Experience as Evidence: A Content Analysis of Reddit Discussions About Alcohol Use During Pregnancy

ABSTRACT

Introduction

Reddit is a space where people commonly discuss sensitive health‐related topics and share experiences. We explore discussions relating to alcohol use during pregnancy to understand why people turn to platforms like Reddit for public health advice, and to identify potential lessons for public health.

Methods

We undertook a descriptive qualitative study, using directed content analysis, to explore 1654 Reddit comments that discussed alcohol and pregnancy, examining the purpose, positioning and use of evidence.

Results

Comments primarily focussed on alcohol consumption while knowingly pregnant (57%) followed by comments about drinking before pregnancy recognition (35%). Comments were evenly split between those supporting (37%) and opposing (37%) alcohol use during pregnancy. A further 14% adopted a precautionary stance, and 11% expressed mixed views. Fifty‐four percent of comments drew on some form of evidence, with anecdotal evidence most common (43%), followed by advice from health professionals (29%). Anecdotal accounts often involved personal experience used to justify conclusions about risk.

Discussion and Conclusions

The findings suggest that Reddit functions as a widely used platform for peer‐to‐peer exchange of knowledge and experiences regarding alcohol consumption, particularly while knowingly pregnant. Taken together, these findings help explain why individuals may turn to platforms like Reddit for pregnancy‐related advice—such spaces offer accessibility, immediacy, and a diversity of perspectives, alongside opportunities for emotional support and normalisation of experience. However, the relatively limited use of scientific evidence suggests an ongoing gap in effective knowledge translation.

Key Point Summary

• Those engaging with Reddit threads related to alcohol use and pregnancy utilise evidence from many sources to inform health‐related behaviours.

• Anecdotal evidence and experience are key features of Reddit discussions about alcohol use during pregnancy.

• Reddit exemplifies how health knowledge is co‐constructed.

1. Introduction

Prenatal alcohol exposure can be associated with a wide range of pregnancy‐related complications along with physical, developmental, and behavioural outcomes [1, 2], including foetal alcohol spectrum disorder (FASD) [3]. A global meta‐analysis estimates that approximately one in 13 alcohol‐exposed pregnancies results in FASD each year [4]. The risk and severity of outcomes are influenced by multiple factors, including the dose and timing of alcohol exposure, as well as maternal and foetal characteristics, such as genetics and prenatal nutrition [2]. Evidence from a recent systematic review and meta‐analysis demonstrates a clear dose–response relationship, with higher levels of prenatal alcohol exposure associated with more severe FASD diagnostic outcomes [2].

Public health guidelines in many countries recommend that women who are, or who plan to become, pregnant avoid drinking alcohol. For example, the Australian National Health and Medical Research Council advises that not drinking is the safest option for those who are planing a pregnancy, are pregnant or are breastfeeding [5]. Similarly, the UK guidelines state that the safest option for those who are pregnant or could become pregnant is not to consume any alcohol [6]. Surveys on public recognition of the guidelines show growing awareness; for example, an Australian survey found that 78% of respondents were aware of the recommendation to avoid alcohol during pregnancy in 2019, compared with 74% in 2016 [7]. Despite this growing awareness, alcohol use in pregnancy remains a significant public health issue.

Globally, an estimated one in 10 women consume alcohol at some point during pregnancy [8]. In Australia, pooled cohort data suggest that 48% (95% confidence interval 38%–57%) of women drink alcohol at some point during pregnancy [9]. While fewer studies have examined the timing of exposure, estimates indicate that 50%–60% of women report alcohol use prior to pregnancy recognition, decreasing to 20%–40% after recognition, with reported consumption typically at low levels [9].

