YouTube as a Source of Water Birth Information: An Analysis of Gaps, Misalignments, and Adherence With American College of Obstetricians and Gynecologists (ACOG) Guidelines

Background Water birth is increasingly popular, yet debates persist regarding its safety and efficacy. There is a need to assess the accuracy and sentiment of publicly available water birth content, and it is essential that water birth content be accurate to support informed decision-making. Objective To identify whether certain YouTube video characteristics play a role in determining whether the contents of the video are aligned with the published recommendations set forth by the American College of Obstetricians and Gynecologists. Materials and methods An analysis of the top 100 English-language YouTube videos on “water birth” sorted by “most viewed” was conducted on March 9, 2023. After applying inclusion and exclusion criteria, a final set of videos met the inclusion criteria and were included in the analysis. Video characteristics were recorded. Video accuracy was assessed against 16 ACOG water birth guidelines. Scores: 1 (accurate), 0 (not mentioned), or -1 (inaccurate). Transcripts were analyzed using MonkeyLearn Sentiment Analyzer to determine sentiment. Results Of the videos analyzed, the majority were neutral in their accuracy, while a smaller proportion were deemed accurate or contained inaccuracies. Critical safety topics, such as umbilical cord avulsion or neonatal infection risks, were almost universally omitted. Videos created by healthcare professionals demonstrated greater accuracy, while personal vlogs were predominantly neutral. Sentiment analysis revealed that most videos conveyed a negative sentiment, followed by positive and then neutral sentiment. Notable geographic disparities were observed, with North American content exhibiting greater emotional polarization compared to international content. Conclusion Most widely viewed YouTube content on water birth lacks alignment with ACOG guidelines, particularly regarding risk communication, posing misinformation risks.