Education level can significantly impact one's perception of body image. Body dissatisfaction increases with age in both men and women, with lower education being linked to a less positive body image and a higher likelihood of maintaining it throughout life (1). This may be attributed to increased awareness of societal influences on body image, critical thinking skills to challenge unrealistic beauty standards, and access to resources promoting body positivity. Education empowers individuals to prioritize health and well-being over unrealistic appearance ideals perpetuated by media and society. Furthermore, education can foster self-confidence and acceptance, leading to a healthier relationship with one's body. Conversely, lower education levels may correlate with higher susceptibility to societal pressures and negative body image perceptions.  However, it was not known how body image in pregnant women was affected by educational status. Therefore, the aim of this study was to determine the effect of educational status on body image in pregnant women.

Pregnant women who routinely applied to gynecology and obstetrics clinics who were at least in the second trimester and older than 18 years were included in the study. Pregnant women who had high-risk pregnancies and those who did not volunteer to participate in the study were excluded from the study. The demographic information obtained included age, height, weight, and educational status. Participants were asked to provide detailed obstetric history information, including number of pregnancies, outcomes (live birth, miscarriage), gestational weeks. The Body Image in Pregnancy Scale (BIPS) was used to assess body image perceptions among pregnant women. The BIPS is a self-report questionnaire specifically designed to measure body image during pregnancy. It consists of 36 items and 7 subscales (preoccupation with physical appearance, dissatisfaction with strength-related aspects of one’s body, dissatisfaction with complexion, sexual attractiveness, prioritization of appearance over function, appearance-related behavioral avoidance, dissatisfaction with body parts) rated on a Likert scale ranging from 1 (strongly disagree/ very satisfied/ never engaged in the behavior) to 5 (strongly agree/not satisfied at all /regularly engages in the behavior). The scale assesses various aspects of body image, including satisfaction with physical appearance, feelings of attractiveness, comfort with weight gain, and concerns about body changes during pregnancy. Higher scores indicate greater body image dissatisfaction. Statistical analysis was conducted using SPSS vers25, with α = 0.05 significance level. Descriptive statistics, including means, standard deviations, frequencies, and percentages, were calculated to summarize the characteristics of the pregnanct women and the distribution of variables. Pregnant women were divided into two groups: those with at least a university degree and those without The Mann-Whitney U test was employed to compare education level on body image.

The study included 94 pregnant women with a gestational week of 27.17±6.98 , an average age of 28.15±5.08 years, ages ranging from 18-38 years, and a mean Body Mass Index (BMI) of 27.65±4.74 kg/m2. The average of age, BMI and gestational week of the pregnant women in the two groups were similar. While the average number of pregnancies is 1.96±1.23, the number of births is 0.61±0.91, the number of miscarriages is 0.33±0.76 and the number of abortions is 0.06±0.24. Pregnant women have varying levels of education, with 5 primary education graduates, 1 secondary education graduates, 39 high school graduates, 46 university graduates, and 3 with master's or doctorate degrees.  It was determined that the total score of body image in pregnant women varied according to their education level (p = 0.008). Accordingly, while the total score in pregnant women with high education level was 75.55±12.91, the total score in pregnant women with low education level was 85.57±17.31. There are similar differences in the subscales of BIPS. Accordingly, while the preoccupation with physical appearance subscale score in pregnant women with high education level was 11.16±3.56, this score was significantly higher with 14.10±4.85 in pregnant women with low education level (p=0.003). While the appearance-related behavioral avoidance subscale score was 4.60±1.97, this score was significantly higher with 5.33±2.04 in pregnant women with low education level (p=0.040). In addition, the dissatisfaction with body parts subscale score in pregnant women with high education level was 10.76±4.27, while it was 13.63±5.03 in pregnant women with low education level (p=0.005).

The preliminary results show that women with a university education were more likely to view their body image more positively during pregnancy. These women were more positive of their physical appearance and feel less dissatisfied with their body parts and are less inclined to avoid certain behaviors related to their appearance.

This study highlights the existence a positive body image throughout pregnancy with educational attainment, particularly within university contexts. Positive body image during pregnancy is essential for maternal well-being and is linked to improved psychological health and obstetric outcomes. Our research reveals that university education can both positively influence perceptions of body image during pregnancy. Since university graduates see pregnancy as a normal process, they can better cope with the changes that occur in the body and develop a more positive body perception.  Detailed studies on this subject may pave the way for trainings to be planned to help women who are not at university level develop similar positive feelings towards body image in pregnancy.

1.	Rosenqvist, E., Konttinen, H., Berg, N., & Kiviruusu, O. (2023). Development of body dissatisfaction in women and men at different educational levels during the life course. International Journal of Behavioral Medicine, 1-12.