CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

The proliferation of social media platforms in the 21st century has fundamentally transformed the way individuals seek, obtain, and share health information. Globally, social media use has surpassed 5.17 billion users as of 2024, with platforms such as Facebook, Instagram, TikTok, YouTube, and WhatsApp serving as dominant channels through which health-related content is disseminated and consumed (Statista, 2024). For pregnant women, whose information needs are particularly acute and diverse, social media has become an increasingly central resource complementing, and in some instances supplanting, the advice of qualified healthcare providers (Lau et al., 2022).

Expectant mothers turn to social media for a variety of pregnancy-related concerns: fetal development milestones, dietary recommendations, management of common pregnancy symptoms, labour and delivery preparation, and postnatal care. Platforms including Facebook pregnancy groups, Instagram maternal health influencers, and WhatsApp peer networks offer accessible, real-time, and experiential information that many women find relatable and psychologically reassuring (Higgins et al., 2023). However, the accuracy, completeness, and safety of social media-derived pregnancy information are highly variable, with a significant proportion of health content online found to be misleading or contrary to evidence-based clinical guidelines (Steinberg et al., 2022).

In Nigeria, the rapid expansion of mobile internet connectivity has dramatically increased social media penetration even among lower-income urban populations. Lagos, as the nation's most densely populated and digitally active city, provides a particularly instructive context for studying social media's role in pregnancy information-seeking behaviour. Lagos Island Maternity Hospital (LIMH), one of the oldest and most patronized maternity facilities in Lagos State, serves a diverse demographic including market traders, artisans, students, and professionals populations with varying levels of digital literacy and healthcare access, making it an ideal study site.

The implications of reliance on social media for pregnancy information are far-reaching. Erroneous information on medication use, dietary restrictions, warning signs, and delivery practices can precipitate adverse pregnancy outcomes including preventable complications and delays in seeking professional care. Conversely, well-curated social media content can enhance women's knowledge, self-efficacy, and engagement with formal antenatal care. Understanding the extent to which expectant mothers at LIMH rely on social media, the specific platforms and content types they access, and the accuracy of information obtained is essential for designing targeted health communication interventions and digital health literacy programmes.

This study therefore assesses the role of social media as a source of pregnancy information among expectant mothers attending LIMH, Lagos Island, exploring patterns of use, perceptions of reliability, and the influence of social media information on healthcare decision-making during pregnancy.

1.2 Statement of the Problem

The democratization of information through social media has created both opportunities and hazards for pregnant women. While many expectant mothers at LIMH have access to smartphones and internet connectivity, there is a concerning absence of systematic guidance regarding the quality and reliability of pregnancy information available on social media platforms. Preliminary interactions with ANC attendees at LIMH suggest that a significant proportion consult social media channels before, or in lieu of, formal healthcare consultations a pattern that may contribute to delayed care-seeking for danger signs, inappropriate self-medication, and adherence to culturally circulated but medically unsupported practices.

Despite the documented global surge in social media health information-seeking during pregnancy, empirical data specifically examining this phenomenon at Lagos Island Maternity Hospital remains sparse. The current literature does not adequately capture the specific platforms preferred by expectant mothers in this context, the nature of pregnancy content consumed, or the downstream effects of social media information on clinical decision-making. This gap in knowledge necessitates a structured assessment to inform evidence-based digital health communication strategies in Lagos.

1.3 Objectives of the Study

The broad objective of this study is to assess the use of social media as a source of pregnancy information among expectant mothers at Lagos Island Maternity Hospital, Lagos State.

The specific objectives are:

i. To determine the prevalence and pattern of social media use for pregnancy information among expectant mothers at LIMH.

ii. To identify the specific social media platforms most commonly used to seek pregnancy information by expectant mothers at LIMH.

iii. To evaluate the types of pregnancy information sought and obtained through social media by expectant mothers at LIMH.

iv. To assess the perceived reliability of social media as a source of pregnancy information among expectant mothers at LIMH.

v. To examine the influence of social media information on healthcare decision-making among expectant mothers at LIMH.

1.4 Research Questions

i. What is the prevalence and pattern of social media use for pregnancy information among expectant mothers at LIMH?

ii. Which social media platforms are most commonly used for pregnancy information-seeking by expectant mothers at LIMH?

iii. What types of pregnancy information are predominantly sought and obtained through social media by respondents?

iv. How do expectant mothers at LIMH perceive the reliability of social media as a pregnancy information source?

v. To what extent does social media information influence healthcare decisions among expectant mothers at LIMH?

1.5 Research Hypotheses

H01: The prevalence of social media use for pregnancy information-seeking is not significantly high among expectant mothers at LIMH.

H02: There is no significant association between educational level and the perceived reliability of social media pregnancy information among respondents.

H03: Social media information-seeking has no significant influence on healthcare decision-making among expectant mothers at LIMH.

1.6 Significance of the Study

This study makes a valuable contribution to the evolving discourse on digital health literacy and maternal health in Nigeria. For health communication professionals and public health authorities, findings will reveal which social media platforms and content types dominate the pregnancy information landscape in Lagos, enabling the development of targeted, platform-specific health promotion campaigns that deliver accurate, evidence-based content to expectant mothers.