Previous research has identified several factors associated with alcohol use during pregnancy. These include older maternal age and risky drinking patterns prior to pregnancy [10], as well as beliefs about risk (including misconceptions about benefits), limited awareness of adverse outcomes, social and cultural norms, and whether the pregnancy was planned [11]. Much of this evidence is based on surveys or qualitative interviews, which may be subject to reporting bias. Discussing alcohol use during pregnancy can be sensitive, and women may be reluctant to report behaviours that conflict with public health guidance. As a result, digital forums and social media have increasingly been used [12] to explore pregnancy‐related beliefs including alcohol use during pregnancy [13, 14, 15], offering insights in spaces where community members may feel less monitored or judged.

Despite the potential benefits of researching public digital communities, research examining public discussions of alcohol use during pregnancy in digitally mediated spaces remains limited. A grounded theory analysis of five German digital forums and blogs found that ‘zero alcohol during pregnancy’ messaging contributed to unintended consequences, including misconceptions about low level exposure (e.g., in foods), and set high expectations of motherhood and behaviour during pregnancy [13]. Similarly, a content analysis of discussions on the UK‐based parenting forum Mumsnet found confusion about guidelines and risks, prompting community members to seek information and reassurance from peers [14]. A discourse analysis, also of Mumsnet discussions, highlighted mixed reactions to public health guidelines; some supportive of the precautionary approach and others criticising it as scaremongering [15]. The study also explored what evidence underpinned information and views, highlighting health professionals as important sources of evidence. Additionally, forum members notably shared, requested, and valued anecdotal evidence—especially for reassurance about unintended exposures [15].

The current study addresses a gap in the literature by examining discussions about alcohol use during pregnancy on Reddit; a large social media platform with wider reach than parenting‐specific forums. Reddit has over 100 million daily active members and more than 100,000 active topic‐based communities, known as subreddits [16]. Content is largely public and posted anonymously using pseudonyms, making Reddit a valuable data source for exploring sensitive and stigmatised health topics. While Reddit has been used to study a wide range of other health‐related topics [17, 18, 19, 20, 21, 22, 23, 24, 25, 26], discussions of alcohol and pregnancy have not been previously examined, nor has previous research focussed on the purpose, positioning, and use of evidence. Using Reddit for the first time in this context, this study undertook a descriptive analysis of discussions relating to alcohol use during pregnancy. The study aimed to: (i) describe the purpose of comments and posters' positions on alcohol use during pregnancy; and (ii) examine the types of evidence used in discussions. Through this analysis, we sought to understand why people turn to platforms such as Reddit for public health advice, and to identify potential lessons for public health efforts aimed at supporting pregnant people and their babies.

2. Methods

We undertook a descriptive qualitative study, using content analysis, to explore Reddit threads that discussed alcohol and pregnancy.

2.1. Sampling Strategy

The sample comprised of Reddit comments identified through Google and Reddit searches using the search term ‘alcohol and pregnancy’ in June 2023. Each retrieved thread (i.e., a collection of comments) was screened against inclusion criteria, which required that the thread: (i) had at least 1 comment; and (ii) explicitly referred to alcohol and pregnancy in the title. Relevant URLs were recorded in a spreadsheet and searching continued until no new eligible threads were identified (see [19, 27] for similar approaches). In total, 45 threads were identified. For clarification, posts refer to the initial piece of user generated content that starts a conversation. Comments are the written responses to this original post from other Reddit community members. Threads refer to the collection of posts and comments. Each subreddit has community members who voluntarily moderate threads and have the ability to remove comments if they break the subreddits rules. There were 151 removed posts in our data set that were not analysed. Posts and comments make up the main data analysed here. We choose to consistently use the term comments to refer to all the data analysed here.

Following identification, data were extracted using the RedditExtractor [28] package in R, which interfaces with Reddit's API. At the time of collection, the tool could retrieve up to 500 comments per thread; no threads exceeded this limit. All comments and thread‐level data were downloaded, merged and de‐identified. Although Reddit community members typically post under pseudonyms, usernames were removed and replaced with unique identifiers to further protect anonymity. The final dataset comprised 3471 unique comments, which were exported to Excel for analysis (see Figure 1). Of these, 1654 comments were coded in line with our developed coding framework (see Section 2.2).

