#ttc on Instagram: a multimodal discourse analysis of the treatment experience of patients pursuing in vitro fertilization

Submitted: 11 October 2018
Accepted: 16 February 2019
Published: 18 April 2019
Abstract Views: 2845
PDF: 1343
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Authors

While searching the Internet for health information is now commonplace, giving and receiving medical expertise on social media platforms such as Instagram (IG) is underexplored. In order to investigate the ways in which social media platforms are a resource for seeking medical expertise, we employed a multimodal discourse analysis; specifically, we focused on the hashtag #ttc and the engagement of the IG community it comprised. We examined three main themes around medical expertise during treatment indexed by the hashtag: treatment protocol choices, treatment side effects and pregnancy diagnosis/confirmation. Our findings suggest that social media platforms provide a new arena in which patients can challenge medical expertise by circumventing it or adopting lay expertise instead of practitioner suggestions. We close with research implications and suggestions for further research.

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Bigelow HR. The moral significance of sterility. Obstetric Gazette 1883;16:1-24.
Gregg RS. Sterility versus fecundity, and the divorce evil. Milwaukee Med J 1905;13:60-2.
Meaker S. Human sterility: causation, diagnosis, and treatment. a practical manual of clinical procedure. Baltimore: Williams and Wilkin; 1934.
Centers for Disease Control and Prevention. Infertility FAQs. Available from: https://www.cdc.gov/reproductivehealth/infertility/index.htm. Accessed: September 2018.
Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health. Infertility and fertility. Available from: https://www.nichd.nih.gov/health/topics/infertility. Accessed: September 2018.
World Health Organization (WHO). Infertility is a global public health issue. Available from: http://www.who.int/reproductivehealth/topics/infertility/perspective/en/ Accessed: September 2018.
Sandelowski M. With child in mind: studies of the personal encounter with infertility. Philadelphia: University of Pennsylvania Press; 1993. DOI: https://doi.org/10.9783/9781512806779
Marsh M, Ronner W. The empty cradle: infertility in America from colonial times to the present. Baltimore: Johns Hopkins University Press; 1996.
Mayo Clinic. In vitro fertilization (IVF). 2019. Available from: https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716.
Bell AV. Beyond (financial) accessibility: Inequalities within the medicalization of infertility. Sociol Health Illn 2010;32:631-46. DOI: https://doi.org/10.1111/j.1467-9566.2009.01235.x
Johnson B. Personal, interpersonal, biomedical, textual: Vignettes on infertility and fertility privilege. Depart Crit Qual Res 2016;5:76-100. DOI: https://doi.org/10.1525/dcqr.2016.5.2.76
Johnson B, Margaret M. You’re doing it wrong! Mothering, media and medical expertise. Rutgers: Rutgers University Press; 2019. DOI: https://doi.org/10.36019/9780813593821
Bute JJ. “Nobody thinks twice about asking”: Women with a fertility problem and requests for information. Health Commun 2009;24:752-63. DOI: https://doi.org/10.1080/10410230903265920
Bute JJ, Vik TA. Privacy management as unfinished business: Shifting boundaries in the context of infertility. Commun Stud 2010;61:1-20. DOI: https://doi.org/10.1080/10510970903405997
Johnson B, Quinlan M, Marsh JS. Telenursing and nurse-patient communication within Fertility, Inc. J Holist Nurs 2018;36:38-53. DOI: https://doi.org/10.1177/0898010116685468
Johnson B, Quinlan M, Myers J. Commerce, industry, and security: Biomedicalization theory and the use of metaphor to describe practitioner-patient communication within Fertility, Inc. Womens Reprod Health 2017;4:89-105. DOI: https://doi.org/10.1080/23293691.2017.1326250
Willer EK. Health-care provider compassionate love and women’s infertility stressors. Commun Monographs 2014;81:407-38. DOI: https://doi.org/10.1080/03637751.2014.940591
Breitkopf E, Rubin L. (Re)productive disorders: The expanding marketplace for infertility medicine. In: McHugh MC, Chrisler JC, eds. The wrong prescription for women: How medicine and media create a “need” for treatments, drugs, and surgery. Santa Barbara: Praeger; 2015. pp 37-59.
Pew Research Center. Millennials: A portrait of generation next. Available from: http://www.pewsocialtrends.org/files/2010/10/millennials-confident-connected-open-to-change.pdf Accessed: September 2018.
Press G. A very short history of the internet and the web. Forbes 2015. Available from: https://www.forbes.com/sites/gilpress/2015/01/02/a-very-short-history-of-the-internet-and-the-web-2/#7f0d5bad7a4e Accessed: September 2018.
