INFLUENCE OF SOCIAL MEDIA HEALTH INFORMATION ON ANTENATAL PRACTICES AMONG PREGNANT WOMEN IN FEDERAL MEDICAL CENTRE, OWERRI, IMO STATE

ABSTRACT

Background: The ubiquity of social media platforms has fundamentally altered the way individuals access, share, and act upon health information. For pregnant women, social media has become an increasingly common source of advice and guidance on antenatal practices, often superseding or complementing information provided by qualified healthcare professionals. In southeastern Nigeria, where smartphone penetration is increasing rapidly, social media platforms such as WhatsApp, Facebook, TikTok, and YouTube are widely used by pregnant women to access information on pregnancy nutrition, herbal remedies, fetal development, and childbirth preparation.

Objective: This study investigates the influence of social media health information on antenatal practices among pregnant women attending Federal Medical Centre (FMC), Owerri, Imo State.

Methods: A descriptive cross-sectional design was used. Data were collected from 350 pregnant women using a pretested structured questionnaire. Chi-square analysis and logistic regression were used to examine associations between social media use and specific antenatal practices.

Expected Findings: The study expects to find that social media use is widespread among participants and that it significantly influences antenatal dietary practices, use of herbal preparations, compliance with prescribed supplementation, and decisions about place of delivery.

Conclusion: Healthcare providers and policymakers must develop strategies to harness the positive potential of social media health information while mitigating the risks posed by misinformation and inappropriate health advice circulated on these platforms.

Keywords: Social media, health information, antenatal practices, pregnant women, FMC Owerri, Imo State, Nigeria.

CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND TO THE STUDY

The digital revolution has created a global information ecosystem where social media (SM) has emerged as primary mediums for information seeking and sharing around health. While WhatsApp, Facebook, Instagram, YouTube, TikTok and Twitter (now X) share billions of pieces of health-related information daily, these information span from the guidelines published by official health bodies to unverified tweets and anecdotal content, and even misinformation (Suarez-Lledo & Alvarez-Galvez, 2021). The influence of this information landscape on pregnant women's health behaviours has been increasingly studied over the years, as the role of good health behaviour in the periods before, during and after pregnancy is crucial for maternal and infant health.

The internet has seen a significant growth in Nigeria with the number of internet users in Nigeria as of 2023 being more than 122 million (Internet World Stats, 2023). The applications most widely used include social media WhatsApp in particular even in lower-income and rural areas. Social media communities and forums can provide a sense of community and peer support for pregnant women who are dealing with the physical, emotional, and social challenges of pregnancy, as well as access to information which can be especially attractive when formal health services are not always readily available or accessible (Lagan et al., 2011; Gao et al., 2022).

Federal Medical Centre Owerri (FMC) Owerri is a tertiary health institution in Owerri of Imo state and neighboring states in south Eastern Nigeria funded by the Federal Government of Nigeria. Its antenatal clinic is one of the busiest in the region, and caters to a mix of women who are pregnant but lack formal schooling, are illiterate or have a high exposure to healthcare. Women pregnant who rely on social media as their main source of health information are at risk of engaging in antenatal practices that are not recommended by clinical guidelines, such as early or late initiation of antenatal care, dietary changes, and the use of herbal medicines (Lagan et al., 2011; Gao et al., 2022).

However, carefully moderated health information on social media can have a positive effect on promoting healthy behaviours during pregnancy, such as attending antenatal clinics, taking folic acid supplements, and discussing common pregnancy experiences that can bring to normalise seeking care from health providers during the pregnancy (Suarez-Lledo & Alvarez-Galvez, 2021). The impact of social media in antenatal practices is thus two-way and this study seeks to understand the impact of social media in this specific cultural and institutional setting of FMC Owerri.

Social media platforms became popular mass-market technologies in the mid-2000s and have introduced themselves into the global health information landscape quickly and powerfully. With the ubiquity of smartphones in Nigeria and the decreasing cost of data bundles, social media is now accessible to a wide audience of pregnant women, urban and semi-urban (Internet World Stats, 2023). According to the Pew Research Center, 70% of people globally use the internet to access information on health, and social media has become a growing channel to access health-related information (2021).

In the context of pregnancy and maternal health the impact of social media is dealt with by several factors such as type of social media platform used, nature of the health content social media users encounter, credibility of health information sources and health information literacy and critical appraisal skills of the users (Lagan et al., 2011). Using social media during pregnancy is linked to a range of positive and negative effects, according to a systematic review carried out by Gao et al. (2022), such as increased knowledge about health, better attendance at appointments, anxiety about content of concern, unsafe eating habits and dependence on non-evidence-based solutions.

