"It's Just Not Very Realistic": Perceptions of Media Among Pregnant and Postpartum Women

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.

Browsing throughout pregnancy: The longitudinal course of social media use during pregnancy

BACKGROUND

The number of people using social media has substantially increased over the past years. Previous studies have shown associations between social media overuse and mental health problems during pregnancy. The current study evaluates changes in social media use during pregnancy.

METHODS

Pregnant women were recruited at their first antenatal appointment between January 2020 and July 2022 (N = 1135). The time spent on social media, frequency of social media use and problematic social media use, using the Bergen Social Media Addiction Scale (BSMAS), were assessed at 12, 20 and 28 weeks of pregnancy. Pearson r correlations and repeated measures ANOVAs were performed to assess possible changes in social media use over the course of pregnancy. Lastly, we stratified social media use throughout pregnancy for parity.

RESULTS

There was a significant change in social media use over time, for the time spent on social media, frequency of social media use and problematic social media use. Mean social media scores were the lowest at 12 weeks of pregnancy and increased significantly at 20 weeks of pregnancy, after which they remained stable at 28 weeks. Compared to multiparous women, primiparous women spent more time on social media at 20 weeks of pregnancy, but not at 12 or 28 weeks.

CONCLUSION

Because overuse of social media has been associated with poor mental health, healthcare professionals should be aware of the intensity of social media use throughout pregnancy.

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.

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.

The influence of disordered eating and social media's portrayals of pregnancy on young women's attitudes toward pregnancy

BACKGROUND

Given the heightened emphasis on physical appearance and the prevalence of social media in young women, they are particularly vulnerable to experiencing negative body image and disordered eating. Therefore, modified social media portrayals of pregnancy could cause young women to have negative attitudes toward a potential pregnancy and subsequently not properly utilize care and resources. The present study examined the influence of disordered eating and modified portrayals of pregnancy on young women's attitudes toward a potential pregnancy and various feelings associated with pregnancy.

METHODS

The sample consisted of 154 women aged 18-30, who were given the Eating-Attitudes Test-26, randomly shown either modified or unmodified social media portrayals of pregnancy, then given the Attitudes Toward Potential Pregnancy Scale and the Gestational Weight Gain Psychosocial Risk Assessment Tool.

RESULTS

A series of hierarchal regressions revealed that there were no significant main effects or interactions for young women's attitudes toward potential pregnancy. However, women who viewed modified portrayals of pregnancy had higher self-efficacy, and women with higher levels of disordered eating had lower self-efficacy, more positive attitudes toward gestational weight gain, and lower current body image satisfaction.

CONCLUSIONS

These results highlight the myriad of different attitudes that young women have toward a potential pregnancy and how these attitudes are influenced by disordered eating and social media. Our findings can be used for educating caregivers and implementing intervention strategies for women.

Does Appearance Matter during Pregnancy? A Cross-Sectional Study of Body Satisfaction from Pre-Pregnancy to Late Gestation

Few studies have explored the associations between body satisfaction and physical activity and weight gain during pregnancy, and none have been conducted in Scandinavia. Hence, the aim of the present study was to evaluate changes in body satisfaction from pre-pregnancy to late pregnancy and investigate whether this differed according to parity. We also wanted to explore the association between body satisfaction and physical activity and weight gain among pregnant women in Norway. This cross-sectional survey used an electronic questionnaire to assess physical activity level, weight gain and women's satisfaction with body weight and size. In total, 150 pregnant women answered the questionnaire. Related-samples Wilcoxon signed rank tests, Mann-Whitney U tests and chi-square tests were used to answer our research questions. The proportion of women who were dissatisfied with their body weight and shape increased from pre-pregnancy to late gestation (body weight p = 0.030 and body shape p = 0.040). Body dissatisfaction before and during pregnancy was linked to weight gain above recommendations. Characterising oneself as physically active prior to pregnancy was associated with satisfaction with body shape pre-pregnancy. Given that mothers strongly influence how a child will judge their body later in life, the results of this study underline the importance of addressing these issues during pregnancy.

