Misinformation about birth control

​Turning to social media influencers for advice on a variety of topics is second nature for many young people. But when it comes to information about sexual health and certain types of birth control, the message may be misleading or even harmful, according to a study by two University of Delaware researchers.

Emily Pfender is a doctoral student in the Department of Communication. She studies health communication with a focus on how social media users consume health, wellness and lifestyle content.

“Young people, especially, spend so much time on social media, and the big question has always been, ‘How does it affect our health?’ ” Pfender said.

Unlike famous actors or athletes, social media influencers become famous by building relationships with their followers. Research has shown influencers have a powerful impact on their followers’ attitudes and behaviors.

“They develop a level of intimacy with the viewer because they disclose personal information,” Pfender said. “And that's attractive for viewers.

“Their storytelling feels authentic and genuine for a lot of viewers. They film videos about their birth control experiences sitting on their bedroom floors. They're in their house cooking, or they're making a video about getting ready for their day putting makeup on, and they're sharing a story. It's all very relatable.”​

Pfender and co-investigator Marie Devlin wanted to know what influencers were saying about sexual health and birth control. They analyzed the content of 50 YouTube videos of lifestyle and fitness influencers with at least 20,000 followers posted between December 2019 and 2021.

Their findings, published in the journal Health Communication, showed nearly three-quarters of the influencers mentioned they had discontinued hormonal birth control such as oral contraceptive pills and injectable contraception, as part of a larger wellness trend and a desire to live a healthy lifestyle.

“They want to be as natural as possible, more in touch with their body, and feel empowered by being natural,” Pfender said.

The researchers also found the videos contained inaccurate or incomplete information about birth control, which could mislead followers who perceived them as credible. Vulnerable audiences could misinterpret the advice and increase their risk of unplanned pregnancies.

For example, 40% of the influencers mentioned switching to non-hormonal birth control. Of those who did, 30% used digital fertility tracking technology such as the Daysy app. As a natural family planning method, the app helps women monitor and record their daily basal body temperatures to track their ovulation.

However, Daysy may not be a reliable form of birth control. While a study published in the journal Reproductive Health showed the Daysy tracker to be 99.4 percent effective, the journal later retracted the article, saying the methodology used to determine that number was flawed.

“None of [the influencers] talked about that,” Pfender said of the retraction. “They still kept saying, ‘Yeah, it's 99% effective’ when we know it's not because the study was retracted.”

Few influencers discussed taking precautions when using non-hormonal birth control.

“Only two people mentioned using condoms,” Pfender said. “If you're tracking your cycle, they just said, ‘I don't have sex around that time.’ But we know that tracking cycles isn't 100% effective.”

Pfender continues to monitor social media for other potential sources of misinformation. She will also continue her research for her dissertation.

“This study was a content analysis, so it only describes influencer messaging,” Pfender said. “My dissertation is going to be a study that tells us how the messages affect people and their behavior. And basically, we'll be able to determine if these messages do affect the intention to use different types of birth control or talk to a doctor about birth control or look for more information on social media about it.”​

​ Article by Stephanie Doroba, photo courtesy of Emily Pfender, illustration by Jeffrey C. Chase 

Published March 24, 2023​