FIGURE 1.

Flow chart of search and coded comments. Excluded comments had no relevant information that could be coded across any of the codes, for example, ‘This is an excellent response. Thanks!’.

2.2. Data Analysis

Building on a previous study of digitally mediated discussions [15], we developed a coding framework that utilised similar categories identified in a study analysing a digital parenting forum (Mumsnet). Given that previous work had already developed theory around how forum members made sense of alcohol use during pregnancy [15], we used directed content analysis [29, 30]. This method allows for utilising existing theory to guide analysis through a deductive approach. We followed the three phases of directed content analysis; preparation, organisation and reporting [30] which is divided into 16 steps (outlined in Table S2). The core coding framework utilised the same sections as in a previous study, namely; (i) the purpose of the comments; (ii) context of alcohol use; (iii) outcomes/risks; and (iv) references to knowledge sources or evidence. In addition, we added categories that came through the overall analysis in the previous study [15]: (v) position towards drinking while pregnant; (vi) amounts of alcohol referenced (woven in with risk); (vii) feelings (intertwined with identity); (viii) early exposure (i.e., exposure before pregnancy recognition; a key finding in previous work and therefore required its own category).

Once the core coding framework had been developed, it was then piloted on three sets of 50 comments by L.S., N.R. and B.R. After each set, the team met to refine the framework, adding new codes, merging overlapping codes, and clarifying definitions, before applying it to the next set of comments. The final coding framework was then piloted on an additional 50 comments before being applied to the remaining dataset and coded individually by L.S., N.R., B.R. and M.C. No interrater reliability calculations were undertaken of double coded data. Meaning was co‐constructed through the interaction between the researcher and the data. Coding, therefore, involved interpretation that recognises that differences in coding between researchers are not necessarily indicative of error or inconsistency but may instead reflect legitimate alternative interpretations that can enrich analysis. Rather than seeking statistical agreement, rigour was enhanced through transparent documentation of coding decisions, iterative refinement of the coding framework, and regular discussion of emerging interpretations within the research team.

The analysis focused on describing eight aspects of the content of the comments with an additional other category to capture mentions of important points not covered by the defined codes (see File S1). The eight codes were: (i) Situation or context involving alcohol (e.g., while trying to conceive); (ii) purpose of the comment (e.g., providing advice); (iii) type of outcome (e.g., FASD); (iv) posters position towards alcohol use in pregnancy (e.g., opposed to any consumption at any point); (v) references or use of scientific or other evidence underpinning their views; (vi) mentions the amount of alcohol and risk (e.g., sipping); (vii) posters' feelings about drinking or not drinking alcohol when pregnant; (viii) posters' views on exposure before pregnancy recognition; plus an additional other category. Multiple codes could be applied to each comment. For this study, analysis focused specifically on how posters engaged with evidence to inform the advice or opinions provided. Codes were quantified and summarised using counts and proportions of comments, consistent with previous analyses [18, 26, 27]. While researchers have been attentive to the conversational context of the Reddit comments examined, example comments are presented in the results without this context.

2.3. Ethical Considerations

The study followed international best practice guidelines for internet mediated research, guided by four key principles: (i) respect for autonomy, privacy and dignity of individuals and communities; (ii) scientific integrity; (iii) social responsibility; and (iv) maximising benefits and minimising harm [31]. Only publicly available data were included. Usernames were removed from the dataset and no identifying information is reported. Example comments presented in this paper are paraphrased (this was manually conducted by LS with specific attention paid to retaining the original meaning) to prevent traceability and protect anonymity [18, 25, 26]. Ethical approval was obtained from the University of Edinburgh Medical School Research Ethics Committee (REC Reference: 23‐EMREC‐018) and La Trobe University (HEC23246).