In the need of a digital cicerone in healthcare? - Guidance for parents

OBJECTIVE

To explore parents' experiences using digital tools in relation to pregnancy, labor and birth, and the child's first 18 months.

BACKGROUND

Parents find relevant information using digital healthcare tools, material obtained from professionals, as well as personal opinions and experiences that vary in quality.

METHOD

Fifteen parents were interviewed and data were analyzed beginning with content analysis and followed by thematic analysis.

RESULTS

The main theme was insecurity and responsibility for own choices and knowledge. Parents use digital tools to take responsibility for their insecurity and need for knowledge when entering parenthood.

CONCLUSION

The parents' experiences highlighted that (1) insecurity can be both eased and enhanced using digital tools, (2) they took responsibility for feelings of insecurity and the search for knowledge, and (3) they needed knowledge to make the right choices and feel secure that these choices are made in the best interest of their new family.

Primiparous women's knowledge of diastasis recti abdominis, concerns about abdominal appearance, treatments, and perceived abdominal muscle strength 6-8 months postpartum. A cross sectional comparison study

BACKGROUND

Diastasis recti abdominis (DRA) is a prevalent condition in the postpartum period. To date, there is scant knowledge on how DRA influences physical, mental, and emotional health. This study investigates primiparous women`s knowledge about DRA, concerns about abdominal appearance, and perceived abdominal muscle strength, comparing women with and without reported DRA.

METHODS

This was a cross-sectional comparison study. Data were collected by a web-based questionnaire, mainly through social media in Norway. To be included in the study women had to be primiparous 6-8 months postpartum. The questionnaire contained questions regarding women`s knowledge about DRA, perceived protrusion, received treatment, concerns with abdominal appearance and muscle strength. Abdominal body image was measured through the shape concern questions from The Eating Disorder Examination questionnaire (EDE-Q 6.0). Demographic and other descriptive variables are presented as means with standard deviations (SD) or as frequencies with percentages. Chi-square test of independence and independent sample t-tests were used to compare differences between women with and without abdominal protrusion for categorical and continuous variables, respectively.

RESULTS

Our sample consisted of 460 women. Knowledge about DRA was reported by 415/440 (94.3%) women. A total of 73.3% reported to have been worried during pregnancy about abdominal appearance postpartum. Mean degree of concern about present abdominal appearance was 5.5/10 (SD 2.4). Almost 80% experienced weaker abdominal muscles than pre-pregnancy. Ninety-six women (20.9%) reported a protrusion along the midline of their abdomen. Significantly more women with protrusion reported weaker abdominal muscles than women without protrusion. The most frequent treatment women with protrusion reported were exercises for the abdominal muscles (92.6%). Mean score on the EDE-Q, shape concern questions, was higher in women with reported protrusion (mean score: 2.37 (SD 1.6) than women without protrusion (mean score: 2.14 (SD 1.4), p = 0.175.

CONCLUSION

Primiparous women are concerned about abdominal appearance both during pregnancy and after birth. Those reporting abdominal protrusion are less satisfied with their abdominal appearance and they report weaker abdominal muscles than women without protrusion. This study may contribute to improved knowledge about women`s health concerns, and assessment of DRA should be part of routine follow-up of postpartum women.

First-Time Mothers' Invisible Presence Using Social Networking Sites

PURPOSE

To describe first-time mothers' experiences with online social networking sites in the early postpartum period, explore how mothers use them to gain support, and to evaluate how their use can aid or hinder maternal role transition.

STUDY DESIGN

Qualitative descriptive study.

METHODS

This qualitative descriptive study, using convenience and snowball sampling, first-time mothers in the early postpartum period were recruited through social media. Semistructured interviews were conducted virtually where mothers were asked to describe their experiences with online social networking. Thematic analysis methods were used to develop themes from participant interviews.