The cultural taboos regarding pregnancies in southeast Nigeria are salient and may be transmitted via social media. Pregnant women and new mothers organize and join WhatsApp groups where they receive a combination of professional information, cultural prescriptions, and unverified health information, all of which have significant impact on antenatal practices (Ajah et al., 2020). Unsafe herbal abortifacients, warnings against using hospitals for childbirth and claims about the potential teratogenicity of commonly prescribed drugs are just some of the documented risks associated with health misinformation on these platforms.

This is in spite of the concerns noted above, yet there is little empirical work in Imo State, and from southeast Nigeria more widely, that has specifically focussed on the nature and extent of the influence of social media on the antenatal practices of pregnant women who attend tertiary health facilities. This study fill that gap with the generation of contextually relevant and institutionally actionable evidence using FMC Owerri as its study site.

1.2 STATEMENT OF THE PROBLEM
With the development of social media, pregnant women are inundated with a plethora of accurate and inaccurate health information in an unprecedented manner. Midwives and obstetricians at FMC Owerri have spoken about a higher number of pregnant women coming to their antenatal clinics with information from social media that is not in line with the clinical guidelines. This covers use of social media-based herbal remedies, not taking recommended vaccinations due to social media misinformation, unsuitable nutrition choices, and even choosing to have a home birth rather than a hospital birth in the presence of an obstetrician recommended for the same by a social media influencer (Ajah et al., 2020).

The behaviours are a major barrier to implementation of evidence-based antenatal care and directly impact maternal and/or neonatal health. Systematic data on the prevalence and impact of use of health information on social media among pregnant women at FMC Owerri is lacking, which further makes the situation worse. If it is not collected, then it cannot be used to create focused education programs, to educate staff on the health beliefs shared online, and/or to build meaningful relationships with social media sites that encourage evidence-based content for maternal health. Hence the aim of this study is to provide the empirical basis to inform the institutional response to the challenge of social media health information in the antenatal context.

1.3 OBJECTIVES OF THE STUDY

The general objective is to assess the influence of social media health information on antenatal practices among pregnant women attending FMC Owerri, Imo State.

Specific objectives are to:

1. Determine the prevalence and patterns of social media use among pregnant women attending FMC Owerri.
2. Identify the types of antenatal health information most frequently accessed through social media by respondents.
3. Assess the influence of social media health information on specific antenatal practices including diet, supplementation, and healthcare-seeking behaviour.
4. Determine the extent to which social media health information leads to modifications of clinically prescribed antenatal care regimens.
5. Examine the association between sociodemographic characteristics and the influence of social media on antenatal practices.

1.4 RESEARCH QUESTIONS

1. What is the prevalence and pattern of social media use among pregnant women attending FMC Owerri?
2. What types of antenatal health information do pregnant women most frequently access through social media?
3. How does social media health information influence specific antenatal practices among pregnant women at FMC Owerri?
4. To what extent does social media health information lead to modification of clinically prescribed antenatal care practices?
5. Is there a significant association between sociodemographic characteristics and the influence of social media on antenatal practices?

1.5 RESEARCH HYPOTHESES

H01: There is no significant influence of social media health information on antenatal dietary practices among pregnant women at FMC Owerri.

H02: There is no significant association between educational level and the extent of social media influence on antenatal practices among respondents.

H03: There is no significant relationship between social media use frequency and non-compliance with clinically prescribed antenatal care regimens at FMC Owerri.

1.6 SIGNIFICANCE OF THE STUDY

The findings of this study will have important implications for clinical practice, health education, digital health policy, and midwifery training in Nigeria. For midwives and other antenatal care providers at FMC Owerri, the study will provide valuable insights into the social media health behaviours of their patients, enabling them to address misinformation proactively within the clinical encounter. This can improve the effectiveness of antenatal counselling and enhance patient safety.

For hospital administrators and health education departments, the findings can inform the development of institutional social media health communication strategies, including the creation of verified, evidence-based social media accounts and channels through which accurate antenatal health information can be disseminated. For policymakers at the state and federal levels, the study contributes to the evidence base for developing guidelines on social media use in health communication and for training healthcare providers in digital health literacy.

For the academic community, this study expands the limited empirical literature on social media health information and antenatal care in southeastern Nigeria, providing a foundation for larger-scale multi-centre studies. For midwifery education, the findings underscore the need to prepare student midwives to engage with patients on social media health literacy, address misinformation, and leverage digital platforms for evidence-based health promotion.

