Betsy Pleasants was conducting research on abortion access when an unprecedented shift occurred in the U.S. legal landscape. As a graduate student at UC Berkeley School of Public Health in spring 2022, she focused on the impact of the Covid-19 pandemic on reproductive health services. However, news of a leaked Supreme Court draft indicating the potential overturning of Roe v. Wade marked a significant turning point in her work.
The Supreme Court's eventual decision in June 2022, which effectively dismantled nearly five decades of constitutional protections for abortion rights, prompted Pleasants and her academic advisors to adapt her dissertation. Her new research pivoted to studying conversations on Reddit, aimed at capturing the immediate ramifications of shifting abortion access and identifying emerging barriers in real-time.
“When it became clear that Roe v. Wade was going to be overturned, we all agreed that we had to shift the project,” explained Pleasants, now a postdoctoral research associate at the Center for Women’s Health Research at the University of North Carolina. “This project was positioned to offer timely insights into what this policy change means in people’s lives.”
Pleasants and her research team analyzed thousands of posts from the Reddit forum r/abortion using natural language processing (NLP), an analytical approach that uncovers patterns in human language. By combining this quantitative method with qualitative readings of selected posts, they aimed to create a framework for using AI tools while maintaining a focus on the nuances of individual experiences shared within the data.
“We are in a complex policy moment for reproductive health,” Pleasants noted. She emphasized that their research is about documenting experiences and advocating for evidence-based policy changes over time. Pleasants’ findings echoed well-established barriers such as high costs and limited appointment availability. More importantly, they revealed emerging challenges like delays in abortion medication, low credibility of online services, and the legal risks associated with seeking abortion care.
Ushma Upadhyay, a professor at the University of California, San Francisco, highlighted the innovative nature of Pleasants’ approach. “At the time, I didn’t know of any other studies using NLP to study online discourse on abortion,” Upadhyay said. This comprehensive approach allowed Pleasants to capture a broader picture often missed by traditional research methods.
A New Model for Studying Online Discourse
Pleasants' passion for reproductive health research traces back to her upbringing in North Carolina, where she observed the disparities in health information access. The disconnect between her own sex education experiences and the realities faced by peers made her acutely aware of the stigma and misinformation prevalent surrounding reproductive health services. This realization drove her academic journey from undergraduate studies at the University of North Carolina to advanced degrees at UC Berkeley, finally returning to UNC for her postdoctoral work.
Initially inclined to pursue a career in medicine, Pleasants shifted her focus towards medical anthropology and critical engagement with the healthcare system. “A big question that came up for me was: ‘Do I want to work within that system or critically engage with it?’” she recalled. This exploration of how to improve health services for women and marginalized groups ultimately shaped her research trajectory.
Her work analyzing Reddit posts allowed her to tap into perspectives that conventional research often overlooks. The anonymity of Reddit offered individuals a space to discuss personal experiences candidly. Many of these voices, untouched by traditional healthcare frameworks, provided rich insights into how people navigate their reproductive health challenges.
“Following the reversal of Roe v. Wade, a lot of people were turning to Reddit for support,” Upadhyay verified. Pleasants’ team studied over 7,000 posts from the period surrounding the Supreme Court's decision, identifying a broad spectrum of topics—including 55 distinct areas of concern. By applying a dual approach, they ensured human oversight complemented the computational methods, thereby enriching the qualitative analysis of the discussions.
This nuanced study uncovered significant barriers to abortion, encompassing state restrictions, steep costs, and limited access to services. Additionally, it highlighted new obstacles, such as delays in receiving medication through mail and uncertainties about online service legitimacy, exacerbating the anxiety and isolation felt by individuals seeking care.
The ethical considerations surrounding the use of Reddit data were paramount in Pleasants’ research. "We are studying sensitive and stigmatized issues that can even pose legal risks," she emphasized. To safeguard user privacy, the team employed a “heavy disguise” methodology, transforming individual remarks into composite quotations, thereby protecting identities while still conveying collective experiences.
As this field continues to evolve, Pleasants’ work sets a precedent for ethical and impactful research that respects privacy while generating significant insights into abortion access in America. "The importance of the research doesn’t lessen just because policies make the work harder," she stated. "Rather, the opposite seems true right now."
Pleasants’ current research has expanded to include topics like contraceptive access and misinformation online. Amid ongoing debates and shifting policies, her work documents vital firsthand experiences, contributing substantially to discussions about how to improve reproductive health services moving forward. Society's understanding of these challenges could shape future policy directions, ensuring that everyone has access to these essential health services.