD_age = 4.43) completed an online questionnaire measuring sociocultural pressure, body dissatisfaction, pregnancy-related anxiety, and self-compassion.

RESULTS

Moderated mediation analyses revealed body dissatisfaction fully mediated the relationship between sociocultural pressure and pregnancy-related anxiety. Analyses confirmed the moderating role of self-compassion and self-criticism on the relationship between sociocultural pressure and body dissatisfaction, but not on the relationship between body dissatisfaction and pregnancy-related anxiety.

LIMITATIONS

The cross-sectional nature of this study limits confirmation of the direction of relationships between sociocultural pressure, body dissatisfaction and pregnancy-related anxiety.

CONCLUSIONS

While the findings of this study need to be replicated in prospective and longitudinal studies, they suggest that sociocultural pressure to meet appearance-related standards contribute to body dissatisfaction, which in turn may facilitate pregnancy-related anxiety. Self-compassion may protect the body image of pregnant women against negative effects of appearance-related sociocultural pressure.

Empowerment for behaviour change through social connections: a qualitative exploration of women's preferences in preconception health promotion in the state of Victoria, Australia

BACKGROUND

Health behaviours in the preconception period have the potential to impact on fertility and pregnancy outcomes, and the health of all women regardless of pregnancy intention. Public awareness of this is low and interventions that promote behaviour change have not been integrated into real-world settings. Aims were to explore women's understandings of health and health behaviours and what supports are important to promote behaviour change in the preconception period.

METHODS

This qualitative study is the first phase of a broader co-design project set in the state of Victoria, Australia. Over 3 months, a series of in-depth interviews were conducted with female participants who were intending to become pregnant in the next 2 years (n = 6) and participants who were not intending to become pregnant in the next 2 years (n = 6). Community advisors (n = 8) aged 18-45 years provided feedback throughout the process. Coding of transcripts from interviews and meetings was undertaken by two researchers before a deductive process identified themes mapped to the COM-B framework.

RESULTS

Nine themes and eight sub-themes were identified. Participants had a holistic view of health with nutrition, physical activity and sleep being most valued. Social connections were considered as being important for overall health and wellbeing and for promoting health behaviours. The only difference between groups was that pregnancy was an additional motivator for women who were planning to become pregnant in the next 2 years. A range of health information is available from health professionals and other sources. Unlimited access to information was empowering but sometimes overwhelming. Being listened to and shared experiences were aspects of social connections that validated participants and guided them in their decision-making.

CONCLUSIONS

Women valued their health and had a holistic view that includes physical, mental and social dimensions. Women viewed social connections with others as an opportunity to be listened to and to gain support that empowers behaviour change. Future interventions to promote behaviour change in preconception women should consider the importance all women placed on social connections and leverage off existing resources to connect women.

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.

Breastfeeding, body image, and weight control behavior among postpartum women

The goal of this study was to examine breastfeeding behavior and attitudes as predictors of women's body image and weight control behavior. This study extends past research by focusing on positive body image variables including body appreciation and perceived body functionality. Women (N = 597) from the United States who had recently birthed biological babies ages 0-12 months participated in an online study. Current breastfeeding rates were high (86 %), and average breastfeeding duration was approximately 3 months. Women who were currently breastfeeding indicated more positive body images and less likelihood of engaging in maladaptive weight control behaviors than women who were no longer breastfeeding or had never breastfed their baby. Women's positive attitudes toward breastfeeding were associated with awareness and appreciation of body functionality and fewer maladaptive weight control behaviors. These findings extend research on the health benefits of positive body image and suggest that breastfeeding may occur within a constellation of beliefs and behaviors indicative of positive body image.

A Close and Supportive Interparental Bond During Pregnancy Predicts Greater Decline in Sexual Activity From Pregnancy to Postpartum: Applying an Evolutionary Perspective

A common topic for advice given to parents after childbirth – both from relationship experts and popular media – is how to “bounce back” to one’s pre-pregnancy sexuality, with warnings that postpartum declines in sexual frequency will take a serious toll on one’s relationship. However, these admonishments may not accurately reflect the ways in which the unique reproductive context of pregnancy and the postpartum transition alter associations between sexual frequency and relationship quality. Evolutionary perspectives on reproductive strategies would suggest that in the postpartum context, decreased sexual activity would help target parental investment in the current offspring (rather than creating new offspring); however, if the parental relationship is lacking in intimacy and support, continued sexual activity may help seal the cracks in the bond. We tested this theory in a longitudinal dyadic study of changes in relationship quality and sexual frequency from pregnancy to 6 months postpartum among 159 heterosexual couples. We found that across three different measures of relationship quality taken from interviews and behavioral observation of couple interactions, higher relationship quality (i.e., greater support, intimacy, and responsiveness) predicted greater decline in sexual frequency whereas sexual frequency remained relatively stable in lower quality relationships. These findings suggest that, during the postpartum transition, decreased sexual frequency may not be a reliable signal of poor relationship quality.