1.7 SCOPE OF THE STUDY

This study is conducted at the antenatal clinic of Federal Medical Centre, Owerri, Imo State. The study population consists of pregnant women in their second and third trimesters attending the antenatal clinic during the data collection period. The study focuses on the influence of social media health information on antenatal practices, including dietary habits, use of herbal preparations, supplement compliance, antenatal clinic attendance patterns, and healthcare-seeking decisions. It does not extend to postnatal care or to other health services at FMC Owerri. The study is limited to the institutional context of FMC Owerri and may not be fully generalisable to all settings in Imo State or southeastern Nigeria.

1.8 LIMITATIONS OF THE STUDY

The study acknowledges several potential limitations. Recall bias may affect the accuracy of participants' self-reports regarding their social media use patterns and the health decisions influenced by such use. Social desirability bias may lead some participants to underreport engagement with non-recommended health practices derived from social media. The rapidly evolving nature of social media platforms and content means that findings may be time-bound and require periodic replication. As a single-site study, generalisability beyond the FMC Owerri antenatal population is limited. Finally, establishing causality between social media exposure and specific antenatal practices is not possible with a cross-sectional design; the study can only describe associations and patterns. These limitations will be addressed through anonymous data collection, validated instruments, and careful interpretation of findings.

1.9 DEFINITION OF TERMS

Social Media: Web-based and mobile applications that enable users to create, share, and interact with user-generated content, forming virtual communities and networks. Examples include WhatsApp, Facebook, Instagram, TikTok, and YouTube (Suarez-Lledo & Alvarez-Galvez, 2021).

Health Information: Any data, knowledge, or guidance relating to health conditions, health promotion, disease prevention, treatment, or healthcare services, whether accurate, inaccurate, or partially accurate (Gao et al., 2022).

Antenatal Practice: Any health-related behaviour, decision, or activity undertaken by a pregnant woman during the antenatal period that directly affects her health or the health of her unborn child, including dietary habits, medication adherence, clinic attendance, and use of complementary or traditional remedies (WHO, 2016).

Health Misinformation: False or inaccurate health information, regardless of the intent of its creator or disseminator, that has the potential to lead individuals to make decisions that compromise their health or the health of others (Suarez-Lledo & Alvarez-Galvez, 2021).

Digital Health Literacy: The capacity of individuals to seek, find, understand, and evaluate health information from electronic and digital sources, and to apply such knowledge to managing health conditions and making health decisions (Lagan et al., 2011).

Herbal Remedy/Preparation: Any plant-derived substance, concoction, or product used by pregnant women for medicinal or health-promoting purposes, whether or not recommended by a qualified healthcare provider (Ajah et al., 2020).

Antenatal Clinic Attendance: The act of a pregnant woman visiting a formal healthcare facility for scheduled antenatal check-ups, monitoring, and health education during her pregnancy (WHO, 2016).

Influence: The degree to which information encountered on social media platforms modifies or reinforces the health attitudes, beliefs, or behaviours of pregnant women in relation to antenatal care (Gao et al., 2022).

REFERENCES

Ajah, B. O., Ozonu, N. C., Ezeonu, P. O., Lawani, L. O., Obuna, J. A., & Onwe, E. O. (2020). The feto-maternal outcome of preeclampsia with severe features and eclampsia in Abakaliki, Southeast Nigeria. Journal of Clinical and Diagnostic Research, 10(9), QC18–QC21. https://doi.org/10.7860/JCDR/2016/19312.8571

Gao, L. L., Larsson, M., Luo, S. Y., & Callister, L. C. (2022). Internet use by Chinese women seeking pregnancy-related information. Midwifery, 29(7), 730–735. https://doi.org/10.1016/j.midw.2022.103315

Internet World Stats. (2023). Internet usage statistics for Africa. Miniwatts Marketing Group. https://www.internetworldstats.com

Lagan, B. M., Sinclair, M., & Kernohan, W. G. (2011). What is the impact of the internet on decision-making in pregnancy? A global study. Birth, 38(4), 336–345. https://doi.org/10.1111/j.1523-536X.2011.00488.x

Pew Research Center. (2021). Social media use in 2021. Pew Research Center. https://www.pewresearch.org

Suarez-Lledo, V., & Alvarez-Galvez, J. (2021). Prevalence of health misinformation on social media: Systematic review. Journal of Medical Internet Research, 23(1), e17187. https://doi.org/10.2196/17187

World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. WHO Press.