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

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Association between location of prenatal care services and non-consented cesarean sections in Mexico: a secondary analysis of the National Survey on the Dynamics of Household Relationships 2016

“…However, another location of public prenatal care, private prenatal location, more than one prenatal care location, and a combination of public and private prenatal services are associated with forced C-sections in women who are not from Indigenous belonging. Also, while the rates of C-sections in Indigenous women have increased in this country, this has been found to be related to the introduction of universal health coverage in the country and an increase in C-sections in poorer municipalities, where Indigenous women are more likely to live (11). Still, for this study, when compared to public prenatal services, receiving prenatal services in a private location for women of Indigenous belonging was signi cantly associated with non-consented C-sections.…”

“…The high number of C-sections is a growing problem in Mexico. Between 2008 and 2017, 45% of the deliveries in Mexico were completed through C-section, one of the highest rates in the world (11). The number of unnecessary C-sections performed in public and private health care settings in Mexico has been increasing since 2002 (9).…”

“…The number of unnecessary C-sections performed in public and private health care settings in Mexico has been increasing since 2002 (9). Different individual-level factors in the Mexican population have been associated with C-sections, such as giving birth in a private setting, having early prenatal care services, and having high socioeconomic status and education (11). Indigenous women in this country also experience higher rates of C-sections (11).…”

Prevalence of Non-Consented Care During the Childbirth Process in Mexico by Geographical Regions: Comparing ENDIREH Survey Data from 2016 and 2021

“…(16) The denial of care to Indigenous women and unnecessary Csections in this country are forms of obstetric violence particularly identi ed in the literature. (11,(17)(18)(19)) Speci c to non-consented care, a mixed-methods study completed in four hospitals across the Mexican states of Puebla and Chiapas found that more than 50% of women experienced non-consented care, as they did not receive adequate information for three invasive procedures (genital cleansing, genital shaving, and enema administration) and did not provide consent for them. (16) Episiotomies, manual uterine cavity revisions, and vaginal examinations are other procedures that have been found to be practiced in Mexico without the consent of female patients during childbirth.…”

How TikTok is Being Used to Talk About Abortion Post-Roe

“…The internet and social media are increasingly used as sources of health information, including others' personal experiences with health services [9,10]. Researchers have examined the role of the Internet and social media across various facets of sexual and reproductive healthcare, including abortion and PrEP for HIV prevention, infertility, and Caesarean sections [11][12][13]. Extant work describes people's use of Google to find information on emergency contraception [14] and abortion [15,16] as well as Reddit and YouTube for information on the self-removal of long-acting reversible methods of contraception [17,18].…”