YouTube Social Media Influencers Promote Inaccurate Birth Control Content, Study Finds

Unplanned pregnancies could result from adopting social media influencers’ contraception advice, according to new research, which found the content largely inaccurate and incomplete.

Researchers from the University of Delaware discovered that YouTube searches presented information about discontinuing birth control rather than safe sex or contraception. The study was published in Health Communication and highlights how for some young adults, social media has become a main source of sexual health knowledge.

This study was conducted to understand trends present in conversations on birth control by influencers creating YouTube vlogs, as little research on sexual health messages in social media has been analyzed. The study focused on non-hormonal modalities such as the Daysy device and app. The app tracks and monitors fertility, cycles, and health, and claimed to be 99.4% accurate by founders; this claims was later found to be false due to flawed methodologies and therefore dubious conclusions.

For the study, researchers used “birth control experience” and “Daysy” for keyword search terms on videos uploaded between December 2019 to December 2021; 50 YouTube videos with a minimum of 20,000 subscribed viewers were included in the final sample.

Video selection depended upon factors such as keywords, date of post, number of subscribers, and type of video. Influencer characteristics were composed of influencer category, subscribers, marital status, and children; categories included lifestyle, fitness, and other (eg beauty, fashion, news personality).

Four stratifications were created to illustrate follower counts for influeencers: “mega” or “super” influencers (>1 million followers), “macro” influencers (100k-1 m), micro-influencers (5k-100k), and “nano” influencers (<5k). “Macro” influencers made up most of the study sample (54%, n= 27), and influencers in this sample were predominately married (38%, n=19) without children (42%, n = 21).

Out of the 3 types of influencers, lifestyle influencers had the highest likelihood of referring to birth control use (72%, n = 36).

Investigators used the lens of framing theory to analyze how birth control information was being presented and how appealing it might be to viewers considering current trends such as mental health and wellness (physical as well as emotional/mental, spiritual, social, and intellectual). They took particular note if the communication emphasized natural family planning.

Vlog characteristics were separated into use of hormonal birth control, hormonal birth control types, reasons for liking hormonal birth control, use of non-hormonal birth control, non-hormonal birth control types, reasons for liking non-hormonal birth control, reasons for discontinuing hormonal birth control, outcomes from discontinuing hormonal birth control, switched to another hormonal birth control, and switch to non-hormonal birth control.

Alarmingly, 94% of influencers were using or had used hormonal birth control, and 74% stopped or planned to stop using it.

Even though stopping hormonal birth control increases the probability of unintended pregnancy, influencers were still more likely to frame discontinuation of hormonal birth control in a positive light, possibly leading the audience to associate hormonal birth control with more unfavorable ramifications.

Almost three quarters of influencers (74%) spoke about stopping birth control and described marginally more positive (53.18%) than negative effects of discontinuation, like mood improvement (18%), energy increase (14%), libido increase (10%), and more.

Reported negative effects included worsened acne (22%), cycle irregularities (14%), stomach pain (12%), and more.

Mental health concerns while on hormonal birth control were cited for about a third of the reasons for stopping by influencers, even though the link between depression and hormonal birth control is found to be ambiguous. The discussion of mental health as reasoning for stopping birth control could discourage young audiences from exploring hormonal birth control because of the high significance of mental health to younger viewers, the authors said.

Of the 40% of influencers who favored non-hormonal birth control, most preferred cycle tracking through an app or basal thermometer. Influencers, the study found, favored non-hormonal birth control because it assists in preventing pregnancy (22%), allows a more natural method (16%), generates fewer side effects (4%), and is cost effective (2%).

The emphasis on natural family planning could promote misunderstanding by viewers, the researchers said.

Reference

Pfender EJ, Devlin MM. What do social media influencers say about birth control? a content analysis of YouTube vlogs about birth control. Health Commun. Published online January 16, 2022. doi:10.1080/10410236.2022.2149091