RESULTS

Twelve first-time mothers ranging from 4 to 12 weeks postpartum participated in the study. Thematic analysis revealed four themes: 1) Habits of first-time mom using social networking sites, 2) New purpose online, 3) Taking it to the moms, and 4) Impact on motherhood.

CLINICAL IMPLICATIONS

Maternal child nurses have opportunities to further customize support for first-time mothers online. Awareness of habits, trends, implications of early mothering during COVID-19, and the role social networking sites can play in supporting mothers in the early postpartum period offers new ways for nurses to support and empower the motherhood collective.

'I wish I had my pre-pregnancy body after birth… but I have to be supported': a theoretical study based on body image perception in working mothers during the postpartum period

The body image of women in the postpartum period can be far from society's idealised body, and this can cause body dissatisfaction. This qualitative study aimed to evaluate the body image perception of women who had started working in the postpartum period, based on the grounded theory research method. A total of 22 face-to-face interviews were conducted with participants who were actively involved in working life and between 3 months and 1 year postpartum. The data were collected through in-depth interviews with a personal information form and semi-structured interview form. Coding created four main categories ('weight fluctuations and body shape', 'body-related perception', 'body-related responses from the environment' and 'body perception improvement process') and eight sub-categories. The results found that the postpartum period is a sensitive one for working women, where they have both positive and negative experiences. Their responsibilities increase, they have little time for themselves and their bodies, they experience body image dissatisfaction, and they expect support from their spouses, families, social circles and health professionals.Impact StatementWhat is already known on this subject? Postpartum body image is an important research subject because it expands the scope of body image literature and has significant effects on gender problems. Not being able to lose the weight gained in postpartum period or the weight gained during pregnancy is an important problem for women. With women starting working life, this period seems to be a more sensitive and anxious one for some women.What do the results of this study add? Most of the women in this study experience body dissatisfaction in the postpartum period. Some women do not want to leave the house because of their negative body image perceptions. It is an important finding that women want their spouse to gain weight during this period.What are the implications of these findings for clinical practice and/or further research? The findings of our study revealed that working mothers in the postpartum period have difficulty in sparing time for themselves and their bodies due to increased responsibilities. Working women are in particular need for more support due to their increased workloads, roles and responsibilities in childcare. Our study may guide future studies focussing on women's body image perceptions and influencing factors.

Expecting parents' use of digital sources in preparation for parenthood in a digitalised society - a systematic review

Background

In today's society, people are experiencing the rapid development of digitalisation. Expecting parents may have difficulties evaluating the information online; they are not always sure which sources of information are trustworthy, and this exacerbates their feelings of anxiety. More research is needed to broaden the knowledge about how their use of digital sources may influence their health.

Question

The focus of this study was to explore expecting parents' use of digital sources and how this influences their health during pregnancy.

Methods

A systematic review covered the thematic analysis of 39 articles.

Findings

The analysis resulted in the following theme: The digitalised society involves both opportunities and challenges, and expecting parents express a need for a variety of digital sources to improve their health, and sub-themes: Digital sources could promote parents' health and well-being in a digitalised society; Consuming digital health information facilitates understanding, different feelings and social connections; and A variety of digital sources may facilitate parental identification and adaption to parenthood.

Conclusion

Different digital sources in our digitalised society mean access to information and opportunities to extend social connections for expecting parents. This can promote their ability to understand and adapt to parenthood, as well as to improve their health and well-being and make the parental transition. However, professional support during face-to-face consultations cannot always be exchanged to digital sources. It is important to base digital sources devoted to expecting parents and digitalisation overall on multi-sectorial collaborations and coordination between different organisations and the digital sources they provide.

