Why Low-Risk Primiparous Women Opt for Cesarean Section: A Social Media Perspective

Luping Wu,1,* Xiaoli Hu,1,* Xiaosa Deng,1 Liuyan He,1 Jiahong Tu,1 Suwen Feng2 1Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China; 2Department of Nursing, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Suwen Feng, Department of Nursing, Women’s Hospital, Zhejiang University, School of Medicine, No. 1 of Xueshi Road, Hangzhou, People’s Republic of China, Email [email protected]: To identify the key factors influencing the decision of low-risk primiparous women to opt for cesarean section (CS), and to provide empirical evidence for optimizing maternal health interventions and reducing unnecessary CS intention.Patients and Methods: A cross-sectional study was conducted among low-risk primiparous women who had no medical indications for CS. A total of 459 valid questionnaires were obtained through stratified sampling. SmartPLS software was used to conduct structural equation modeling (SEM) and multigroup analysis (MGA) to examine the relationship between social media exposure and cesarean section intention, the mediating effects of social norm and self-efficacy, and the model’s stability across demographic subgroups.Results: Social media exposure directly and positively predicted cesarean section intention (β = 0.260, p < 0.001). Social media exposure also showed significant indirect associations with cesarean section intention mediated through social norm (β = 0.164, p < 0.001) and self-efficacy (β = 0.074, p < 0.001). Furthermore, multigroup analysis indicated that while the overall mediation framework remained stable, specific influence pathways exhibited significant variations across age and occupational groups.Conclusion: This study clarifies the underlying mechanisms through which social media exposure shapes cesarean section intention. These findings provide empirical evidence to inform targeted maternal health interventions, optimize digital health communication, and support evidence-based childbirth decision-making.Keywords: social media exposure, cesarean section intention, social norm, self-efficacy, low-risk primiparous women