Les mères célèbres sur Instagram : ce que nous révèlent leurs mises en scène de l’allaitement

Cadre de la recherche : Ces dernières années, les mises en scène de l’allaitement se sont multipliées sur les réseaux sociaux (RS). Ayant d’abord fait l’objet de censure, ces images sont aujourd’hui autorisées sur les plateformes comme Facebook et Instagram. Ce n’est que récemment que les célébrités ont emboîté le pas aux mères non célèbres en publiant des photographies d’allaitement sur les RS. La popularité de ces femmes a notamment contribué à décupler la visibilité de l’allaitement dans l’espace public, une pratique encore critiquée et perçue comme relevant du domaine privé.

Objectif : Dans cet article, nous cherchons à mieux cerner le phénomène peu étudié des célébrités qui publient des photographies d’allaitement sur le réseau social Instagram.

Méthodologie : Pour ce faire, nous avons procédé à l’analyse qualitative de 50 photographies d’allaitement publiées entre les mois de janvier 2014 et août 2016 sur les comptes Instagram publics et vérifiés de 13 célébrités exerçant les professions de mannequin, d’actrice, de chanteuse et d’animatrice de télévision.

Résultats : Notre recherche a démontré que les photographies d’allaitement relayées par les célébrités sur Instagram servent de multiples intérêts. Elles permettent à ces femmes d’inscrire leur maternité dans leur trajectoire familiale et professionnelle, tout en revêtant un caractère publicitaire et en participant au développement de leur marque. Ces images participent également à la construction du discours social en faveur de l’allaitement dans l’espace public. Enfin, les images publiées par les célébrités sur Instagram présentent une forme de maternité idéalisée.

Conclusions : Les photographies d’allaitement des célébrités mettent en scène des mères « performantes » qui allaitent leur enfant sans difficulté, qui semblent concilier aisément travail et allaitement, en maintenant une apparence physique soignée et un corps postnatal « discipliné ». Sur Instagram, ces femmes proposent une façon idéalisée d’être mère, peu accessible à la majorité des femmes qui consomment leurs images.

Contributions : Notre travail de recherche permet d’appréhender la contribution des célébrités à la construction des normes en matière d’allaitement et de maternité.

Yummy Mummy - The ideal of not looking like a mother

BACKGROUND

Pregnancy and childbirth are important life experiences that entail major changes, both physically, psychologically, socially and existentially for women. Motherhood transition and the accompanying bodily changes involve expectations of body image that are simultaneously naturally and socially produced and culturally informed by public, private and professional discourses about motherhood transition.

PROBLEM

Much focus is levelled at the antepartum body in maternity services whereas the postpartum body seems left alone, although bodily dissatisfaction is of concern for many mothers, whose expectations of bodily appearance postpartum are sharp and explicit.

AIM

To explore Danish first-time mothers' experiences of their body postpartum, focusing on body image.

METHODS

Eleven first-time mothers participated in semi-structured interviews related to the postpartum body image. Data was analysed thematically.

FINDINGS

Four themes: (1) Reverting the body: on bouncing back and losing weight; (2) Picturing me: on standards of beauty and ideal bodies; (3) Redefining earlier self-images: on meta-reproachment of the body; (4) Idealisation of not looking like a mother: on societal pressure to think positively. Findings were discussed through the theoretical concepts by Scheper-Hughes and Lock: the body as both individual, social and political.

CONCLUSION

Despite nuanced reflections over the body as subject and object, women identified beauty as a personal trait dependent on visual appearance. Bodily beauty was identified as something individual, yet standardised. Women felt strengthened through motherhood but looking like a mother was not considered worth pursuing. To allow for women's contradictory perspectives, caregivers are advised to communicate reflexively about the postpartum body.

The Effect of Media on Body Image in Pregnant and Postpartum Women

Much research has found that exposure to certain types of media portrayals of women can be related to body image concerns among women. The current paper focuses on the impact of certain messages on pregnant and postpartum women. These women are rarely examined in a media research context but are particularly vulnerable to body image concerns. This experimental study involved 192 pregnant or postpartum women who read a magazine containing glamorized media portrayals of pregnant/postpartum women or a control magazine. Pregnant women reported lower body image after only five minutes of exposure to the magazine with pregnant/postpartum women compared to the control group. There was no immediate effect on postpartum women. Implications for the media industry, health professionals, and women are discussed.

“I see my section scar like a battle scar”: The ongoing embodied subjectivity of maternity

Though many women may be dissatisfied with their bodies, maternity represents a period when the body deviates significantly from Western beauty ideals. However, the developing corpus of literature is contradictory and there is limited knowledge about the longer-term implications of maternity. Further, much of the early postpartum literature focuses on body image, precluding consideration of broader embodiment and other potential issues. Taking account of recent feminist critiques about acknowledging women’s reproductive capacities, the study reported here explores the embodied subjectivity of longer-term bodily changes resulting from pregnancy, childbirth and early mothering. The data explored are from three focus groups. Mothers were recruited from two universities in the North of England, UK. Data were transcribed and analysed thematically and discursively using a feminist and poststructuralist approach, while also taking account of where language was elusive. A number of contradictory, yet interrelated embodied constructions were identified including the aesthetic, the maternal, the suffering/sentient, the strong and the embarrassing body. New insights are offered, in that, not only are the postpartum body and the “work of mothering” inextricably linked, but also that maternal embodied identities are in continuous process across the life course and may have implications for health and well-being.

