Abstract:
The study sought to establish the long-term cumulative influence of television childbirth representation on mode of delivery preferences among primiparous women in Nairobi, Kenya. To achieve this, it was guided by cultivation and medicalization theories to address four fundamental objectives of establishing (a) nature of childbearing shows, (b) television viewing frequency, (c) television viewership context, and (d) moderating role of socio-demographics. A sequential mixed-methods approach was used, involving 300 purposefully selected primiparous women from all eleven sub-counties in Nairobi during routine child immunization schedules. 150 of the participants had vaginal deliveries, while the remaining underwent elective caesarean deliveries. Data was collected using interviewer-administered questionnaires, complemented by three focused group discussions and six in-depth interviews. Quantitative data was analyzed using descriptive and inferential statistics, while thematic analysis was applied to qualitative data. The study found that television childbirth representation significantly influences perceptions and subsequent mode of delivery preferences (p < 0.05). In particular, prolonged exposure to dramatized and medicalized portrayals shaped both first-order cultivation beliefs, such as perceptions of risk, safety, and childbirth medical interventions, and second-order attitudes toward preferred mode of delivery. The frequency of watching television, along with knowing and discussing someone who has had a childbirth experience similar to TV depictions, reinforced these perceptions. Socio-demographic characteristics, especially educational attainment, moderated these effects. The study concludes television childbirth representation plays a considerable role in shaping mode of delivery preferences among first-time mothers. It recommends that TV viewers to critically evaluate media information, healthcare workers need to engage with such content proactively to address fears, concerns, and misconceptions. There is a need for collaboration between content producers, recent mothers, and healthcare workers for authentic portrayals. Additionally, policymakers should implement media literacy programs and support evidence-based research for informed policy decisions. These measures aim to improve perinatal outcomes, reduce harm from unnecessary cesareans, and reduce healthcare costs associated with unnecessary childbirth interventions.