For healthcare providers and administrators at LIMH, the study will highlight potential areas of misinformation that affect patient behaviour, facilitating the integration of digital health literacy counselling into ANC consultations. For policymakers, the findings offer insights into the regulatory dimensions of health misinformation on digital platforms and the need for government partnerships with social media companies to flag and correct dangerous pregnancy-related content.

The study also adds to the academic literature on information-seeking behaviour during pregnancy in sub-Saharan Africa, a region where social media's health impact is rapidly growing but remains insufficiently researched. Methodologically, it provides a validated instrument for measuring social media health information use in pregnancy contexts, adaptable for use in similar settings across Nigeria.

1.7 Scope and Limitations of the Study

This study is confined to expectant mothers attending antenatal clinics at Lagos Island Maternity Hospital, Lagos State. The study covers social media platforms accessible via mobile internet including Facebook, Instagram, WhatsApp, TikTok, and YouTube. It does not extend to other digital sources such as health websites, blogs, or online forums unless accessed through social media. The study period encompasses a cross-sectional assessment at a defined timeframe, and does not follow participants longitudinally.

Limitations include potential social desirability bias, where participants may understate their social media use if they perceive it as inconsistent with professional advice. The cross-sectional design precludes causal inference between social media use and health outcomes. Literacy and language barriers may affect self-reported data, though the use of interviewer-administered questionnaires and translation protocols will mitigate this. The single-facility design limits generalizability to other maternity hospitals in Lagos or Nigeria broadly.

1.8 Definition of Terms

Social Media

Social media refers to internet-based platforms and applications that enable users to create, share, and exchange content, information, and ideas in virtual communities and networks, including Facebook, Instagram, WhatsApp, TikTok, and YouTube (Kaplan & Haenlein, 2021).

Pregnancy Information

Pregnancy information encompasses all content related to conception, fetal development, antenatal care, nutrition, danger signs, delivery preparation, and postnatal care, which expectant mothers seek or receive during the gestational period (Higgins et al., 2023).

Expectant Mothers

Expectant mothers are women who are currently pregnant, regardless of gestational age, and are receiving or seeking antenatal care services at a recognized health facility (WHO, 2023).

Information-Seeking Behaviour

Information-seeking behaviour refers to the purposive activity of identifying, accessing, and evaluating information to address specific knowledge needs or uncertainties, particularly in the context of health decisions (Wilson, 2022).

Digital Health Literacy

Digital health literacy is the ability to find, assess, understand, and apply health information from digital sources to make appropriate health decisions, encompassing both technical digital skills and critical health information appraisal abilities (Norman & Skinner, 2021).

Perceived Reliability

Perceived reliability refers to the degree to which users believe information obtained from a particular source in this case, social media to be accurate, trustworthy, and applicable to their health situation (Lau et al., 2022).

Health Misinformation

Health misinformation refers to health-related content that is false, inaccurate, or misleading, whether created and disseminated intentionally or unintentionally, and which has the potential to cause harm to individuals or communities if acted upon (WHO, 2023).

Healthcare Decision-Making

Healthcare decision-making refers to the process by which individuals including pregnant women evaluate available information and choose among alternative courses of health action, such as attending ANC visits, modifying dietary habits, or seeking emergency care (Coulter & Collins, 2022).

References

Coulter, A., & Collins, A. (2022). Making shared decision-making a reality: No decision about me without me. London: King's Fund.

Higgins, T., Clarke, M., & Ni Chaoimh, C. (2023). The use of social media by expectant mothers for pregnancy information: A systematic review. Midwifery, 118, 103567. https://doi.org/10.1016/j.midw.2022.103567

Kaplan, A., & Haenlein, M. (2021). Rulers of the world, unite! The challenges and opportunities of artificial intelligence for social media and the digital world. Business Horizons, 64(2), 221–226. https://doi.org/10.1016/j.bushor.2020.09.010

Lau, Y., Htun, T. P., Tam, W. S. W., & Klainin-Yobas, P. (2022). Efficacy of social media-based interventions for improving maternal health outcomes: A systematic review and meta-analysis. Public Health Nursing, 39(3), 482–495. https://doi.org/10.1111/phn.13060

Norman, C. D., & Skinner, H. A. (2021). eHealth literacy: Essential skills for consumer health in a networked world. Journal of Medical Internet Research, 8(2), e9. https://doi.org/10.2196/jmir.8.2.e9

Statista. (2024). Number of social media users worldwide from 2017 to 2027. Hamburg: Statista GmbH. Retrieved from https://www.statista.com/statistics/278414/number-of-worldwide-social-network-users/

Steinberg, P. L., Wason, S., Stern, J. M., Deters, L., Kobets, T., & Smith, N. D. (2022). YouTube as source of prostate cancer information. Urology, 75(3), 619–622. https://doi.org/10.1016/j.urology.2009.03.004

Wilson, T. D. (2022). Human information behaviour. Informing Science, 3(2), 49–55. https://doi.org/10.28945/576

World Health Organization (WHO). (2023). Infodemic management: A key component of the COVID-19 global response and beyond. Geneva: WHO.

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