Epidural anesthesia on Reddit: A multi-subreddit sentiment and thematic analysis of labor analgesia discourse
James R. Burmeister, Lauren Walkon, Ismail Zazay, Roy G. SotoObjective
Labor epidural anesthesia provokes anxiety and online peer-seeking, yet patient-generated discourse about the procedure has not been systematically characterized. This study analyzes the sentiment and thematic content of labor epidural–related posts across multiple Reddit communities.
Methods
We analyzed 121 epidural-relevant posts/comments identified from 1,067 candidates across six Reddit communities (four contributed eligible posts) using a mixed-methods approach. Sentiment was assessed with TextBlob and VADER; thematic coding followed a deductive framework. Cohen’s κ measured agreement between TextBlob and VADER sentiment classifications. Subreddit-level sentiment variation was explored using a Freeman–Halton exact test and one-way ANOVA.
Results
Cross-classifier agreement was substantial (κ = 0.73). Sentiment was predominantly neutral (52.9%; n = 64) or positive (42.1%; n = 51), with only 5.0% negative posts/comments (n = 6). Using the tabulated subreddit counts, sentiment distribution did not differ significantly across subreddits (χ 2 (6) = 5.66, p = 0.462; Freeman–Halton exact p = 0.318; Cramér’s V = 0.15). Five recurring thematic categories were identified: Pain and Relief Experience (39.7%), Provider Communication and Trust (18.2%), Fear and Anxiety (16.5%), Complications and Outcomes (16.5%), and Decision-Making and Expectations (15.7%). Word count was weakly positively correlated with VADER compound score (r = 0.18; 95% CI 0.00 to 0.35).
Conclusion
In an indirect comparison with our prior propofol analysis (30% negative posts), labor epidural Reddit discourse in this sample was predominantly neutral-to-positive; whether these communities function as peer reassurance was not tested. Subreddit-level differences were not statistically significant and subgroup sizes were small, so community-level patterns should be considered hypothesis-generating. These findings may have implications for peripartum patient education and obstetric anesthesia counseling.