Only One in Four New Mothers in Eastern Ethiopia Turns to the Internet for Pregnancy Information

In the maternity wards of Dire Dawa, a commercial city in eastern Ethiopia, a quiet digital divide is shaping how new mothers learn about their own bodies and their babies. A mixed-method study conducted across ten health institutions in the city has found that fewer than three in ten women who had just given birth used the internet to seek pregnancy-related information, a figure that stands in stark contrast to the near-universal reach of mobile technology in many other settings. The research, led by Abdusellam Yimer of Dire Dawa University together with Yalelet Belay Alemu and Yonatan Solomon, was published in BMC Health Services Research and offers one of the most detailed portraits to date of how digital health information flows, or fails to flow, to women in eastern Ethiopia during the critical window surrounding childbirth.

The study team surveyed 570 immediate postpartum women, recruited through systematic random sampling between December 27, 2024 and March 20, 2025. Data were collected using a semi-structured, pretested, interviewer-administered questionnaire delivered through the Kobo digital data collection platform, and analyzed statistically in SPSS version 25. Binary logistic regression was used to identify factors independently associated with internet use for pregnancy-related information, with a p-value of 0.05 or below treated as statistically significant. Alongside the quantitative survey, the researchers conducted in-depth interviews with eleven participants, analyzing the transcripts thematically with OpenCode version 4.03 software. This dual design allowed the team to measure not only how many women went online, but why they did or did not.

The headline number is striking: the prevalence of internet utilization for accessing pregnancy-related information was 28.4 percent, with a 95 percent confidence interval of 25 to 32 percent. In other words, roughly seven out of ten women in the immediate postpartum period had not used the internet as a source of information about pregnancy, even though the internet is one of the most widely accessible sources of health-related information worldwide. The authors note that this figure is low compared with previous studies, a gap that carries real consequences, because timely, accurate and reliable information during pregnancy, childbirth and the postpartum period is essential for safeguarding maternal and fetal health and reducing the risks of morbidity and mortality.

What distinguished the women who did go online? Education emerged as the most powerful predictor, and the effect sizes are remarkable. Women with secondary education had nearly three times the odds of using the internet for pregnancy information compared with those without it, with an adjusted odds ratio of 2.96. But the jump to tertiary education was dramatic: women with higher education had an adjusted odds ratio of 11.42, meaning their odds of seeking pregnancy information online were more than eleven times those of women with less schooling. The pattern repeated for husbands. When a husband had secondary education, his wife’s odds of internet use rose more than fourfold, at 4.02, and with tertiary education the odds ratio reached 5.02. These findings suggest that in this setting, digital health literacy is not an individual attribute but a household one, shaped by the educational resources of both partners.

The clinical pathway also mattered. Women who attended eight or more antenatal care contacts had 4.71 times the odds of using the internet for pregnancy-related information compared with those with fewer visits, indicating that sustained engagement with the formal health system appears to open a door to the informal digital one. Women who experienced health problems during pregnancy had 2.70 times the odds of going online, a pattern consistent with the idea that perceived need drives information-seeking: when something feels wrong, women look for answers. Most striking of all was the role of the care provider. Women who received care from obstetricians had an adjusted odds ratio of 11.70 for internet use, and those cared for by both obstetricians and midwives had an odds ratio of 4.96. The type of provider a woman encounters during antenatal care appears to be one of the strongest levers on whether she ever consults a screen about her pregnancy.

The qualitative arm of the study illuminated the motivation behind the numbers. Participants explained that they turned to the internet for pregnancy-related information because of its convenience and accessibility. In a city where health facilities can be distant, crowded or costly to reach, a phone in one’s pocket offers answers at any hour, without travel, queues or appointment schedules. That convenience, the interviews suggest, is precisely what makes the low overall utilization rate so significant: the tool is available and valued by those who use it, yet the majority of women in the study never crossed the threshold into digital information-seeking during one of the most information-hungry periods of their lives.

Why might utilization remain so low? The study’s statistical model points to structural barriers embedded in the predictors themselves. Education is a proxy for literacy, digital skills, income and phone ownership, and the enormous gradient between secondary and tertiary education implies that women without formal schooling face compounding obstacles. The provider effect hints at a second mechanism: obstetricians may be more likely than other providers to discuss online resources, recommend platforms, or model digital information-seeking during consultations, while women seen primarily by other cadres of health workers may never hear that trustworthy online sources exist. The authors’ recommendation that health professionals guide women to reliable online platforms during antenatal care follow-up follows directly from this finding, positioning the antenatal visit as an underused channel for digital health navigation.

The implications extend beyond Dire Dawa. Maternal mortality remains a central challenge in global health, and access to accurate information during pregnancy and the postpartum period is a recognized protective factor, helping women recognize danger signs, adhere to recommended care, and make timely decisions about seeking help. As mobile connectivity expands across low- and middle-income countries, digital platforms are increasingly promoted as a scalable way to deliver maternal health education. But this study is a caution against assuming that connectivity alone translates into health information access. A woman may live in a household with a smartphone and still never use it for pregnancy information if she lacks education, confidence, or a trusted pointer to quality content. The digital divide, in other words, is not only about infrastructure but about education, guidance and perceived quality.

That last point, perceived information quality, sits at the heart of the study’s framing. The internet’s convenience cuts both ways: the same open accessibility that makes it attractive also exposes users to misinformation of variable reliability, and pregnancy is a domain where false claims can have serious consequences. The researchers call for enhancing digital maternal health education and expanding access to trustworthy online platforms, a dual strategy that addresses both the demand side, by building women’s skills and confidence, and the supply side, by ensuring that when women do search, they find content that is accurate and safe. The involvement of health professionals as curators of online resources could serve as a bridge between the formal and informal information systems that pregnant women navigate.

The study was funded by Dire Dawa University, which also granted ethical clearance through its institutional review board, with additional permissions from the Dire Dawa Health Bureau and the participating health institutions. Informed written consent was obtained from all participants, no personal identifiers were recorded, and the research was conducted in accordance with the Declaration of Helsinki. Its authors declare no competing interests. What they leave the field with is a clear and actionable picture: in eastern Ethiopia in 2025, the internet’s promise for maternal health remains largely unrealized, held back not by the technology itself but by the educational, clinical and informational scaffolding around it. Closing that gap, the findings suggest, may depend less on new apps than on something far simpler, a health worker at an antenatal visit taking a moment to show a woman where reliable answers live online.

Subject of Research: Internet utilization for accessing pregnancy-related information among immediate postpartum women in Dire Dawa, eastern Ethiopia

Article Title: Experiences of internet utilization for accessing pregnancy-related information, perceived information quality and associated factors among immediate postpartum women in Dire Dawa health institutions, eastern Ethiopia, 2025: a mixed method study design

Article References: Experiences of internet utilization for accessing pregnancy-related information, perceived information quality and associated factors among immediate postpartum women in Dire Dawa health institutions, eastern Ethiopia, 2025: a mixed method study design. (n.d.). https://doi.org/10.1186/s12913-026-15814-2

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15814-2

Keywords: internet utilization, pregnancy-related information, postpartum women, maternal health, digital health literacy, antenatal care, Ethiopia, Dire Dawa, mixed-methods study, health information quality, eHealth, BMC Health Services Research