Scrolling for safety: Digital health literacy and pregnancy danger sign recognition in primary care
Main Article Content
Abstract
Pregnancy carries the risk of complications such as hemorrhage, hypertension, and infection, key causes of maternal death, making early detection of danger signs essential. Digital media are increasingly used for health information, yet prior research remains largely quantitative and rarely triangulates pregnant women, husbands, and midwives within a single primary care setting, a gap this study addresses. Using a descriptive phenomenological design, in-depth interviews and focus group discussion were conducted wth 27 participants (16 key informants, 5 FGD participants, 2 husbands, 4 midwives) at Community Health Center Sokaraja 1, analyzed using Colaizzi’s method. Four themes emerged: (1) passive, alogirthm-driven access to short-form videos, especially TikTok; (2) a conflict-triggered verification pattern, where online information was cross-checked with midwives mainly when it conflicted with prior belief; (3) adequate danger-sign knowledge anchored in the Maternal and Child Health Handbook and face-to-face education rather than digital media; and (4) formal education constrained by scheduling, quota, and referral barriers, pushing women toward informal digital sources. These findings offer novel, multi-informant qualitative evidence that digital health literacy functions as an adaptive complement to formal education, supporting social media-based education strategies and stronger digital integration in primary care services.
Article Details
How to Cite
Alifah, N. N. N. ., & Purwito, D. . (2026). Scrolling for safety: Digital health literacy and pregnancy danger sign recognition in primary care. Journal of Midwifery and Nursing, 8(3), 202-214. https://doi.org/10.35335/jmn.v8i3.7392
References
Abdalla Osman Mohamed, S., Mohamed, G. S., Attaelmanan Mahgoub, A. khidir, Ahmed, F., Taha, A. B., Abbashar Abdelmahmoud, E. M., Safieldin Mahamad, S. M., Majzoub Karamalla, S. badwey, & Taha, M. (2025). Barriers to Antenatal Care Attendance in Developing Countries: A Systematic Review. Cureus. https://doi.org/10.7759/cureus.95342
Aftab, N. (2025). Social Media Use During Pregnancy: Risks and Benefits for Women’s Health. Cureus. https://doi.org/10.7759/cureus.90410
Al-Dahshan, A., Chehab, M., Al-Kubaisi, N., & Selim, N. (2022). Reliability of online pregnancy-related information and associated feelings of worry among expectant women in Qatar. BMC Pregnancy and Childbirth, 22(1), 117. https://doi.org/10.1186/s12884-022-04457-w
AlDughaishi, M. Y., Seshan, V., & Matua, G. A. (2023). Challenges and Strategies of Providing Effective Antenatal Education Services in Oman’s Public Healthcare System. Sultan Qaboos University Medical Journal, 23(4), 510–518. https://doi.org/10.18295/squmj.5.2023.032
Girmay, M. (2024). Digital Health Divide: Opportunities for Reducing Health Disparities and Promoting Equitable Care for Maternal and Child Health Populations. International Journal of Maternal and Child Health and AIDS, 13, e026. https://doi.org/10.25259/IJMA_41_2024
Hussain, I. M., Hartney, N., & Sweet, L. (2023). A survey of Australian women’s digital media usage in pregnancy and labour and birth. BMC Pregnancy and Childbirth, 23(1), 688. https://doi.org/10.1186/s12884-023-06003-8
Insani, K. N., & Purwito, D. (2020). Persepsi tenaga kesehatan tentang praktek kolaboratif di puskesmas bojong kabupaten purbalingga. Jurnal Keperawatan Muhammadiyah. https://doi.org/10.30651/jkm.v0i0.5653
Kim, M., & Lee, G. (2025). Pregnant women's eHealth literacy and attitudes toward internet health information and their relationship to shared decision making: a cross-sectional study. Women’s Health Nursing, 31(2), 155–164. https://doi.org/10.4069/whn.2025.06.19
