A mixed-methods exploration of attitudes towards pregnant Facebook fitness influencers – BMC Public Health

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Four of the five influencers’ posts included in this study were linked to some sort of advertising, marketing or sponsorship. Two influencers included a hyperlink to their fitness app in both posts, while one influencer included references to the clothing the influencer was wearing. Another influencer included their Facebook page address in their two posts while the remaining influencer made no reference to any advertising, marketing or sponsorship in either of their posts. None of the influencers declared that their posts were sponsored, or that they had received any form of renumeration from an external source for any of their posts included in this study. See Table 1 for additional influencer characteristics below.

At the time of data collection, the 10 selected video posts had been viewed a total of 12,117,200 times and were shared a total of 11,181 times. The total number of comments (including written and visual text) from each post ranged from at least 8 comments to 8,300. After removing comments that only consisted of visual text (emojis), written text comments ranged from 1 to 251. The number of emotive icon reactions generated by all video posts totalled 128,804, with the most frequently used icon being ‘like’ (81.48%). Detailed Facebook user engagement information is shown in Table 2.

A range of exercises including aerobic exercises (such as skipping and modified burpees), resistance-based exercises (consisting of either bodyweight exercises [squats, lunges, planks]) or exercises that encompassed weights (shoulder press, deadlift, squats with a kettlebell), were demonstrated in the video posts by the influencers. Some video posts included a combination of aerobic and resistance-based exercises.

A total of 706 Facebook user comments were thematically analysed, and four overarching themes identified: [1] attitudes towards exercise during pregnancy, [2] attitudes towards the influencers, [3] attitudes towards the types of exercise, and [4] community. The first three themes characterise both positive and negative views, while the final theme, community, relates to the level of social support that was apparent among Facebook user comments. See Table 3 for a summary of themes and subthemes.

Attitudes towards exercise during pregnancy in general, and attitudes towards the influencer were mostly positive. However, attitudes towards the types of exercise the influencer performed were mixed, with all negative comments found to be associated with posts that involved the influencer performing resistance-based exercises using weights.

Table 1 Influencer Characteristics a Total influencer followers according to Facebook as of 20 January 2023
Table 2 Number of views, shares, comments, and emotive icon reactions per Facebook influencer video post
Table 3 Themes and subthemes resulting from thematic analysis of Facebook user comments

User attitudes towards exercise during pregnancy

Health benefits to mother and baby

Users generally held positive attitudes about the importance of exercising when pregnant and acknowledged the health benefits for the mother and child. Users identified improved mental health and mood, reduction in the physical discomforts of pregnancy, reduced labour complication, and healthy development of the baby as benefits of exercise during pregnancy. For many users, exercise was recognised as contributing to a quick and safe labour:

You’ll find that labour is so much “easier” when you’ve been fit before and during your whole pregnancy!! It gives you the endurance you need! With my first I ran 3 miles on my due date!

Users also acknowledged that exercise behaviours of the pregnant woman supported foetal development:

Working out at moderate intensity is actually proven to be more beneficial. Increased blood, oxygen, and endorphins to the foetus help strengthen baby and actually help build a healthier heart in the baby.

Exercise is beneficial and safe when pregnant

Many users considered exercise during pregnancy to be an important factor in prenatal care, with one user suggesting:

…it is encouraged by doctors to exercise and maintain a healthy lifestyle during pregnancy.

Some users even sought advice directly from the influencer or other commenters, recognising the importance of exercise during pregnancy, and highlighting the perceived ‘expert role’ of influencers:

…can I ask you what kind of exercises you did during your pregnancy? I know exercising during pregnancy is good, but I know there are specific types of exercises to avoid as they are harmful to the baby. I just wanted to know which exercises were safe.