Zimmermann KA, Emspak J. Internet history timeline: ARPANET to the world wide web. Live Science 2017. Available from: https://www.livescience.com/20727-internet-history.html Accessed: September 2018.
Eastin MS. Credibility assessments of online health information: The effects of source expertise and knowledge of content. J Comput Mediat Commun 2001;6. DOI: https://doi.org/10.1111/j.1083-6101.2001.tb00126.x
Kata A. A postmodern Pandora’s box: Anti-vaccination misinformation on the Internet. Vaccine 2010;28:1709-16. DOI: https://doi.org/10.1016/j.vaccine.2009.12.022
Sillence E, Briggs P, Harris P, Fishwick L. Going online for health advice: Changes in
usage and trust practices over the last five years. Interact Comput 2006;19:397-406. DOI: https://doi.org/10.1016/j.intcom.2006.10.002
Pew Research Center. Social media update. Available from: http://www.pewinternet.org/2016/11/11/social-media-update-2016/pi_2016-11-11_social-media-update_0-03/ Accessed September 2018.
Johnson SA. “Maternal devices,” social media and the self-management of pregnancy, mothering and child health. Societies 2014;4:330-50. DOI: https://doi.org/10.3390/soc4020330
Lupton D. Caring dataveillance: Women’s use of apps to monitor pregnancy and children. In: Green L, Holloway D, Stevenson K, et al. (eds.) The Routledge Companion to Digital Media and Children. Abingdon-on-Thames: Routledge; 2019. DOI: https://doi.org/10.4324/9781351004107-37
Riley-Smith B. How Instagram took over the world in just three years. Telegraph 2013. Available from: https://www.telegraph.co.uk/technology/10355980/How-Instagram-took-over-the-world-in-just-three-years.html Accessed: September 2018.
Escoffery C, Miner KR, Adame DD, et al. Internet use for health information among college students. H Am Coll Health 2005;53:183-88. DOI: https://doi.org/10.3200/JACH.53.4.183-188
Morahan-Martin JM. How internet users find, evaluate, and use online health information: A cross-cultural review. CyberPsychol Behav 2004;7:497-510. DOI: https://doi.org/10.1089/cpb.2004.7.497
Feiler B. App time for nap time: The Parennials are here. The New York Times 2017; Available from: https://nyti.ms/2hDJK7y Accessed: September 2018.
Edison Research. Moms and media. 2013. Available from: http://www.edisonresearch.com/wp-content/uploads/2013/05/Moms-and-Media-2013-by-Edison-Research.pdf Accessed: September 2018.
Khouri JS, McCheyne MJ, Morrison CS. #Cleft: The use of social media amongst parents of infants with clefts. Cleft Palate Craniofac J 2017;55:974-6. DOI: https://doi.org/10.1597/16-156
Landry T. How social media has changed us: The good and the bad. Business 2 Community. Weblog. 2018. Available from: https://www.business2community.com/social- media/social-media-changed-us-good-bad-01000104# 8k65A08r0MVI4XyD.97 Accessed: September 2018.
Ridgway JL, Clayton RB. Instagram unfiltered: Exploring association of body image satisfaction, Instagram #Selfie posting, and negative romantic relationship outcomes. Cyberpsychol Behav Soc Net 2016;19:2-7. DOI: https://doi.org/10.1089/cyber.2015.0433
Olszanowski M. Feminist self-imaging and Instagram: Tactics of circumventing censorship. Vis Commun Q 2014;21:83-95. DOI: https://doi.org/10.1080/15551393.2014.928154
Olszanowski M. The 1x1 common: The role of Instagram’s hashtag in the development and maintenance of feminist exchange. In: Rambukkana N, ed. Hashtag Publics. New York: Peter Lang Publishing; 2015. pp 229-242.
Zappavigna M. Searchable talk: the linguistic functions of hashtags. Soc Semiotics 2015;25:274-91. DOI: https://doi.org/10.1080/10350330.2014.996948
Adami E. What’s in a click? A social semiotic framework for the multimodal analysis of website interactivity. Vis Commun 2014;14:133-53. DOI: https://doi.org/10.1177/1470357214565583
Hiscott R. The beginner’s guide to the hashtag. Mashable [online curated blog] 2013 Available from: https://mashable.com/2013/10/08/what-is-hashtag/#6XoZi1AZpPqO. Accessed: 2019 Jan 25.
Tiidenberg K. Odes to heteronomativity: Presentations of femininity in Russian-speaking pregnant women’s Instagram accounts. Int J Commun 2015;9.
Ahmed W. Public health implications of #ShoutYourAbortion. Public Health. 2018;163:35-41. DOI: https://doi.org/10.1016/j.puhe.2018.06.010
Dorfman RG, Vaca EE, Mahmood E, et al. Plastic surgery-related hashtag utilization on Instagram: implications for education and marketing. Aesth Surg J 2017;38:332-38. DOI: https://doi.org/10.1093/asj/sjx120
Ucar T, Culpan M, Caskurlu T, et al. The activity and discussion points of #Circumcision through Twitter; a microblogging platform. Int J Impot Res 2018;30:249-52. DOI: https://doi.org/10.1038/s41443-018-0058-y
Doctor V. Hashtag history: When and what started it? Hashtags.org [online curated
