How Reddit helps one expert understand post-Roe abortion access in America

Betsy Pleasants, a doctoral student studying maternal child and health at UC Berkeley School of Public Health, has spent the past two years on Reddit. A mindless pastime for many, Pleasants uses social media not to kill time but to understand how technology can address gaps in maternal healthcare.

Her research examines the thousands of posts made on the r/abortion subreddit to understand how Americans are navigating access to abortion in light of the Dobbs v. Jackson Supreme Court decision, which held that the US Constitution does not confer a right to abortion. Using a mix of qualitative analysis and machine learning, Pleasants hopes to get a big-picture view of what online communities are doing to answer women’s questions and assuage their fears when it comes to receiving abortion care.

“Technology has this potential to be an equalizer in access to information and services,” Pleasants said in an interview. “Abortion in some ways is this really fantastic way to show the way technology has mitigated the impact of certain policies.”

Abortion access has been severely restricted in about half the country since the U.S. Supreme Court overturned Roe v. Wade in 2022. Fourteen states, including Texas, Tennessee, and Alabama, have made it illegal to receive an abortion; seven others have restricted access. As reproductive health services become more politicized across the country, more people are turning to the corners of the internet for answers to intimate questions traditionally reserved for the doctor’s office. Some questions users have asked are “What is the Florida abortion law?” and “Are you honest to your doctors about your abortions?”

r/abortion is run and maintained by the volunteer group Online Abortion Resource Squad who identify themselves as experienced abortion experts. Their goal is to provide resources to the thousands of people who visit the subreddit every month to wade through the heaps of information and misinformation online.

Between the legal questions and moral ponderings, Peasants sought to systematically understand what users discussed on r/abortion using a mix of qualitative and quantitative research methods. This included using machine learning to sift through about 7,000 posts to identify recurring themes. Her analysis showed that people used the r/abortion community more after the Dobbs decision than before and that more posts focused on medication abortions.

Natural language processing, or machine learning, is a novel tool in the public health field. It was important for Pleasants to incorporate it into her research to accurately assess the thousands of posts. “Machine learning tools should be a part of our toolkit,” Pleasants said.

The qualitative approach looked at a smaller portion of the subreddit with the help of five readers who identified different patterns from the text. For example, words such as “medical,” “pills,” and “contraception,” were ranked by their frequency. Their results found that people often discussed ways to get an abortion, the decision-making process, and experiences with physical pain.

Pleasants decided to study r/abortion for her doctoral research after noticing how redditors interacted with the community, such as answering questions about where to get an abortion or how to tell loved ones, which made her recognize how powerful technology can be used to address gaps in public health and medical care. And it’s already paid off: last year, she presented her findings at the Society of Family Planning Conference.

“The core challenge is that policy is really disconnected from science and the desires of the population,” she said. She hopes her work will illuminate the ways everyday technology can be used to shape more effective maternal healthcare policy decisions.