New study characterizes how Twitter users discuss miscarriage, preterm birth

A new Boston University School of Public Health (BUSPH) study characterizes how Twitter users discuss miscarriage and preterm birth. Published in Paediatric and Perinatal Epidemiology, the study finds that miscarriage disclosures by Michelle Obama and other public figures prompted spikes in discussion, and in other people sharing their own experiences of miscarriage. The study also gathered thousands of individuals' tweeted experiences with miscarriage, showing gaps in knowledge and support.

Most individuals who self-disclosed a miscarriage in our data did not appear to have been offered any type of mental health support as part of medical management of their miscarriage. The need for emotional and psychological support seems to drive individuals to seek information and community online.

Dr. Elaine Nsoesie, the study's senior author and an assistant professor of global health at BUSPH

Dr. Nsoesie points to a quote from the former First Lady's disclosure: "What nobody tells you is that miscarriage happens all the time, to more women than you'd ever guess, given the relative silence around it." In fact, 15-20% of known pregnancies end in a miscarriage.

Dr. Nsoesie and colleagues obtained and analyzed 291,443 tweets on miscarriages and preterm births from January 2017 through December 2018, including 7,282 personal miscarriage disclosure tweets, and categorized them into eight topics: Michelle Obama (8.4% of tweets), other celebrity disclosures (23.0%), preterm birth (10.9%), politics (17.6%), loss and anxiety (10.1%), ectopic pregnancy (7.50%), healthcare (10.7%) and misconceptions about the influenza vaccine (11.7%). Celebrity miscarriage disclosures prompted disclosures by Twitter users, and the most common emotions expressed about users' own miscarriages were grief (50.64%) and annoyance (16.19%).

The study also found increases in discussion of miscarriage around events related to reproductive rights, including legislation passed in Texas in 2017 requiring burial or cremation of fetal tissue associated with miscarriages, ectopic pregnancies, and abortions, and a pharmacist refusing to fill a prescription for misoprostol to end a Michigan woman's failed pregnancy in 2018. Preterm birth tweets spiked around reports of the high rate of preterm birth in the U.S., expressing frustration and calling for action. The researchers also found significant misinformation on the causes of miscarriage and preterm birth.

"Social media data provides a lens into the physical, emotional, and psychological impacts of miscarriages," says Dr. Nsoesie, explaining that this information can inform care and support for people who have experienced miscarriages, and help identify knowledge gaps and misinformation in the public.