Kirkpatrick, C. E., & Lawrie, L. L. (2024). TikTok as a Source of Health Information and Misinformation for Young Women in the United States: Survey Study. JMIR Infodemiology, 4, e54663. https://doi.org/10.2196/54663
Mayasari, W., & Rochmaedah, S. (2024). The Influence of Education on Pregnancy Danger Signs on the Knowledge of Pregnant Women in the Coastal and Island Areas. Indonesian Journal of Global Health Research, 6(S6), 867–870. http://jurnal.globalhealthsciencegroup.com/index.php/IJGHR
Nambile Cumber, S., Williams, A., Elden, H., & Bogren, M. (2024). Fathers’ involvement in pregnancy and childbirth in Africa: an integrative systematic review. Global Health Action, 17(1). https://doi.org/10.1080/16549716.2024.2372906
Nandani, R. D., & Purwito, D. (2013). Determinan Perilaku Pemanfaatan Posyandu Dengan Sistem Pelayanan 5 Meja Oleh Ibu Bayi Dan Balita Di Wilayah Kerja Puskesmas 1 Sokaraja Kab. Banyumas. Universitas Muhammadiyah Purwokerto. https://repository.ump.ac.id/7138/1/Rilly Dwi Nandani COVER.pdf
Norman, C. D., & Skinner, H. A. (2006). eHealth Literacy: Essential Skills for Consumer Health in a Networked World. Journal of Medical Internet Research, 8(2), e9. https://doi.org/10.2196/jmir.8.2.e9
Purwito, D., Linggardini, K., & Jaitieng, A. (2025). Barriers To Healthcare Access: Examining Travel Time, Waiting Times, And Service Costs in Indonesia Primary Health Care. Jurnal Berita Ilmu Keperawatan, 18(2), 236–245. https://doi.org/10.23917/bik.v18i2.9068
Putri, A. P., & Lu, Y. Y. (2024). Maternal Health Literacy in Pregnant Women: A Concept Analysis. Maternal and Child Health Journal, 28(8), 1272–1282. https://doi.org/10.1007/s10995-024-03945-z
Rianti, A., Mikawati, Asriyanti, Muaningsih, & Pratiwi, R. (2024). Hubungan Pengetahuan Ibu Hamil Tentang Risiko Tinggi Dan Tanda Bahaya Pada Kehamilan, Persalinan, Nifas Dengan Sikap Dan Perilaku Ibu Dalam Perawatan Kehamilan. Journal of Pubnursing Sciences, 2(03), 81–86. https://doi.org/10.69606/jps.v2i03.116
Rizkianti, A., Saptarini, I., & Rachmalina, R. (2021). Perceived Barriers in Accessing Health Care and the Risk of Pregnancy Complications in Indonesia. International Journal of Women’s Health, Volume 13, 761–772. https://doi.org/10.2147/IJWH.S310850
Sahin, E., Yesilcinar, I., Geris, R., Pasalak, S. I., & Seven, M. (2021). The impact of pregnant women’s health literacy on their health-promoting lifestyle and teratogenic risk perception. Health Care for Women International, 42(4–6), 598–610. https://doi.org/10.1080/07399332.2020.1797036
Shibeshi, K., Lemu, Y., Gebretsadik, L., Gebretsadik, A., & Morankar, S. (2024). Sex Disparities: Couple’s Knowledge and Attitude Towards Obstetric Danger Signs and Maternal Health Care: in Rural Jimma Zone of Ethiopia. International Journal of Women’s Health, Volume 16, 987–1007. https://doi.org/10.2147/IJWH.S457357
Storm, C. P., Amaro, L. M., & Kim, L. P. (2026). #healthypregnancy: A content analysis of TikTok posts about nutrition and exercise during pregnancy. DIGITAL HEALTH, 12. https://doi.org/10.1177/20552076261426329
Tavakol, M., & Sandars, J. (2025). Twelve tips for using phenomenology as a qualitative research approach in health professions education. Medical Teacher, 47(9), 1441–1446. https://doi.org/10.1080/0142159X.2025.2478871
van Lonkhuijzen, R. M., Rustenhoven, H., de Vries, J. H. M., & Wagemakers, A. (2023). The role of the partner in the support of a pregnant woman’s healthy diet: an explorative qualitative study. BMC Pregnancy and Childbirth, 23(1), 760. https://doi.org/10.1186/s12884-023-06072-9
