Unhealthy commodities and pregnant consumers: Analysis based on 4C framework with teaching strategies for higher...

Pregnant women are particularly vulnerable due to biological sensitivity and intergenerational consequences, yet little is known about how digital marketing, product availability, and regulation jointly shape their exposure. This study examines how unhealthy commodities are marketed and consumed during pregnancy and how policy tools can be adapted across product categories and jurisdictions to reduce maternal risk. Guided by the Maternal 4C framework-focusing on consumer behavior, content exposure, commodity characteristics, and contextual governance-the analysis employed a qualitative design. It drew on semi-structured interviews with 37 pregnant women in hospital outpatient settings, plus interviews with healthcare providers, regulators, platform and retail actors, and public health advocates. Data were analyzed using the Framework Method with abductive reasoning. Findings reveal that perceptions of safety and necessity among pregnant women are heavily influenced by persuasive narratives, influencer promotion, and algorithmic recommendations that normalize unhealthy products as convenient or acceptable. Ultra-processed foods and sugary drinks often substitute healthier options amid time, fatigue, or financial constraints, while discrepancies between clinical advice and market messages erode risk awareness. The study develops an integrative governance framework and a crossjurisdictional strategy model that combine fiscal measures, supply-side regulation, pregnancy-specific warnings, marketing controls, and digital platform interventions. Together, these contributions deepen theoretical understanding of the commercial determinants of maternal health and provide practical guidance for coordinated policy, platform governance, and responsible marketing education aligned with the Sustainable Development Goals.