Abstract
BackgroundSubstance use among young pregnant women is a common and significant public health concern associated with a number of adverse outcomes for both mothers and infants. Social media posts by young women can provide valuable, real-world insight into their perceptions of substance use immediately before and during pregnancy.ObjectiveThe aim of this study was to characterize the frequency and content of posts regarding substance use in the year before pregnancy and during pregnancy among young mothers.MethodsFacebook posts were mined from young pregnant women (age, 16-24 years) who consented from 2 Midwest primary care clinics that serve a predominantly low-income community. Natural language processing was used to identify posts related to substance use by keyword searching (eg, drunk, drugs, pot, and meth). Using mixed-methods techniques, 2 investigators iteratively coded and identified major themes around substance use from these mined Facebook posts. Outcome measures include the frequency of posts and major themes expressed regarding substance use before and during pregnancy.ResultsWomen in our sample (N=43) had a mean age of 21 (SD 2.3) years, and the largest subgroup (21/43, 49%) identified as non-Hispanic black; 26% (11/43) identified as non-Hispanic white; 16% (7/43) as Hispanic; and 9% (4/43) as non-Hispanic mixed race, Native American, or other. The largest subgroup (20/43, 47%) graduated high school without further education, while 30% (13/43) completed only some high school and 23% (10/43) completed at least some postsecondary education. Young women discussed substance use on social media before and during pregnancy, although compared with the year before pregnancy, the average frequency of substance-related posts during pregnancy decreased. Themes identified included craving alcohol or marijuana, social use of alcohol or marijuana, reasons for abstaining from substance use, and intoxication.ConclusionsFacebook posts reveal that young pregnant women discuss the use of substances, predominantly alcohol and marijuana. Future work can explore clinical opportunities to prevent and treat substance use before and during pregnancy among young, at-risk mothers.
Highlights
Substance use among young pregnant women is common and a significant public health concern
Facebook posts were mined from 43 young pregnant women who were recruited as a convenience sample and consented from 2 Midwest primary care clinics that serve a predominantly low-income community
Facebook posts that occurred during pregnancy were identified by a timestamp occurring after the subject’s last menstrual period (LMP), which was imputed from the estimated date of delivery
Summary
Substance use among young pregnant women is common and a significant public health concern. Studies have demonstrated that pregnant and nonpregnant women more commonly perceive regular marijuana use as having no risk to their health [5], which may be attributed to remaining areas of uncertainty in the literature regarding effects of marijuana use on the developing fetus, such as fetal growth [6,7]. This discrepancy between perceived safety and physician-identified risk is one of several obstacles that may exist for disclosure of stigmatized behaviors during pregnancy. Future work can explore clinical opportunities to prevent and treat substance use before and during pregnancy among young, at-risk mothers
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