Vera-Ponce, V. J., Loayza-Castro, J. A., Ballena-Caicedo, J., Valladolid-Sandoval, L. A. M., Zuzunaga-Montoya, F. E., & Gutierrez De Carrillo, C. I. (2025). Global prevalence of preeclampsia, eclampsia, and HELLP syndrome: a systematic review and meta-analysis. Frontiers in Reproductive Health, 7. https://doi.org/10.3389/frph.2025.1706009
Vogels-Broeke, M., Daemers, D., Budé, L., de Vries, R., & Nieuwenhuijze, M. (2022). Sources of information used by women during pregnancy and the perceived quality. BMC Pregnancy and Childbirth, 22(1), 109. https://doi.org/10.1186/s12884-022-04422-7
Xu, J., Chen, Y., Zhao, J., Wang, J., Chen, J., Pan, X., Zhang, W., Zheng, J., Zou, Z., Chen, X., & Zhang, Y. (2024). Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study. BMC Pregnancy and Childbirth, 24(1), 392. https://doi.org/10.1186/s12884-024-06594-w
Yunitasari, E., Matos, F., Zulkarnain, H., Kumalasari, D. I., Kusumaningrum, T., Putri, T. E., Yusuf, A., & Astuti, N. P. (2023). Pregnant woman awareness of obstetric danger signs in developing country: systematic review. BMC Pregnancy and Childbirth, 23(1), 357. https://doi.org/10.1186/s12884-023-05674-7
Aftab, N. (2025). Social Media Use During Pregnancy: Risks and Benefits for Women’s Health. Cureus. https://doi.org/10.7759/cureus.90410
Al-Dahshan, A., Chehab, M., Al-Kubaisi, N., & Selim, N. (2022). Reliability of online pregnancy-related information and associated feelings of worry among expectant women in Qatar. BMC Pregnancy and Childbirth, 22(1), 117. https://doi.org/10.1186/s12884-022-04457-w
AlDughaishi, M. Y., Seshan, V., & Matua, G. A. (2023). Challenges and Strategies of Providing Effective Antenatal Education Services in Oman’s Public Healthcare System. Sultan Qaboos University Medical Journal, 23(4), 510–518. https://doi.org/10.18295/squmj.5.2023.032
Girmay, M. (2024). Digital Health Divide: Opportunities for Reducing Health Disparities and Promoting Equitable Care for Maternal and Child Health Populations. International Journal of Maternal and Child Health and AIDS, 13, e026. https://doi.org/10.25259/IJMA_41_2024
Hussain, I. M., Hartney, N., & Sweet, L. (2023). A survey of Australian women’s digital media usage in pregnancy and labour and birth. BMC Pregnancy and Childbirth, 23(1), 688. https://doi.org/10.1186/s12884-023-06003-8
Insani, K. N., & Purwito, D. (2020). Persepsi tenaga kesehatan tentang praktek kolaboratif di puskesmas bojong kabupaten purbalingga. Jurnal Keperawatan Muhammadiyah. https://doi.org/10.30651/jkm.v0i0.5653
Kim, M., & Lee, G. (2025). Pregnant women's eHealth literacy and attitudes toward internet health information and their relationship to shared decision making: a cross-sectional study. Women’s Health Nursing, 31(2), 155–164. https://doi.org/10.4069/whn.2025.06.19
Kirkpatrick, C. E., & Lawrie, L. L. (2024). TikTok as a Source of Health Information and Misinformation for Young Women in the United States: Survey Study. JMIR Infodemiology, 4, e54663. https://doi.org/10.2196/54663
Mayasari, W., & Rochmaedah, S. (2024). The Influence of Education on Pregnancy Danger Signs on the Knowledge of Pregnant Women in the Coastal and Island Areas. Indonesian Journal of Global Health Research, 6(S6), 867–870. http://jurnal.globalhealthsciencegroup.com/index.php/IJGHR
Nambile Cumber, S., Williams, A., Elden, H., & Bogren, M. (2024). Fathers’ involvement in pregnancy and childbirth in Africa: an integrative systematic review. Global Health Action, 17(1). https://doi.org/10.1080/16549716.2024.2372906
Nandani, R. D., & Purwito, D. (2013). Determinan Perilaku Pemanfaatan Posyandu Dengan Sistem Pelayanan 5 Meja Oleh Ibu Bayi Dan Balita Di Wilayah Kerja Puskesmas 1 Sokaraja Kab. Banyumas. Universitas Muhammadiyah Purwokerto. https://repository.ump.ac.id/7138/1/Rilly Dwi Nandani COVER.pdf
