(562) Baby got #vbac: a content analysis of trending videos on TikTok

Objective: Obstetric providers may be able to combat disinformation and strengthen patient-provider trust by understanding health information many of their patients consume on social media. We aimed to characterize and evaluate vaginal birth after Cesarean (VBAC) video content presented on TikTok.

Study Design: We used the web-scraping tool Apify to compile the 100 top “#vbac” videos.  Unrelated, unavailable, or non-English videos were excluded. Two independent reviewers collected twenty-six descriptive data points for each video; a third arbitrated differences. Medical facts were appraised using VBAC guidelines from American College of Obstetricians and Gynecologists and Society of Maternal Fetal Medicine. Two validated measures were used: a modified 5-point DISCERN scale assessed information quality and Patient Education Materials Assessment Tool (PEMAT) assessed understandability and actionability.

Results: The top 100 videos had approximately 156 million views, 12 million likes, and 317,000 shares. A majority (81.0%) were made by non-healthcare professionals. The most common primary video theme was a personal experience or opinion (36.0%); of these, 13 (36.0%) mentioned distrust of or dismissal by providers. Twenty percent of all videos addressed home birth after Cesarean (HBAC), including 16 promoting HBAC by a single creator. Twenty-four videos presented medical facts; of these, videos by healthcare providers (n=11) and non-healthcare providers (n=13) included evidence-based facts 64.0% (n=7) and 46.0%(n=5) of the time, respectively. Overall videos exhibited high understandability (PEMAT median 85.5%, SD 15.7%), but low information quality (DISCERN mean 1.5, SD 0.9).

Conclusion: Videos with #vbac had low information quality, a finding consistent with previous work evaluating videos on contraception and abortion. Our study shows that top #vbac videos often lack health information. Of videos that include medical facts, many are incomplete or inaccurate. Obstetric providers can use the findings of this study to engage with patients they know are using TikTok for health education.