Feb.2, 2023 – Add this to the list of social media’s potential health risks: unintended pregnancy.
That’s for women who take birth control advice from influencers, particularly on YouTube, where many talk about stopping hormonal contraception and may give incomplete or inaccurate sexual health information.
In an analysis of 50 YouTube videos, University of Delaware researchers found that nearly three-quarters of influencers talked about discontinuing birth control pills or other forms hormonal birth control. And 40% were using or had used a “natural family planning” method – when women track their cycle, sometimes using an app, to identify days they might get pregnant.
“We know from previous research that these non-hormonal options, such as fertility tracking apps, are not always as accurate as hormonal birth control,” says lead study author Emily Pfender, who reported her findings in the journal Health Communication. “They rely on so many different factors, like body temperature and cervical fluid, that vary widely.”
In fact, this “natural” approach only works when women meticulously follow guidelines like measuring basal body temperature and tracking cervical fluid daily. But many influencers left that part out. Using fertility-tracking methods without the right education and tools could raise the risk of unplanned pregnancy, as failure rates using these methods vary from 2% to 23%, according to the CDC.
Even more alarming: Of the influencers who stopped hormonal birth control, only one-third mentioned replacing it with something else, Pfender says.
“The message that some of these videos are sending is that discontinuing [hormonal birth control] is good for if you want to improve your mental health and be more natural, but it’s not important to start another form of birth control,” she says. “This places those women at an increased risk of unplanned pregnancy, and possibly sexually transmitted diseases.”
Rise of the Health Influencer
Taking health advice from influencers is nothing new and appears to be getting more popular.
“People have been sharing health information for decades, even before the internet, but now it is much more prevalent and easier,” says Erin Willis, PhD, an associate professor at the University of Colorado’s College of Media, Communication, and Information who studies digital media and health communication.
Peer-to-peer health information is very influential, Willis says. It makes people feel understood, especially if they have the same health condition or share similar experiences or emotions. “The social support is there,” she says. “It is almost like crowdsourcing.”
In her study, Pfender and another researcher watched 50 YouTube videos posted between December 2019 and December 2021 by influencers with between 20,000 and 2.2 million followers. The top reasons influencers gave for discontinuing birth control included the desire to be more natural and to improve mental health.
Although hormonal birth control, namely the pill, has been used for decades and is considered safe, it has been linked to side effects like depression. And people sharing their experiences with hormonal birth control online may create controversy over whether it’s safe to use.
But Pfender found that influencers didn’t always share accurate or complete information. For example, some of the influencers talked about using the cycle tracking app Daysy, touting it as highly accurate, but none mentioned that the study backing up how well it worked was retracted in 2019 due to flaws in its research methods.
Not all health influencers give bad information, Willis says. Many go through ethics and advocacy training and understand the sensitive position and influence they have. Still, people have different levels of “health literacy” – some may understand health information better than others, Willis points out. It’s crucial to analyze the info and sort the good from the bad.
Look for information that is not linked to a particular product, the National Institutes of Health recommends. And cross-check it against reliable websites, such as those ending in “.gov” or “.org.”