California law generates online conversation about IVF coverage

Posts share concerns about PFAS in condoms and unnecessary C-sections among Black women.

This past week, a California law expanding access to in vitro fertilization sparked significant online conversation about reproductive health. In other discussions, posts shared concerns that condoms contain cancer-causing per- and polyfluoroalkyl substances, or PFAS, with some TikTok videos and Instagram posts discouraging condom use. Plus, a news story that Black women are more likely to undergo unnecessary Cesarean sections raised concern about how racial bias affects Black maternal mortality and pregnancy outcomes.

In response, public health communicators may recirculate information about IVF. Communicators may also share sex education resources outlining the benefits of condoms and other forms of birth control, as well as resources for Black birthing parents.

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What’s trending nationally in vaccine conversation:

On September 29, California’s governor signed a bill into law that will require large health insurance companies and disability insurance policies to cover IVF, among other reproductive health services. The law also expands health care benefits to LGBTQ+ families seeking to have children through IVF. Within a day, online conversation about the decision spread across multiple news websites and social media platforms, with many celebrating the news. Comments on the posts were largely positive, but some included anti-LGBTQ+ sentiments. Other posts claimed that the law will make health insurance unaffordable due to the cost of IVF. One X post read, “So now California is going to make insurance companies cover it, which means everyone is going to have higher insurance costs to cover the few people who use it.” The post received approximately 63,000 views, 450 likes, 80 reposts, and 70 comments as of October 1. A comment on the post read, “Anything that can balance the abortions to support population growth is needed.” While California’s law dominated conversation about IVF, other posts acknowledged the announcement that federal employees will also have access to IVF through their insurance.

An early September lawsuit claiming that Trojan condoms contain PFAS has sparked ongoing conversation on social media. In the past week, TikTok videos in English and Spanish warning condom users about PFAS received thousands of views. One TikTok video used the lawsuit to advocate for monogamy to protect against sexually transmitted infections and for menstrual cycle tracking to prevent pregnancy by avoiding sex during the fertile ovulatory phase, making the misleading claim that these practices are more effective than using condoms and other forms of birth control. The video received approximately 140,000 views, 11,100 likes, and 170 comments as of October 1. In the comments, some users said they had stopped using condoms, and others asked questions about cycle tracking. Some comments attempted to debunk misleading claims about cycle tracking, stating that it must be done correctly in order to be effective and that people with irregular periods may not be able to accurately identify when they are ovulating.

Conversation also continued this past week about an early September news story, based on a working paper, reporting that Black women are more likely to undergo unnecessary C-sections than white women. Instagram posts and TikTok videos sharing concerns about Black maternal mortality rates received thousands of likes. In the comments, Black women shared their experiences with childbirth and their concerns about giving birth in a hospital setting where racial bias could affect their care. One comment read, “As a black woman myself, it’s why a lot of us are looking into things like birthing centers and away from hospitals because [they keep] proving that they may not have our best interests at heart. And that’s terrifying for any black woman who has been pregnant, wants to be pregnant, or is pregnant.” These posts were shared amid ongoing conversation about two Black women who died in Georgia due to the state’s abortion restrictions.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about reproductive health. 

In light of online conversation about IVF, public health communicators may share information about state laws mandating IVF coverage, as well as tips for those who are paying for IVF out of pocket, including information about grants for LGBTQ+ families. If responding directly to claims that few people use IVF, messaging may emphasize that 42 percent of U.S. adults say that they or someone they know has used fertility treatment and that more than 8 million births in the U.S. have resulted from IVF.

In response to concerns about condoms, communicators may explain that while an independent lab found PFAS in several condom brands, the FDA regulates condoms and still says they are safe to use. Recirculating information about the types of birth control, their effectiveness, and how to access them is recommended. Messaging may emphasize that while birth control is very effective, no form of birth control is 100 percent effective at preventing pregnancy. Combining multiple birth control methods further reduces the risk of pregnancy. Communicators may explain that in addition to preventing pregnancy, condoms also protect against the transmission of STIs like HIV, chlamydia, and gonorrhea. Messaging may also note that avoiding sex during the ovulatory phase of the menstrual cycle is 77 to 98 percent effective, but only when done correctly, which may be challenging for people with irregular menstrual cycles. It’s best to combine menstrual cycle tracking with other forms of birth control to prevent pregnancy.

Conversations about unnecessary C-sections for Black pregnant people call attention to racial bias in health care, which contributes to poor maternal health outcomes. Encouraging pregnant people who wish to avoid a C-section about how to advocate for their needs in the delivery room is recommended. Resources geared toward Black pregnant people seeking support for hospital or home births include the BLACK Doula Network, the National Black Doulas Association, and the Sista Midwife Directory.