2.4. Researcher Characteristics and Reflexivity

The research team comprised five researchers: three women (two public health researchers and one clinical psychologist) and two men (psychology researchers). All researchers were experienced in qualitative analysis. LS and NR have specific expertise in prenatal alcohol exposure and FASD, while B.R., E.K., and M.C. have experience analysing alcohol‐related content on social media.

Several team members also brought relevant lived experience to the study. During the study period, BR had recent experience of supporting a pregnancy within his family context, while N.R. had lived experience of planning a pregnancy and being pregnant. These experiences provided insight into the uncertainty, risk negotiation, information‐seeking, and emotional considerations that can accompany pregnancy‐related decision making. We recognise that these experiences may have increased our sensitivity to themes relating to reassurance‐seeking, conflicting advice and the importance of experiential knowledge in discussions about alcohol use during pregnancy.

Our clinical and research experience in prenatal alcohol exposure and FASD also shaped the analytic process. Through our professional roles, we are familiar with the evidence base regarding the potential harms associated with prenatal alcohol exposure, public health recommendations to abstain from alcohol during pregnancy, and the challenges of communicating risk in situations where evidence is complex and nuanced. This background may have heightened our attention to how commenters interpreted and used different forms of evidence, including scientific studies, professional advice and anecdotal experiences. It may also have predisposed us to notice instances where personal experiences were used to draw conclusions about safety or risk. At the same time, our expertise enabled us to critically evaluate discussions referencing prenatal alcohol exposure research and public health guidance.

Recognising these influences, we approached the analysis with the intention of understanding how Reddit community members constructed and shared knowledge rather than evaluating the accuracy of individual viewpoints. Throughout coding and analysis, researchers met regularly to discuss interpretations, challenge assumptions, and consider alternative explanations. The coding framework was refined collaboratively, and analytic decisions were documented through coding notes and team discussions to support reflexive practice and ensure interpretations remained grounded in the data.

3. Results

3.1. Overview of the Original Comments and Their Purpose

We identified 45 threads, and there were 3471 original comments analysed. The average number of comments per thread was 72.3 (standard deviation = 81.0; range = 3–314). These threads were published on 20 individual subreddits which fell into five main topics: pregnancy, general science, parenting, women's health and women's discussion, plus an additional miscellaneous category. Of the original 3471 comments, 1654 included relevant information that was coded.

As shown in Table 1, comments primarily focussed on alcohol consumption while knowingly pregnant (57%), followed by comments about drinking before pregnancy recognition (35%). Less frequent topics included drinking while trying to conceive (7%) and after birth (1%).

TABLE 1.

Descriptives of evidence.

Category	Characteristic	N	Evidence
			Scientific	Government	Anecdotal	Evidence informed	Health professional	Other
			N	N	N	N	N	N
Context	Knowingly pregnant	800	77	7	187	57	117	12
	Trying to conceive	105	1	1	13	4	8	2
	Before finding out	489	16	—	208	16	127	3
	Post birth	21	—	—	11	1	1	—
Purpose a	Experience	453	30	1	302	27	148	7
	Information	235	89	4	49	54	43	11
	Advice	60	1	—	20	1	47	2
	Conditional reassurance	23	2	—	15	2	6	—
	Opinion	175	63	3	62	30	32	3
	Reassurance	61	2	—	45	2	24	—
Position	In favour	260	21	2	78	29	40	3
	Opposed	260	20	2	52	16	23	1
	Mixed	77	8	—	29	12	13	2
	Precautionary	100	11	—	25	5	9	2

Note: Not every comment could be coded across every code.

^a Not mutually exclusive.