The WOMBS Framework: A review and new theoretical model for investigating pregnancy-related weight stigma and its intergenerational implications

As the growing weight stigma literature has developed, one critically relevant and vulnerable population has received little consideration-pregnant and postpartum women. Because weight fluctuations are inherent to this life phase, and rates of prepregnancy overweight and obesity are already high, this gap is problematic. More recently, however, there has been a rising interest in pregnancy-related weight stigma and its consequences. This paper therefore sought to (a) review the emerging research on pregnancy-related weight stigma phenomenology and (b) integrate this existing evidence to present a novel theoretical framework for studying pregnancy-related weight stigma. The Weight gain, Obesity, Maternal-child Biobehavioral pathways, and Stigma (WOMBS) Framework proposes psychophysiological mechanisms linking pregnancy-related weight stigmatization to increased risk of weight gain and, in turn, downstream childhood obesity risk. This WOMBS Framework highlights pregnant and postpartum women as a theoretically unique at-risk population for whom this social stigma engages maternal physiology and transfers obesity risk to the child via social and physiological mechanisms. The WOMBS Framework provides a novel and useful tool to guide the emerging pregnancy-related weight stigma research and, ultimately, support stigma-reduction efforts in this critical context.

Nurses' and midwives' perspectives on how the pursuit for the 'perfect' body image affects their own breastfeeding practices: a qualitative study in Ghana

Background

Body image concerns have been widely documented in the literature as one reason why most women shorten the breastfeeding duration of their infants. Negative body image concerns among breastfeeding mothers may lead to depressive symptoms. There is a paucity of literature on how body image affects the breastfeeding practices of nurses and midwives. Therefore, this study explored the perspectives of breastfeeding nurses and midwives on how their body image affected their breastfeeding practices.

Methods

A qualitative design was used in this study. Five focus group discussions were conducted with each group having five members. The study was conducted in the Greater Accra Region of Ghana between November and December of 2020. Participants were recruited into the study using a purposive sampling method. Focus group sessions were audiotaped and transcribed verbatim. Data were analyzed using a content analysis.

Results

Three main themes emerged from the data analysis: body image concerns and breastfeeding, sociocultural pressures and breastfeeding and coping strategies. Participants had concerns regarding weight gain due to the need to eat adequately while breastfeeding. Body image concerns included increase in abdominal size, sagging breasts and generalized weight gain. These concerns and pressures negatively affected the breastfeeding practices of participants. Body image concerns reflected sociocultural pressures such as negative comments from loved ones and in the social media. The coping strategies adopted by the mothers were self-motivation and the love they had for their children.

Conclusions

The perspectives of breastfeeding nurses and midwives on the ways their body image affected their breastfeeding practices identified the need for support in order to successfully breastfeed.

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

OBJECTIVES

For many women, the postpartum period is a particularly vulnerable time to experience body image dissatisfaction. We aimed to examine the impact of social media usage frequency in the context of postpartum body image dissatisfaction and eating disorder psychopathology. We therefore empirically tested a hypothetical model assuming that social media usage influences postpartum body image dissatisfaction and eating disorder psychopathology via multiple mediation through appearance-related social comparisons and thin ideal internalization.

DESIGN

Cross-sectional online-survey.

SETTING

Online forums, social media groups, community groups PARTICIPANTS: Two-hundred-fifty-two new mothers who had given birth within the last 26 weeks prior to the assessment.

MEASUREMENTS

Social media use was assessed by the average frequency of using Facebook, Instagram, Youtube or other per week. Body image dissatisfaction was assessed with the Body Shape Questionnaire and eating disorder psychopathology with the Eating Disorder Examination-Questionnaire. Path analyses using SPSS Amos were conducted to examine whether the hypothetical model fitted our data.

RESULTS

After minor modification, the final model revealed a good fit to the data, CFI = .977, TLI = .964, SRMR = .061, RMSEA = .056 (90%CI .027, .084), and as expected the indirect multiple mediation pathway via appearance-related social comparisons and thin ideal idealization was significant, IE = 4.395; 95%BCaCI 2.969, 7.394; p = .001. The number of target groups for appearance-related social comparisons did not moderate the results.

KEY CONCLUSIONS

Our results provide first evidence that social media use may play an important role in postpartum body dissatisfaction and eating disorder psychopathology. Mediational pathways proposed by socio-cultural theories of body image also hold for the postpartum period.