Norman, C. D., & Skinner, H. A. (2006). eHealth Literacy: Essential Skills for Consumer Health in a Networked World. Journal of Medical Internet Research, 8(2), e9. https://doi.org/10.2196/jmir.8.2.e9
Purwito, D., Linggardini, K., & Jaitieng, A. (2025). Barriers To Healthcare Access: Examining Travel Time, Waiting Times, And Service Costs in Indonesia Primary Health Care. Jurnal Berita Ilmu Keperawatan, 18(2), 236–245. https://doi.org/10.23917/bik.v18i2.9068
Putri, A. P., & Lu, Y. Y. (2024). Maternal Health Literacy in Pregnant Women: A Concept Analysis. Maternal and Child Health Journal, 28(8), 1272–1282. https://doi.org/10.1007/s10995-024-03945-z
Rianti, A., Mikawati, Asriyanti, Muaningsih, & Pratiwi, R. (2024). Hubungan Pengetahuan Ibu Hamil Tentang Risiko Tinggi Dan Tanda Bahaya Pada Kehamilan, Persalinan, Nifas Dengan Sikap Dan Perilaku Ibu Dalam Perawatan Kehamilan. Journal of Pubnursing Sciences, 2(03), 81–86. https://doi.org/10.69606/jps.v2i03.116
Rizkianti, A., Saptarini, I., & Rachmalina, R. (2021). Perceived Barriers in Accessing Health Care and the Risk of Pregnancy Complications in Indonesia. International Journal of Women’s Health, Volume 13, 761–772. https://doi.org/10.2147/IJWH.S310850
Sahin, E., Yesilcinar, I., Geris, R., Pasalak, S. I., & Seven, M. (2021). The impact of pregnant women’s health literacy on their health-promoting lifestyle and teratogenic risk perception. Health Care for Women International, 42(4–6), 598–610. https://doi.org/10.1080/07399332.2020.1797036
Shibeshi, K., Lemu, Y., Gebretsadik, L., Gebretsadik, A., & Morankar, S. (2024). Sex Disparities: Couple’s Knowledge and Attitude Towards Obstetric Danger Signs and Maternal Health Care: in Rural Jimma Zone of Ethiopia. International Journal of Women’s Health, Volume 16, 987–1007. https://doi.org/10.2147/IJWH.S457357
Storm, C. P., Amaro, L. M., & Kim, L. P. (2026). #healthypregnancy: A content analysis of TikTok posts about nutrition and exercise during pregnancy. DIGITAL HEALTH, 12. https://doi.org/10.1177/20552076261426329
Tavakol, M., & Sandars, J. (2025). Twelve tips for using phenomenology as a qualitative research approach in health professions education. Medical Teacher, 47(9), 1441–1446. https://doi.org/10.1080/0142159X.2025.2478871
van Lonkhuijzen, R. M., Rustenhoven, H., de Vries, J. H. M., & Wagemakers, A. (2023). The role of the partner in the support of a pregnant woman’s healthy diet: an explorative qualitative study. BMC Pregnancy and Childbirth, 23(1), 760. https://doi.org/10.1186/s12884-023-06072-9
Vera-Ponce, V. J., Loayza-Castro, J. A., Ballena-Caicedo, J., Valladolid-Sandoval, L. A. M., Zuzunaga-Montoya, F. E., & Gutierrez De Carrillo, C. I. (2025). Global prevalence of preeclampsia, eclampsia, and HELLP syndrome: a systematic review and meta-analysis. Frontiers in Reproductive Health, 7. https://doi.org/10.3389/frph.2025.1706009
Vogels-Broeke, M., Daemers, D., Budé, L., de Vries, R., & Nieuwenhuijze, M. (2022). Sources of information used by women during pregnancy and the perceived quality. BMC Pregnancy and Childbirth, 22(1), 109. https://doi.org/10.1186/s12884-022-04422-7
Xu, J., Chen, Y., Zhao, J., Wang, J., Chen, J., Pan, X., Zhang, W., Zheng, J., Zou, Z., Chen, X., & Zhang, Y. (2024). Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study. BMC Pregnancy and Childbirth, 24(1), 392. https://doi.org/10.1186/s12884-024-06594-w
Yunitasari, E., Matos, F., Zulkarnain, H., Kumalasari, D. I., Kusumaningrum, T., Putri, T. E., Yusuf, A., & Astuti, N. P. (2023). Pregnant woman awareness of obstetric danger signs in developing country: systematic review. BMC Pregnancy and Childbirth, 23(1), 357. https://doi.org/10.1186/s12884-023-05674-7
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