Overall, comments were evenly split between those supporting (37%) and opposing (37%) alcohol use during pregnancy. A further 14% adopted a precautionary stance, and 11% expressed mixed views. Mixed views often reflected uncertainty and competing information, as illustrated by comments describing difficulty interpreting inconsistent guidance:

I am trying to get pregnant and I can't get a doctor's appointment to ask them about it so looking for thoughts on this. I am wondering about no/lo alcohol products and if they are safe in pregnancy or if I should avoid them? I have searched online and on Reddit but am getting mixed messages. I have changed my alcohol intake while trying for a baby but if I am pregnant at [special occasion] coming up I would like to have something. (Parenting‐themed subreddit)

3.2. Sources of Evidence

Of the comments containing codable information, 879 (54%) drew on some form of evidence. Anecdotal evidence was most common (43%), followed by advice from health professionals (29%). Scientific (19%) and evidence‐informed (12%) sources were less frequently cited. Evidence‐informed sources were secondary sources such as books that included discussions of scientific evidence, while scientific evidence was direct references to research studies. The most commonly referred evidence‐informed source was Expecting Better by Emily Oster. For example:

I see Expecting Better cited quite often like its endorsing drinking alcohol during pregnancy, but that isn't really the book's central message. Its aim is to encourage readers to examine the available evidence themselves and make informed decisions based on the data.

Anecdotal accounts often involved personal experience used to justify conclusions about risk, particularly when the poster described how drinking had not had any negative effect on their pregnancy or their child's development. For example:

I drank in the last stage of my pregnancy, perhaps four or five drinks over 12 weeks. My baby is doing amazing, hitting all milestones and is already talking. Based on this I can say drinking at this stage of pregnancy is okay. (Pregnancy‐themed subreddit)

In contrast, comments referencing health professionals commonly described seeking reassurance or guidance, particularly regarding low level consumption or exposure prior to pregnancy recognition. Comments often encouraged consulting healthcare providers. For example:

I can admit I had a few drinks later in pregnancy and my doctor was okay with that. My baby has not had any issues and is developing fine. I think you can't control for other things and there are individual differences, so what is fine for one woman is not for another and some will not follow the recommendation. So, I would say have something small and talk to your health professional about it, but if it'll make you anxious, I would say don't have any at all. (Pregnancy‐themed subreddit)

References to formal guidelines were rare. When present, they most often cited guidance from the US Centers for Disease Control [32].

3.3. Purpose of Posting and Evidence

The most common purpose of commens was sharing personal experience (45%), followed by sharing specific information (23%) and opinions (17%) (Table 1). Less frequent were comments providing reassurance (6%) or advice (6%), while only 2% offered ‘conditional reassurance’ (i.e., reassurance contingent on cessation of alcohol use).

Comments sharing experiences focused on communicating decisions or rationales the poster had for drinking/not drinking during pregnancy, as well as sharing issues like struggles with alcohol dependence:

I was a big drinker before I got pregnant but just stopped when I got pregnant because to me there is no point in just having a little bit, so I'd have none. (Pregnancy‐themed subreddit)

I am an alcoholic, ¹ relapsed when my first baby was a toddler when I had postnatal depression. I got help and got sober. I am pregnant again but finding it so hard this time, the temptation to drink is really strong. I just want to say you are not alone in this. (Mothers‐themed subreddit)

Posters whose purpose was to share experience mainly relied on anecdotal evidence and evidence from health professionals (see Figure 2). Posters at times referenced cultural/temporal variation in acceptability of alcohol consumption during pregnancy and drew on historical anecdotes when sharing their views on prenatal alcohol exposure. For example,

A little bit now a few times a week won't hurt the fetus. Back in the day people didn't know about FAS (Fetal Alcohol Syndrome) and women both drank and smoked when they were pregnant. It's a problem of having too much of it, but the best thing is to have none because studies can't be done ethically to show this. (Science‐themed subreddit)

FIGURE 2.

Evidence underpinning comments in relation to purpose of the comments. Categories are not mutually exclusive. Conditional reassurance i.e., reassurance contingent on cessation of alcohol use.

