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The portrayal and perceptions of cesarean section in Mexican media Facebook pages: a mixed-methods study

2022; BioMed Central; Volume: 19; Issue: 1 Linguagem: Inglês

10.1186/s12978-022-01351-8

1742-4755

Martha Vazquez Corona, Ana Pilar Betrán, Meghan A. Bohren,

Grief, Bereavement, and Mental Health

Mexico has one of the highest rates of cesarean sections globally at over 45%. There is limited research about social factors influencing these rates. This study explores the portrayal and perceptions of cesarean section in Facebook media pages to better understand the socio-cultural context of childbirth in Mexico.This is a mixed-methods social media analysis using two data sources. First, to study the portrayal of cesarean section, we identified ten Mexican media Facebook pages with the largest audiences (based on number of page "likes"). We searched these pages for articles containing the word "cesárea" (Spanish for cesarean section), and posts (articles) were eligible for inclusion if they contained the word "cesárea". Second, to understand perceptions of cesarean section portrayal, we extracted comment threads of each Facebook post sharing the included articles. We performed a qualitative thematic analysis of articles and a quantitative content analysis of comments.We included 133 Facebook posts depicting 80 unique articles and identified three major themes: (1) information about cesarean section, (2) inequality and violence against women, (3) governance failures. Cesarean section was portrayed as a lifesaving procedure when medical necessary, and riskier than vaginal birth, with a longer recovery time, and possible negative health consequences. We extracted comments from 133 Facebook posts, and 6350 comments were included. We inductively developed 20 codes to then classify comments under six major categories: (1) violence and discrimination, (2) health and health services, (3) mode of birth choice, (4) disbelief at information about cesarean section, (5) abortion, and (6) discontent at the government.We found that Facebook media did not promote cesarean section over vaginal birth, and risks and consequences were mostly represented reliably. Perceptions about the portrayal of cesarean section showed strong discontent and distrust against providers and the health system, as well as rejection of factual information about the consequences of cesarean section. We documented gross gender inequality and violence against women, highlighting the urgent need for human rights approaches to maternal health to address these inequalities and prevent harmful practices. Our study also contributes to the emerging field of social media analysis, and demonstrates clear areas where social media communication can be improved.ANTECEDENTES: México tiene una de las mayores tasas de cesáreas con más del 45%. Este estudio tiene como objetivo explorar la representación y percepción de la cesárea en las páginas de medios de comunicación en Facebook para comprender mejor el contexto sociocultural del parto en México. MéTODOS: Este es un análisis de redes sociales de métodos mixtos. Para estudiar la representación de la cesárea, identificamos diez páginas de Facebook de los medios de comunicación mexicanos con las mayores audiencias. Incluimos publicaciones de artículos de dichas páginas si contenían “cesárea” en el título, encabezado, o texto previo de la publicación. Después, para comprender las percepciones de la representación de la cesárea, extrajimos los comentarios de cada publicación incluida. Realizamos un análisis temático de los artículos y un análisis de contenido de los comentarios.Incluimos 133 publicaciones de Facebook con 80 artículos únicos e identificamos tres temas principales: (1) información sobre la cesárea, (2) desigualdad y violencia contra las mujeres, (3) fallas de gobernanza. La cesárea se describió como un procedimiento que salva vidas cuando es médicamente necesario, más riesgoso que el parto vaginal, con un mayor tiempo de recuperación, y posibles consecuencias negativas para la salud. Incluimos 6350 comentarios que fueron clasificados en 20 códigos agrupados en seis categorías: (1) violencia y discriminación, (2) salud y servicios de salud, (3) modo de elección del nacimiento, (4) incredulidad ante la información sobre la cesárea, (5) aborto y (6) descontento con el gobierno.Los artículos incluidos no promovieron la cesárea sobre el parto vaginal, y los riesgos y consecuencias se representaron mayormente con precisión. Las percepciones sobre la representación de la cesárea mostraron un fuerte descontento y desconfianza hacia los médicos y el sistema de salud mexicano, así como incredulidad de los usuarios de Facebook hacia información factual sobre las consecuencias de la cesárea. Adicionalmente, este estudio documentó inequidad de género y violencia contra las mujeres, resaltando la necesidad de un enfoque de derechos humanos para el trato adecuado hacia las mujeres durante el embarazo y parto en México. Los resultados de este estudio contribuyen al campo emergente del análisis de redes sociales, y demuestran áreas donde se puede mejorar la comunicación en salud dentro de redes sociales.Cesarean section is a medical intervention that can save women and babies when there are complications during pregnancy or birth. Mexico has one of the highest rates of cesarean section in the world (45%); much higher than what we would expect. We do not fully understand why this is happening, but we think social influences are important.We know that traditional and social media are important social influences on health and health-seeking behaviors in other countries. In our study, we aimed to explore how cesarean section is portrayed in Facebook Mexican media pages, and how people (Facebook users) interacted with these articles. To do this, we identified the most popular Facebook media pages in Mexico.Next, we searched for all articles posted to these pages. We found 80 articles and studied them to understand how they discussed cesarean section. We found that media articles posted on Facebook did not encourage women to have cesarean section, and they correctly showed risks and consequences.Then, we explored the comments from Facebook users that were attached to these posts about cesarean section. We found 6350 comments, and classified each comment based on the what the Facebook users said.Lastly, we connected the main themes of the articles to the types of comments. We found that Facebook users distrusted the Mexican health system, rejected information about the consequences of cesarean section, and often responded with the content with sexist and aggressive comments against women.Our research shows that while there is accurate and useful information on social media about cesarean section, other social issues like gender inequality and violence may influence pregnancy and childbirth.