By Britta Wigginton
What was the purpose of our research?
We were interested in understanding whether or not women used online pregnancy forums to discuss questions, issues or concerns about smoking during their pregnancy.
What did we do?
Fifty women completed a survey about using online pregnancy forums while pregnant and smoking.
What did we find?
This report provides a summary of the survey findings. The results will be of interest to the women who kindly participated, women using online pregnancy forums and the wider community.
Findings
Looking for support and advice
Most women started using pregnancy forums for information, support and advice, often for reasons unrelated to smoking or quitting. Women spoke about wanting to read about other women’s experiences of pregnancy and gaining a sense of support during and after pregnancy. For instance, one woman wrote about going online:
“To talk to other mums going through what I was”
More than half of the women who participated said that they had told family or friends they were using pregnancy forums.
Several women did not tell anyone because they wanted to remain anonymous online or felt that others (friends or family) wouldn’t understand why they were going online for support or information.
For instance, one woman stated:
“Part of the reason why I don’t talk about smoking on forums is a fear someone I know will find that post and somehow figure out it’s me”
However, only four women indicated that they had posted about smoking in pregnancy on a pregnancy forum.
What stops women posting online?
- Fear of judgement or backlash
- Shame and embarrassment about smoking in pregnancy
- The topic was never raised by others
Many women had read very negative and judgemental posts from other women about smoking in pregnancy.
Here are some examples of what women wrote:
“Some were supportive, some just bragged on how they ‘instantly gave up that easily’ and others were really rude about it”
“Most people were very critical even of those who had cut down considerably, like myself”
“Some people are really passionate keyboard warriors. A lot were negative and ‘verbally bashed’ women who smoked”
Some women felt their experience of being pregnant and smoking had to remain hidden, and they had no one to talk to about it. For instance:
“I looked up women’s experiences of trying to quit smoking in online forums because I literally don’t know a single real life person experiencing the same thing, not because I felt I would be more or less judged”
“I don’t know anyone else who is pregnant and smoking, so yes, it’s easier to discuss [smoking in pregnancy] online than with my non-existent pregnant smoking friends”
For women who did post, very few women described any support, understanding or empathy online regarding their smoking.
Only a few women spoke of receiving support and advice online in discussions of smoking in pregnancy.
For the minority of women who described positive experiences online, what did support look like?
“On general posts you get some slamming from mothers who really judge you for it, I never posted in those for that reason. In the quitting group there was a lot of support and encouragement. When a woman would post saying she was smoking but not quitting there was always help, advice offered, but never judgement or criticism”
“Others [had] created posts seeking help and support. I often commented on them giving them tips I used to cut down”
“Women who had smoked during pregnancy were less critical about doing it and more supportive about quitting, decreasing or lightly smoking. Heavy smoking was discouraged. I could chat without being judged and they understood”
“There was a group specifically for women trying to quit during pregnancy, offering advice, support and just somewhere to vent”
From these few positive experiences, there was some common ground. Positive experiences usually occurred within forum threads that were specifically about “seeking support” or “quitting smoking”. In these threads women felt less likely to be judged because the title (and content) of the thread meant that smoking would be discussed, implying that this was not the space for judgement.
In addition, women emphasised the value of personal advice about reducing or quitting smoking. Other women (who had also smoked in pregnancy) were generally supportive by providing tips for cutting down or quitting – as long as heavy smoking wasn’t being promoted. Some women spoke of the importance of ‘understanding’ what it’s like to smoke in pregnancy – or to smoke at all. Women described non-smokers as not understanding addiction, shame, guilt and the need to remain ‘hidden’ – all of which were very difficult aspects for women who smoked during their pregnancy.
Take home messages
Women described their need for support, advice and information about reducing or quitting smoking and the overwhelming difficulty in discussing or disclosing their smoking online. In the context of smoking in pregnancy, it is important that women are able to disclose, or ask questions about, smoking (e.g. tips for reducing or quitting) in order to help them in their journey towards cessation.
Recommendations for forums*:
Pregnancy forums are an important source of information and support for women. The following are suggestions to provide a “safe” space for women to talk more openly online, reducing the fear of backlash or judgement.
- Threads specifically designed for discussions about quitting and reducing smoking in pregnancy. A space like this provides women with an opportunity to share advice and tips on reducing smoking and managing cravings. A clear title to show that “quitting” smoking will be discussed sets the tone for supportive discussions.
- Women need options online to report an inappropriate post or to alert forum moderators to offensive comments. Many women who participated in the survey feared being ‘verbally bashed’ online for disclosing their smoking. It is important that women with a range of life experiences are able to talk to each other in online pregnancy forums without feeling judged or shamed for their behaviour.
Silencing an experience because it is considered “controversial” does not help women in their journey towards cessation.
*Notably, we experienced significant difficulty in advertising this research study in online pregnancy forums. Many forums were reluctant to carry our advertisement, replying that smoking in pregnancy is a “controversial” topic that elicits strong opinions. Although many forums prefer to avoid discussions of smoking in pregnancy, we believe that avoidance does not help women to quit smoking and suggest that a supportive space should be offered to women.
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