Many users alluded to the need for exercise during pregnancy to be ‘safe’ and be guided by healthcare providers, and that users should modify exercise and/or “listen” to their body. When the influencer was performing resistance-based exercises with weights and aerobic exercises, one user commented:

[Influencer] is well conditioned to this exercise before her pregnancy and is using safe regressions to her training, at a very safe time in her pregnancy to be doing this training.

Exercise is unachievable

While users had positive attitudes about the influencer and the exercises depicted, they often perceived the exercises performed by influencers as unachievable for themselves and made comparisons between the capabilities of the influencer and themselves. A commonly expressed attitude by users towards the influencers was ‘she can, but I can’t’. Users also expressed negative beliefs and doubts about their own ability to partake in exercise when pregnant, due to past or current pregnancy experiences.

Comparative comments were often linked to factors that prevented users from exercising such as, concerns about risk, lack of motivation, negative social influence, physical discomforts of pregnancy, health complications, lack of time, lack of knowledge, and fatigue.

My second pregnancy in a row I would have been totally burned out after that far along! I was exhausted.

I didn’t work out before or during my pregnancy. Even though I started under 130 lbs and only gained just under 30 lbs, I had some issues with feet and ankle swelling and my son was born early. I wish I was in better shape beforehand!

…I puked 24 hrs a day 7 days a week for 8 months. I barely had the energy to walk to the bathroom so there wasn’t any exercise for me…except for vomiting…lol

Overall, users held positive attitudes about the importance of exercising when pregnant, acknowledging the health benefits and need for safety when exercising during pregnancy. Users also perceived exercise an important aspect of prenatal care, and some users actively sought guidance from influencers. Some users also perceived the exercises of the influencer to be unachievable for themselves, resulting in comparisons between the capabilities of the influencer and themselves. These perceptions were often accompanied with personal user experiences often linked to factors that prevented the user from exercising.

Attitudes towards the influencer

Motivational and inspiring

Facebook users’ attitudes toward the influencer were typically positive, with influencers viewed as role models. The inspirational role of the influencer was characterised by comments providing praise and admiration:

I’m almost 30 weeks and absolutely love following your workouts! You been an inspiration and this being my first pregnancy has been wonderful so far! A lot of it has to do with me staying so active! Thanks for your posts!

Synonymous with expressions of praise and admiration were comments about the influencer’s physical attractiveness, strength, capabilities, and commitment to exercising while pregnant:

Your dedication, positivity and beauty motivate and amaze me!

Other users aspired to achieve the influencers level of fitness and the influencers physique:

I wish I looked like her, she is so fit!

Relating to the influencer

Intertwined with user admiration for the influencer was a positive (albeit one-sided) relationship with the influencer. This one-sided parasocial relationship was portrayed when users expressed knowledge of intimate details about the influencer’s life (e.g., living location, children or partners’ names), aggressively defended the influencer against criticism from other users, gave personal well wishes to the influencer and their family, or found other ways to relate directly with the influencer:

Congratulations, I know how you feel am just over the 26 week mark, still training but nowhere near what I use to do and I can’t wait to get back at it probably as it’s doing my head in not been able to lift my normal strength in weights lol .. x

Expertise and credibility

Influencers were mostly trusted and regarded as experts by users. This perceived expertise also meant users saw the influencers as credible sources of information. Some users commented, “She knows what she’s doing’, and “Her form is perfect and it is not like she is a beginner exerciser”, while others sought advice:

Did you have a pregnancy workout daily routine we can follow? I am currently 22 weeks. I’ve never seen a modified burpee before! This is great! I have some joint issues and could totally do this version! Thanks for sharing.

Overall, users’ attitudes toward the influencer were positive. Users considered the influencers trustworthy and credible. Comments mostly consisted of praise and admiration in addition to positive comments regarding the influencer’s physical attractiveness, strength, capabilities, and commitment to their exercise behaviours. Evidence of parasocial relationships between the user and the influencer emerged as users demonstrated connections with the influencer (e.g., citing personal details about the influencer), and defended the influencer behaviours to other users’ criticism.

