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Discovering changes in birthing narratives during COVID-19

We investigate whether, and if so how, birthing narratives written by new parents on Reddit changed during COVID-19. Our results indicate that the presence of family members significantly decreased and themes related to induced labor significantly increased in the narratives during COVID-19. Our work builds upon recent research that analyze how new parents use Reddit to describe their birthing experiences.

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1 Introduction

Social media has the potential to elucidate a deeper level of understanding of COVID-19’s impacts across wide ranging communities. Recent work leveraged publicly available data from social media platforms to detect emerging symptoms from COVID-19 [Santosh et al.2020] as well as the pandemic’s impacts on mental health [Biester et al.2020, Tabak and Purver2020, Thukral et al.2020, Wolohan2020].

With tightened restrictions in hospital settings, COVID-19 has greatly impacted expecting parents, newborns, and their families [Findeklee and Morinello2020, DeYoung and Mangum2021, Gutschow and Davis-Floyd2021, Altman et al.2021, Vazquez-Vazquez et al.2021, Mariño-Narvaez et al.2021]

. However, no existing work has used natural language processing techniques to analyze impacts of COVID-19 from long-form text written by new parents explicitly describing their birthing experiences.

We investigate whether, and if so how, birthing narratives written by new parents on Reddit changed during COVID-19. Our results indicate that the presence of family members significantly decreased and themes related to induced labor significantly increased in the narratives during COVID-19. Our work builds upon recent research that analyze how new parents use Reddit to describe their birthing experiences [Pilkington and Rominov2017, Antoniak et al.2019, Pilkington and Bedford-Dyer2021].

2 Data Collection

Reddit is a social media platform where users can post anonymous submissions and comments in various subreddits. We use the Pushshift Reddit API [Baumgartner et al.2020] to collect all submissions posted to nine subreddits related to the birthing experience between April 2009 and June 2021.111These nine subreddits are: r/BabyBumps, r/beyondthebump, r/BirthStories, r/daddit, r/predaddit, r/pregnant, r/Mommit, r/NewParents, and r/InfertilityBabies. Following antoniak2019narrative, we remove all posts that do not include any of the terms “birth story,” “birth stories,” or “graduat,” guaranteeing our corpus consists of birthing narratives. We remove all posts that contain less than tokens,222We noticed that in recent years, new parents post a picture of the baby and then describe the birthing narrative in the first comment. We include these examples in our filtering process. resulting in a corpus of 4,484 birthing narratives before and 913 during COVID-19.333We demarcate March 11th, 2020 as the start of COVID-19, the day the WHO declared a global pandemic.

3 Method

Topic Modeling.

To discover distinct topics across our collection of birthing narratives, we apply Latent Dirichlet Allocation [Blei et al.2003], as implemented in Mallet [McCallum2002]. In initial experiments, , the number of topics, ranges from to . We choose based on coherence [Röder et al.2015]

. Discovered topics include induced labor, family, breastfeeding, and the first moments between a new parent and child. To determine whether the prevalence of these topics changed during COVID-19, we fit topic-specific Prophet models, an additive regression approach for forecasting time series data 

[Taylor and Letham2018]

, on the topic’s average monthly prevalence in our corpus prior to March 2020. We then compare the topic’s actual average monthly prevalence in our corpus during COVID-19 with the corresponding model’s forecast. Following biester-mental-health, we quantify how often the actual topic’s monthly probabilities fall outside the model’s 95% CI and use one-tailed Z-tests to determine statistical significance.

Quantifying Personas Presence.

Determining the prevalence of types of characters, or personas, in a narrative can illuminate information from an author’s perspective, e.g. who is most the relevant, valued, or supportive character. Following antoniak2019narrative, we quantify a persona’s prevalence by counting how often they are mentioned, using a dictionary of terms for each persona.444 Doctor: [doctor, dr, doc, ob, obgyn, gynecologist, physician]; Partner: [partner, husband, wife]; Nurse: [nurse]; Midwife: [midwife]; Family: [mom, dad, mother, father, brother, sister]; Anesthesiologist: [anesthesiologist]; Doula: [doula] We examine the difference in average mentions of each persona before and during COVID-19.555

Since narratives during COVID-19 were on average roughly 20% shortner, we adjust the counts. We apply t-tests to compute statistical significance.

4 Results

Figure 3 shows how the forecasted prevalence’s for the family and induction topics significantly differ with the topics’ prevalence during COVID-19. The increase in the induction topic (Figure (b)b) may reflect the increased recommendation of planned induction, enabling COVID-19 testing of expecting parents in advance of delivery [Goer2020]. The decrease in the family topic (Figure (a)a) might correlate with hospitals restricting visitors during the pandemic.

Our experiments quantifying the personas’ presence demonstrate that the healthcare providers were mentioned at similar rates before and during COVID-19, indicating that from the perspective of birthing parents, providers’ roles in birthing narratives remained consistent. We notice a significant drop in the family persona’s presence (22.8% , ) and significant increase in the partner persona’s presence (5%, ) during the pandemic. Figure 4 indicates that these differences were usually most apparent from periods 2 to 8 in the stories, which correlates with the time generally spent in the hospital during birthing narratives [Antoniak et al.2019]. This might suggest that partners supplemented the support missing by families that were unable to visit hospitals before and after delivery.

5 Conclusion

We presented a study demonstrating how parents’ self-described birthing experiences significantly changed during COVID-19. Our results indicate that hospital policies may be reflected in birthing narratives. Our work presents a case study in how we can analyze patient experience from their own written narratives and perspectives.

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