Exploring the Tripartite Influence Model of body dissatisfaction in postpartum women

Pregnancy and childbirth result in dramatic changes in a woman's body shape, which can be associated with body image concerns. To date, however, little is known about how sociocultural factors may influence body dissatisfaction in postpartum women. This study aimed to test a sociocultural model of body image and eating concerns among a sample of postpartum women. A sample of N=474 women, mean (SD) age=30.6 (4.8), having given birth during the last year, completed an online survey and reported on sociocultural pressures from media, peers, family and partners, thin-ideal internalization, appearance comparison, body dissatisfaction, and psychological functioning. Structural equation modeling analyses revealed a good fit to the data, χ² (49)=220.20, p<.001, RMSEA=.086, CFI=.93. Findings suggest that women experience strong sociocultural pressures to attain unrealistic body shapes/sizes during the post-pregnancy period, contributing to their body image concerns.

High incidence of body image dissatisfaction in pregnancy and the postnatal period: Associations with depression, anxiety, body mass index and weight gain during pregnancy

This study aimed to delineate the prevalence of body image dissatisfaction in pregnant women and parturients in relation to depression and anxiety symptoms. We assessed 126 pregnant women during the third trimester and 2-3days and 4-6weeks after delivery using the Body Image Scale (BIS). Many pregnant participants (34.1%) showed body image dissatisfaction (BIS score ≤3) which was associated with current antenatal depression, severity of depression, a lifetime history of mood disorders, trait anxiety, body mass index (BMI) and weight gain during pregnancy. The BIS score improved after delivery but was still associated with depression, lifetime history of mood disorders, age, BMI and weight gain during pregnancy. These findings suggest that about a third of pregnant women have a body image disturbance which is strongly associated with current and a life history of clinical depression and anxiety symptoms. Medical personnel should be alert to detect body image dissatisfaction in pregnant women because it may indicate an underlying mood disorder.

Media Representations of Breech Birth: A Prospective Analysis of Web-Based News Reports

INTRODUCTION

Recent research has demonstrated that the media presentation of childbirth is highly medicalized, often portraying birth as risky and dramatic. Media representation of breech presentation and birth is unexplored in this context. This study aimed to explore the content and tone of news media reports relating to breech presentation and breech birth.

METHODS

Google alerts were created using the terms breech and breech birth in online English-language news sites over a 3-year period from January 1, 2013, to December 31, 2015. Alerts were received daily and filed for analysis, and data were analyzed to generate themes.

RESULTS

A total of 138 web-based news reports were gathered from 9 countries. Five themes that arose from the data included the problem of breech presentation, the high drama of vaginal breech birth, the safe option of cesarean birth versus dangers of vaginal breech birth, the defiant mother versus the saintly mother, and vaginal breech birth and medical misadventure.

DISCUSSION

Media reports in this study predominantly demonstrated negative views toward breech presentation and vaginal breech birth. Cesarean birth was portrayed as the safe option for breech birth, while vaginal breech birth was associated with poor outcomes. Media presentations may impact decision making about mode of birth for pregnant women with a breech fetus. Health care providers can play an important role in balancing the media depiction of planned vaginal breech birth by providing nonjudgmental, evidence-based information to such women to facilitate informed decision making for birth.

The portrayal of infant feeding in British women's magazines: a qualitative and quantitative content analysis

Background

Exclusive breastfeeding is the best start an infant can receive. However, in many high-income countries breastfeeding rates are low and this may be a reflection of social norms which in turn may be influenced by the media. This study therefore explored the portrayal of infant feeding in women's general interest magazines.

Methods

The five top selling women's weekly magazines in Britain and Ireland for 2013 over a 4-month period were included. A quantitative and qualitative content analysis was conducted for both written and visual content.

Results

In 58 magazines, there were 90 references to infant feeding with an average of 1.5 (range: 0-5) per magazine. Breastfeeding and formula feeding references were present in equal number and both were predominantly portrayed positively. There was only 1 visual representation of breast feeding compared with 11 of bottle feeding. Potential drivers for breastfeeding included its role in post-pregnancy weight loss and celebrity endorsement while family routine, the role of males in the house and concerns about adverse health effects were identified as barriers to breastfeeding.

Conclusion

An improvement in visual representations of breast feeding and factual information in women's weekly magazines may be helpful in re-defining social norms regarding infant feeding. Keywords: food and nutrition, health promotion, public health.

An exploration of appearance and health messages present in pregnancy magazines

This study explored appearance-related images and messages present in pregnancy magazines (e.g. Fit Pregnancy, Pregnancy & Newborn, and Pregnancy Magazine). A substantial portion of advertisements and articles promoted appearance-related products or products for postpartum weight loss. Health messages and messages related to diet and exercise were also present. Images also sexualized pregnant women’s bodies. Appearance-related messages aimed toward pregnant women may be problematic and may contribute to body dissatisfaction in these women.