Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.
UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, Geneva, Switzerland.
Reprod Health. 2022 Feb 22;19(1):49. doi: 10.1186/s12978-022-01351-8.
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.
墨西哥的剖宫产率居全球之首，超过 45%。关于影响这些比率的社会因素的研究有限。本研究通过对 Facebook 媒体页面中剖宫产的描述和认知进行探讨，以更好地了解墨西哥分娩的社会文化背景。
这是一项混合方法的社交媒体分析，使用了两个数据源。首先，为了研究剖宫产的描述，我们确定了十个拥有最大受众（基于页面“点赞”数）的墨西哥媒体 Facebook 页面。我们在这些页面上搜索包含单词“cesárea”（西班牙语中的剖宫产）的文章，并且如果文章包含“cesárea”这个词，那么该文章就符合纳入标准。其次，为了了解对剖宫产描述的认知，我们提取了每个分享包含文章的 Facebook 帖子的评论线程。我们对文章进行了定性主题分析，对评论进行了定量内容分析。
我们共纳入了 133 个描述 80 篇独特文章的 Facebook 帖子，确定了三个主要主题：（1）剖宫产信息，（2）对妇女的不平等和暴力，（3）治理失败。剖宫产被描述为一种医疗必要时的救命程序，比阴道分娩风险更大，恢复期更长，并且可能对健康产生负面影响。我们从 133 个 Facebook 帖子中提取了评论，共纳入了 6350 条评论。我们归纳出 20 个代码，然后将评论分为六大类：（1）暴力和歧视，（2）健康和卫生服务，（3）分娩方式选择，（4）对剖宫产信息的怀疑，（5）堕胎，（6）对政府的不满。
我们发现，Facebook 媒体并没有宣传剖宫产优于阴道分娩，并且风险和后果大多是可靠的。对剖宫产描述的看法显示出对提供者和卫生系统的强烈不满和不信任，以及对剖宫产后果的事实信息的拒绝。我们记录了严重的性别不平等和对妇女的暴力，突出表明需要采取人权方法来解决这些不平等问题，防止有害做法。我们的研究还为社交媒体分析这一新兴领域做出了贡献，并展示了社交媒体沟通可以改进的明确领域。
