Critical discourse analysis of social media responses to GP-performed caesarean section policy in Indonesia

Abstract

The Indonesian Minister of Health stated that general practitioners (GPs) could perform caesarean sections under certain circumstances, sparking public discussion on the social media platform X (formerly Twitter), particularly regarding clinical safety and policy implementation. Using critical discourse analysis (CDA) and drawing on van Leeuwen’s (2008) social actor representation framework, this study examines how key actor groups, namely the Minister of Health, GPs, OB-GYNs, and pregnant women, are linguistically represented in public posts. These actors were examined because they constitute the main institutional decision-maker, the professional groups most directly invoked in the debate, and the primary affected subjects in the context of childbirth care. The findings show recurring representational patterns that produce an apparent asymmetry in how actors are positioned within the discourse. The Minister of Health is frequently activated and personalized through repeated attribution of agency and informal nomination, which renders his role especially visible and discursively central. By contrast, GPs and OB-GYNs are commonly functionalized and passivated through occupational and institutional role labels that cast them as professional categories rather than as individual speakers. At the same time, pregnant women are represented through relational and vulnerability-oriented framings that link them to risk and consequence. Taken together, these patterns characterise how actors in social media discourse are positioned through linguistic representation, particularly with respect to agency, responsibility, and visibility.