The current study investigated internet usage as a source of health information among pregnant women in Qatar. It was found that accessing the internet for such purpose was prevalent (81.1%) among our study participants and significantly associated with a specific age group, Arabs, higher level of education, being employed or a housewife, and having up to two children.
In this study, pregnant internet users represented a majority (88.1%) of the total sample. This result aligns with the findings of earlier studies that reported a high prevalence of internet use as a source of health information during pregnancy in developed countries such as Sweden, China, and Canada (2, 4, 14). The widespread use of online sources for health info during pregnancy can be explained by increased internet availability among the global population. It is estimated that by the end of 2019, 4.1 billion individuals or more than half (53.6 %) of the global population were using the internet. This represents almost a seven-fold increase in the percentage of internet users since 2001 at 8% (15). Another driving force behind this trend could be the abundance of online health information. However, the credibility of this information varies widely among different sources and it becomes the responsibility of the consumer to navigate, seek, and validate it (16).
In addition to that, nearly two-thirds (64.4%) of participants recognized their healthcare providers as a source of pregnancy-related information during the current gestation. Subsequently, healthcare professionals in the country must adopt a patient-centered communication strategy through open dialogue about the use of the internet for health information. Also, pregnant women are a vulnerable cohort and must be empowered with the proper skills to access online health information and encouraged to discuss this info with their health care providers. Similarly, Qatar’s health officials must collaborate with experts in the field to develop comprehensive, user-friendly, and culturally appropriate online resources for pregnant women. In the meantime, health professionals must be trained on how to identify and recommend valid online sources for pregnant internet users (17).
Another study finding was the low level of participation in educational activities related to pregnancy, where only a small proportion (9.2%) of participants acknowledged doing so. Likewise, there is a declining trend of attending childbirth education classes as evidenced in the literature. Childbirth education classes have a well-documented positive impact on pregnancy outcomes (18–20). Hence, organizers of such classes in the country need to integrate internet use as part of the class activities as an effort to attract this large cohort of pregnant women. The classes will offer an organized environment for the sharing and flow of credible pregnancy-related information without the overwhelming and puzzling aspect of the online environment. Given the COVID-19 pandemic, there is an opportunity to offer these classes as part of the virtual consultations taking place across Qatar’s PHC centers.
Regarding the most searched online topics, fetal development and diet during pregnancy were the most frequently reported themes. These results corroborate the evidence of an earlier systematic review that detected these two topics as the most common areas of interest among expecting mothers on the internet (21). Seeking online information about fetal development might reflect a maternal need for comfort or reassurance in this regard. Many pregnant women will be concerned regarding their fetal wellbeing. Regarding nutrition during pregnancy, a study in China associated this concern with the popular underlying belief that nutrition plays an important role in maternal health (22). On the other hand, intimacy was the least searched online theme in this study. This could be due to the sensitivity of such issues among the conservative community in Qatar. Moreover, healthcare providers should be aware of these themes and provide more evidence-based information to their pregnant women in a timely and comprehensible manner. Specifically, health professionals may want to focus on the normal intrauterine development of the fetus during the different stages of pregnancy as well as nutritional guidance to pregnant women during this critical phase of their life.
Our study has identified a significant association between several participant characteristics and using the internet for pregnancy-related information. First, participants between the ages of 26 and 35 years were the most (86%) likely to surf the internet for health information during pregnancy. This result conforms with that of a Turkish study in which participants aged 25–34 years reported using the internet more frequently than their younger (18–24 year) and older (≥ 35 years old) peers (5). On the other hand, an earlier study among 19 pregnant Swedish women did not find any significant association between age and using the internet for health information (2). This area requires further research to understand the drivers behind such differences.
Secondly, pregnant women with tertiary education as well as those who were employed reported the highest internet usage as a source of pregnancy-related info. Similarly, a study on the information needs and health-seeking practices of pregnant women found that the internet was not widely accessed by pregnant women with a low income and low education level (23). However, unemployed participants in our study might still have a high income depending on their spouses’ or families’ financial status. As such, we cannot infer a similar explanation in this study. Nevertheless, being highly educated is associated with possessing the skills to search for health information online (21).
Third, our study detected that pregnant women, with up to 2 children at home, used the internet more frequently than their peers. Moreover, there was a minimal difference in internet use between those participants who had no children (82.6%) and those having 1–2 children at home (84.1%). These results are like that of a multicenter Italian study that found no significant difference regarding internet access among primiparous and multiparous women (6). In contrast, a study among American pregnant women found that nulliparous participants (50.3%) were two times more likely to use the internet than their multiparous counterparts (21.3%) (24). A similar finding was noted among pregnant women in our study, with 3 or more children at home, who reported the least internet use (69.9%) for online information. Thus, pregnant women with more than two children might have gained enough knowledge and experience from the earlier pregnancies. Subsequently, these participants have assimilated a higher level of confidence that explains their relative independence from using the internet as a source of pregnancy-related information.
Finally, the respondents who were in the third trimester of their pregnancy reported more usage of the internet as a source of health information (88.8%) in comparison to those in the first (72%) and second trimesters (77.4%). So, our participants portrayed an increasing need for health information throughout their pregnancy. In contrast, a study among Chinese pregnant women revealed a drastic decrease in internet usage from the first (81.5%) till the third trimester (5.1%). This was attributed to a stronger need for information during the early stage of pregnancy, where the clinical consultations under the Chinese antenatal program begin from the 20th week of gestation (4). On the other hand, the Qatari antenatal program initiates clinical visits early on from the 6th week of pregnancy and offers up to six visits during the first trimester (25). Consequently, more research is needed to understand the increasing trend of internet use by stage of pregnancy among pregnant women in Qatar.
The current study has some limitations. First, it was conducted among pregnant women attending the antenatal clinics under the Primary Health Care Corporation, Qatar’s governmental primary health care provider. So, our results cannot be extrapolated onto the pregnant women seeking antenatal care in the private health sector. Another limitation of this study was that certain questions in the questionnaire relied on pregnant women’s ability to remember. Additionally, the cross-sectional study design cannot generate enough evidence to establish causality.
Nevertheless, our study has several strengths. It is the first study to assess the use of the internet as a source of pregnancy-related information among pregnant women in Qatar. Moreover, the high level of response among the participants and the completeness of the questionnaires can be attributable to employing nurses and midwives for administering the questionnaire. Furthermore, a probability sampling technique was employed to select participants from the appointment list of each chosen PHC center. All governmental PHC centers cater to a population of diverse ethnicities and cultures. Therefore, the results can be generalizable to most of the population in Qatar. In addition, the study has identified several gap areas that can be used in enhancing the quality and comprehensiveness of antenatal care in the country.