Background: The decision to undergo labor epidural analgesia (LEA) is a significant aspect of childbirth planning for many pregnant individuals. With the rise of social media, platforms like Instagram, Facebook, and Twitter have become popular sources of information and personal narratives. These platforms provide a space for patients, healthcare professionals, and organizations to share educational content, personal experiences, and professional advice. However, the influence of these social media posts on the decision-making process of expectant mothers regarding LEA remains unclear. In this study, we intend to report the recent trends in online portrayal of LEA and the entities posting this content.

Methods: Public posts on Instagram, Facebook, and Twitter made between 1/1/2022 and 12/31/2022 using the search terms #epidural, #naturalbirth, and #unmedicatedbirth were categorized. Data was collected by three independent reviewers, each focusing on one platform. Posts were categorized by media type, perspective (patient, family/friend, physician, etc.), timing (prepartum, peripartum, postpartum), and tone (persuasive positive, persuasive negative, reflective, neutral). Data analysis was performed using Microsoft Excel to identify patterns in how social media content influences the choice to undergo labor epidural analgesia.

Results: It was found that on Twitter and Facebook, patients were the primary perspective (60% and 59%, respectively), and the tone was mainly reflective (67.7% and 54.9% respectively). For Instagram, doulas yielded the majority perspective (30.4%) while the tone remained neutral (52.9%). Posts on all three forms of social media occurred overwhelmingly in the postpartum period. Reviewers searched for the maximum number of results yielded by each search term, with Instagram generating the most results concerning #unmedicatedbirths. In contrast, Facebook and Twitter results were mainly obtained using the search term #epidural.

Conclusion: This study indicates that social media platforms have distinct user demographics and tones when discussing labor epidural analgesia. Facebook predominantly features postpartum patient perspectives with a reflective tone, suggesting it serves as a platform for sharing personal experiences post-childbirth. Instagram, dominated by doula perspectives, provides neutral and reflective content, highlighting a more balanced view on epidural use. Twitter, similar to Facebook, primarily features patient perspectives with reflective posts in the postpartum period. The variation in content and tone across platforms highlights the need for targeted educational strategies to address the diverse audiences and their preferences on social media. These insights can help healthcare professionals better understand and engage with expectant mothers considering labor epidural analgesia.