IMPLICATIONS FOR PRACTICE

Practitioners in the field should be aware of the association between social media use and body image dissatisfaction and mediating factors among new mothers and sensitive when directing new mothers to those media.

Exploring womens' experiences and decision making about physical activity during pregnancy and following birth: a qualitative study

BACKGROUND

Physical activity (PA) tends to decline during pregnancy, and remains low in the early postpartum period, despite the known physical and psychological benefits. This study aimed to explore: (1) women's experiences of PA during pregnancy and following birth; and (2) decision-making processes related to PA during this time.

METHODS

Semi-structured telephone interviews were conducted with 16 women who were either pregnant or had recently given birth. Interviews were transcribed verbatim and analysed using thematic analysis.

RESULTS

There were two over-arching themes: (1) ownership of body, which consisted of the sub-themes: others try to take ownership, important to maintain fitness into pregnancy and motherhood, expectations of PA, and pressure to conform; and (2) unknown territory, which consisted of the sub-themes: engaging in PA with caution, and unclear advice. Decision-making about PA during pregnancy was influenced by: pressure from others who felt responsible to protect the woman from coming to harm; pressure from social media to lose weight postpartum; participant's beliefs about the benefits of maintaining fitness and participants expectations of how active they thought they would be able to be during pregnancy. Participants felt that pregnancy was an 'unknown territory' in terms of the unfamiliar feelings in their body and the inability to continually monitor their baby for reassurance of baby's health. Advice received from midwives was often lacking, or not tailored to the individual. Advice from friends and family was often regarded as incorrect, but still caused doubt and fear of PA during pregnancy.

CONCLUSIONS

These findings contribute to the understanding of women's experiences of PA during pregnancy and post-partum, and their decision-making processes about PA during pregnancy. Developing accurate and tailored advice as part of midwifery care, that considers the physical and psychological aspects of engaging in PA during pregnancy, will help to ensure that women are supported to make informed decisions about their PA behaviour.

Social Media and the Mediation of Childbirth: So, What for Mothers, Maternity, and Midwifery Practice?

Social media is fast becoming a global phenomenon with recent research providing insight into the complex inter-weaving relationship between the media and women and families over the childbirth continuum. Additionally, a growing body of evidence demonstrates a major cultural shift in the agency and information-seeking practices of women through social media. This perhaps suggests that services fall short of providing real and lived value to the women navigating through maternity systems in the United Kingdom, due to changes in culture and society. A deeper understanding of this phenomenon may help providers and practitioners offer care which better supports women's needs and enable them to develop innovative new approaches for future service provision. The aim of this article is to examine the literature and develop a deeper understanding of how social media may impact upon women, childbearing and midwifery practice via six domains. In conclusion, informational, experimental, and relational needs of women could be enhanced with funding and investment into the role of new expert tech-midwives using social media initiatives within maternity systems. Thus, supporting the demands of modern technology use by woman to elevate midwifery care provision and satisfaction and protect against the technocratic and patriarchal influence of childbirth. This synthesis of the literature through a western cultural lens may also be relevant to an international audience.

Women's Use of Social Media: What Is the Evidence About Their Impact on Weight Management and Body Image?

PURPOSE OF THE REVIEW

This review aims to summarize recent research on the effects of social media-delivered weight management interventions on weight loss and the impact of social media use on body image concerns in women and adolescent girls.

RECENT FINDINGS

Evidence supports the feasibility, but not the efficacy, of studies using single-component social media-delivered weight management interventions (i.e., including no other modes of intervention delivery) in women. Studies conducted in adolescent girls and women suggest that the impact of social media on body image outcomes is mostly detrimental, but is dependent on the context (e.g., exposure to idealized social media appearance images), peers' feedback, and constructs, such as appearance comparison tendency. More research is needed to conclude on the efficacy of social media-delivered interventions on both weight and body image outcomes and to understand how and when exposure to social media could promote effective weight management and also advocate positive body image in women.