Comments citing scientific evidence aimed to inform others, often including links to studies or discussing research findings. These discussions sometimes engaged critically with study design, interpretation, and broader contextual factors. For example, one thread discussed a JAMA Paediatrics study, which found low levels of alcohol consumption affects physical foetal development. Comments discussed several aspects of the study including the way the alcohol measure was constructed, other culturally specific data and limitations with the interpretation of the findings.

3.4. Evidence Use by Position on Drinking

Patterns of evidence use varied by position on alcohol consumption (Figure 3). Anecdotal evidence was referenced similarly across all positions. Scientific evidence was less common among comments supportive of drinking (12%) or expressing mixed views (13%) compared to those adopting precautionary (21%) or opposed positions (18%).

FIGURE 3.

Cited evidence based on position towards prenatal alcohol use. Categories are not mutually exclusive.

In contrast, evidence‐informed sources were more frequently cited in comments supportive of drinking (17%), or mixed (19%), than in precautionary (10%) or opposed comments (14%). An example of a poster who drew on evidence‐informed sources, with a favourable position towards alcohol use, explained the way they weighed up the information against anecdotal evidence:

Like others have said, Expecting Better is a good book to read to learn about alcohol and pregnancy. I did my own research too, so I think it is accurate, apart from some information about groups that are at more risk. I won't get drunk, but I also won't listen to relatives from an older generation who claim it was fine to drink every day, but I want to be able to enjoy myself. (Pregnancy‐themed subreddit)

4. Discussion

The present study examined the purpose, positioning, and use of evidence in Reddit discussions about alcohol use during pregnancy. The findings suggest that Reddit functions as a widely used platform for peer‐to‐peer exchange of knowledge and experiences regarding alcohol consumption, particularly while knowingly pregnant. The volume and diversity of threads suggest individuals are actively seeking information, reassurance, and shared experiences in this space, consistent with previous research regarding alcohol and pregnancy from other digitally mediated communities [14]. Overall, comments were evenly divided between those supporting alcohol use during pregnancy and those opposed, highlighting Reddit as a contested informational environment rather than one dominated by a single normative stance. This contrasts with previous mainstream media analyses, which have shown stronger and increasing support of drinking guidelines advising not consuming alcohol during pregnancy [33]. Our findings may likely be due to platform differences, including the anonymity that Reddit provides [20]. However, the coexistence of competing perspectives, alongside the varying forms of evidence, may contribute to uncertainty or confusion for community members seeking clear guidance [13]. Given that misconceptions and inconsistent interpretations of risk are associated with alcohol use during pregnancy [11], this environment underscores the challenges of navigating health information in informal, peer‐driven spaces.

A key finding was the central role of anecdotal evidence. Over half of comments drew on some form of evidence, with personal stories overwhelmingly dominant across all positions, whether supportive, opposed, or uncertain about alcohol use. Building on the work of many digital media community scholars [20, 34], these findings suggest that experiential knowledge functions as a primary currency in this context. In discussions of pregnancy, which involve embodied, uncertain, and emotionally salient experiences, anecdotal accounts may carry particular authority because they are perceived as relatable and trustworthy [15, 35]. Rather than simply competing with scientific evidence, such accounts appear to mediate how formal knowledge is interpreted, accepted, or contested. While anecdotal evidence is often positioned in opposition to scientific evidence, the findings support a more complex relationship in digitally mediated environments [36]. Anecdotes frequently intersect with, reinterpret or selectively align with formal guidance, effectively shaping how risk is understood in everyday decision making. For example, posters commonly used positive personal outcomes to infer safety, illustrating how lived experience can interact with population‐level risk messaging. This highlights a key limitation of current public health approaches: while guidelines emphasise statistical risk, they may not adequately engage with the experiential frameworks through which individuals make sense of that risk.

In contrast, scientific evidence was less frequently cited overall and was particularly uncommon among comments supportive of alcohol use or those expressing ambivalence. When scientific evidence was used, it primarily served an informational function, often involving links to studies or summaries of research findings. This suggests that scientific evidence is not the dominant mode through which Reddit members engage in these discussions, but rather one resource among many. Similarly, references to health professionals were reasonably common, indicating that Reddit members are not disconnected from formal healthcare systems. Instead, clinical advice is often integrated into peer discussions, where it may be reframed or interpreted through anecdotal experiences.