Attitudes toward the type of exercise

Not all exercise is safe

Although users expressed a desire to exercise, uncertainty about the safety of exercises during pregnancy was another barrier to performing the exercises themselves:

I’m pregnant now and would love an easy list of what’s safe and when, so I can feel more confident in the exercise I do.

Users held mixed attitudes towards the different types of exercise the influencer performed. When influencers engaged in aerobic or bodyweight exercises, user attitudes towards the influencer and the type of exercise the influencer was performing were positive and supportive. An example comment relating to these types of exercises was:

YOUR body is MADE for burpees, so don’t sweat it. You kept doing what your body was used to.

In contrast, when influencers engaged in resistance-based exercise using weights, the user attitudes were mixed. Users expressed a range of concerns and questioned the safety and necessity of the exercise being performed:

is that a good idea to be lifting heavy weights when you are this far along?

Other users perceived exercises involving weights to be high risk, harmful to the baby, and contradictory to health provider recommendations:

Any midwife or gyno doc will tell you don’t lift or strain during last trimester. Why risk both your lives.

Specifically, almost all negative comments from users towards influencers were associated with the influencer engaging in resistance-based exercises using weights. Medical complications during pregnancy, and the advice of healthcare providers, were identified as some of the reasons why resistance-based exercises using weights was viewed as unsafe:

I was absolutely huge out front and could NOT do any of these sorts of exercises whilst pregnant. Believe me I so wanted to, but genetics had other plans for me. I couldn’t even see a weight on the floor past the bump let alone pick it up. It would have been incredibly detrimental to me to have put any more strain on my abdominals. My midwives checked my abdomen throughout my pregnancy and strongly advised against anything like this. I ended up with a 6cm separation post-partum, so they were completely on the money.

Expertise and credibility

Negative user attitudes towards resistance-based exercises using weights during pregnancy was also associated with discreditation of the influencer’s status as an exercise professional and/or expert. Although some users appeared to admire an influencer, the same users also disapproved of the influencer’s choice in exercise:

You are an amazing and smart person and a true inspiration to all out there, but this is too risky sorry.

Influencer credibility was also brought into question after they chose to perform resistance-based exercise using weights when pregnant, as it was perceived to be against healthcare provider recommendations and exercise guidelines, as one user commented:

I am under the impression that when you reach a certain point in pregnancy, you shouldn’t be lifting weights. My OBGYN told me I couldn’t lift weights but could do other exercises.

The influencer’s motivations to exercise was also questioned and deemed as a selfish act of choosing appearance over health:

…exactly figure or health of baby. Totally irresponsible.

Overall, user attitudes were positive and supportive when influencers engaged in aerobic or bodyweight exercises. but users expressed concerns about the safety and need when influencers engaged in resistance-based exercises. Negative user attitudes tended to lower levels of influencer trust and credibility, with some users questioning the influencers expertise.

Community

Social support and guidance

A ‘community’ theme was identified however this theme is not directly related to attitudes about exercise during pregnancy. This theme suggests that by sharing personal experiences, seeking and offering advice, and supporting other users, a supportive community of users is created independent of the influencer. Within this community, users challenged attitudes and misconceptions about exercise during pregnancy and offered emotional support and guidance about exercise to each other:

[user name] that’s how I was with my first. I knew that with my second pregnancy, I wanted to change that. If you have another baby in the future, definitely try to work out before and during! Makes a world of difference.

[user name] congratulations you’re a wonderful woman, just like me, I have 7 beautiful children, 4 boys and 3 girls…hope that you’re in good health, because it’s all that matters.

[user name] we live in a country with extremely poor habits. Exercise is one of the keys to long healthy life and very important while pregnant.

Overall, a supportive community of users was created independent of the influencer. Users shared personal experiences, sought advice from each other and offered emotional support and guidance to one another. Attitudes and misconceptions about exercise during pregnancy were also challenged between users.

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