blog]. 2013 Available from: https://www.hashtags.org/featured/hashtag-history-when-and-what-started-it/. Accessed: 2019 Jan 25.
Barthes R. Elements of semiology. London: Jonathan Cape; 1967.
Miller AF. Redneckaissance: Honey Boo Boo, Tumblr, and the stereotype of poor white trash [dissertation]. Columbia, South Carolina: University of South Carolina; 2015.
de Saussure F. Course in general linguistics. London: Fontana; 1974.
Van Leeuwen TV, Kress G. Multimodal discourse: the modes and media of contemporary communication. London: Hodder Arnold Publishers; 2001.
Plastina, AF. Patient (mis)understanding of prescription drug ads in social media: Multimodal discourse analysis of eDTCA. In: Maci S, Sala M, eds. Insights into medical communication. Bern, Switzerland: Peter Lang Publishers; 2015. pp. 189-212.
Berger J. Ways of Seeing. London: British Broadcasting Corporation; 1972.
Mitchell WT. Iconology: image, text, ideology. Chicago: University of Chicago Press; 1986. DOI: https://doi.org/10.7208/chicago/9780226148052.001.0001
Mitchell WT. Picture theory: essays on verbal and visual representation. Chicago: University of Chicago Press; 1994.
Jensen RE. The eating disordered lifestyle: Imagetexts and the performance of similitude. J Am Forensic Assoc 2005;42:1-18. DOI: https://doi.org/10.1080/00028533.2005.11821634
Bucher T, Helmond A. The affordances of social media platforms. In: Burgess J, Poell T, Marwick A, eds. The Sage handbook of social media. London: Sage; 2017. pp. 223-253. DOI: https://doi.org/10.4135/9781473984066.n14
Fallon K. Streams of the self: The Instagram feed as narrative autobiography. In: Proceedings of the interactive narratives, new media & social engagement international conference. Toronto: University of Toronto Press; 2014. pp. 4-60.
Borzekowski DL, Schenk S, Wilson JL, Peebles R. e-Ana and e-Mia: A content analysis of pro-eating disorder web sites. Am J Public Health 2010;100:209-38. DOI: https://doi.org/10.2105/AJPH.2009.172700
Dylko IB, Beam MA, Landreville KD, Geidner N. Filtering 2008 presidential election news on YouTube by elites and novelties: An examination of the democratizing potential of the internet. New Media Soc 2012;14:832-49. DOI: https://doi.org/10.1177/1461444811428899
Hwang KO, Fahren K, Johnson CW, et al. Quality of weight loss advice on internet forums. Am J Med 2007;120:604-9. DOI: https://doi.org/10.1016/j.amjmed.2007.04.017
Hwang KO, Ottenbacher AJ, Green AP, et al. Social support in an internet weight loss community. Int J Med Inform 2010;79:5-13. DOI: https://doi.org/10.1016/j.ijmedinf.2009.10.003
Van Hoof W, Provoost V, Pennings G. Reflections of Dutch patients on IVF treatment in Belgium: A qualitative analysis of internet forums. Hum Rep 2013;28:1013-22. DOI: https://doi.org/10.1093/humrep/des461
Saldaña J. The Coding Manual for Qualitative Researchers. Thousand Oaks, CA: Sage Publishing; 2009.
Rambukanna N. FCJ-194 From #racefail to #Ferguson: The digital intimacies of race-activist hashtag publics. Fibreculture J 2015;26:159-88. DOI: https://doi.org/10.15307/fcj.26.194.2015
Potter J, Wetherell M. Discourse and Social Psychology: Beyond Attitudes and Behaviour. Thousand Oaks, CA: Sage Publishing; 1987.
Jungheim ES, Meyer M, Broughton DE. Best practices for controlled ovarian stimulation in IVF. Sem in Rep Med 2015;33:77. DOI: https://doi.org/10.1055/s-0035-1546424
CBSNEWS.com. Buyer beware: Fertility drugs online. CBS News Online [online news source] 2000. Available from: https://www.cbsnews.com/news/buyer-beware-fertility-drugs-online/ Accessed: 2019 Jan 25.
Levy L. What this “army of infertility warriors” did for complete strangers going through IVF. PopSugar [online curated blog] 2017. Available from: https://www.popsugar.com/family/Strangers-Donating-IVF-Medicine. Accessed: 2019 Jan 25.
Mamo L. Fertility, Inc.: Consumption and subjectification of lesbian reproductive practices. In: Clarke AE, Mamo L, Focscket JR, et al., eds. Biomedicalization: Technoscience, health and illness in the US. Durham, NC: Duke University Press; 2010. pp 173-196. DOI: https://doi.org/10.2307/j.ctv125jk5c.10
Instagram. Controlling your visibility. Accessed: September 2018. Available from: https://help.instagram.com/116024195217477/?helpref=hc_fnav&bc[0]=Instagram%20Help&bc[1]=Privacy%20and%20Safety%20Center
Quinlan M, Johnson B. #motherhoodishard: Narrating our research and mothering in the postpartum stage through texting and social media. Health Commun 2019 [in press]. DOI: https://doi.org/10.1080/10410236.2019.1587694

How to Cite

Johnson, Bethany, Margaret M. Quinlan, and Nathan Pope. 2019. “#ttc on Instagram: A Multimodal Discourse Analysis of the Treatment Experience of Patients Pursuing in Vitro Fertilization”. Qualitative Research in Medicine and Healthcare 3 (1). https://doi.org/10.4081/qrmh.2019.7875.