The predominance of experience‐sharing as the main purpose of comments aligns with previous Reddit‐based research that reinforces the social and supportive nature of these types of digitally mediated interactions [18, 19]. Reddit appears to serve not only as an information source but also allows individuals to seek reassurance, validation, and connection with others in similar situations. This also aligns with broader literature suggesting that digital forums are often used to supplement, rather than replace, formal healthcare advice, especially in contexts where individuals may feel uncertain, judged, or underserved [15, 37]. In this sense, Reddit may be particularly valuable for navigating ambiguity, but less effective for conveying consistent, evidence‐based guidance.

Taken together, these findings help explain why individuals may turn to platforms like Reddit for pregnancy‐related advice. Such spaces offer accessibility, immediacy, and a diversity of perspectives, alongside opportunities for emotional support and normalisation of experience. However, the relatively limited use of scientific evidence suggests an ongoing gap in effective knowledge translation. For public health practitioners, this study highlights several important considerations. First, there is a need to recognise the value that individuals place on experiential knowledge and anecdotes and to engage with rather than dismiss anecdotal narratives. Incorporating living/lived experiences into public health messaging may enhance relevance and credibility. Additionally, efforts could focus on translating scientific evidence into clear, relatable, and context sensitive formats that resonate with how people interpret risk in everyday life. Finally, there may be opportunities to develop interventions that leverage existing peer‐to‐peer dynamics of these platforms.

4.1. Strengths and Limitations

A key strength of this study is the use of Reddit, where pseudonym participation likely enables more candid and honest discussion of a highly stigmatised topic. This may reduce social desirability bias and provide insights that are less accessible through traditional research methods. However, several limitations should be considered. Reddit members are not representative of the general population, tending to skew younger, male and US‐based [38, 39, 40], and those with strong political beliefs [41], which may shape the nature of discussions. Platform‐specific norms, moderation practices, and subreddit cultures may also influence how topics are discussed. Additionally, while this study analysed a large sample of comments, it focused on content rather than deeper interpretive analysis of how community members engage with evidence. Future research could explore these processes in greater depth. The data collection methods also mean that our data represent a snapshot of the data that was available at the time of data collection. Finally, categories of evidence combine types of evidence sources and forms, e.g., anecdotal evidence and health professionals, given the significant overlap between categories and the limitations of the available data to be able to tease these apart. Future research is needed to tease apart these categories.

5. Conclusion

Given the well‐established risks associated with prenatal alcohol exposure [1, 2], and the influence of personal experiences, cultural context, and information quality on risk perception [35, 42], effective public health communication requires engagement across multiple platforms. This study highlights the predominance of experiential knowledge in digitally mediated discussions of prenatal alcohol exposure and the challenges of translating population‐level evidence into peer‐driven digital environments. Reddit exemplifies how health knowledge is increasingly co‐constructed through interaction rather than delivered top‐down. Addressing this shift will require public health approaches that are not only evidence‐based, but also socially and contextually responsive.

Author Contributions

Conceptualisation: Natasha Reid, Lisa Schölin, Benjamin C. Riordan and Emmanuel Kuntsche. Methodology: Natasha Reid, Lisa Schölin and Benjamin C. Riordan. Analysis: Megan Cook, Natasha Reid, Lisa Schölin and Benjamin C. Riordan. Writing – original draft: Megan Cook, Lisa Schölin, Natasha Reid and Benjamin C. Riordan. Writing – editing and review: Megan Cook, Lisa Schölin, Natasha Reid and Benjamin C. Riordan.

Funding

The authors have nothing to report.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

File S1: Supplementary Code Book.

Table S2: Directed content analysis steps.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.