“River” details the struggles of a failing relationship that culminates in an abortion. The story initially depicts a man who has been cheating on his girlfriend. The girl finds out about his infidelity, and, she seeks revenge by cheating on him with Eminem. Em knows he is getting used, yet he persists anyways in order to fill the romantic void in his heart.

After the man finds out what his girlfriend has been doing, he ends up leaving her at the same time as Eminem has lost interest in her. Em’s struggles come to fruition as soon as he realizes the woman is pregnant by him. His selfish actions cause the destruction of the girl’s relationship and the abortion of her unborn child.

Ed Sheeran—who collaborates with Eminem for the first time—sings a powerful chorus of a remorseful man who wants to be washed from his sins.

The river most likely symbolizes the Jordan River, as John The Baptist used its water to wash away peoples' sins, which can be found on Matthew 3:1-12:

People went out to him from Jerusalem and all Judea and the whole region of the Jordan. 6 Confessing their sins, they were baptized by him in the Jordan River.

The river could also symbolize The Nile River, as the Pharaoh would order his people to keep one girl for every boy they threw in the river, which can be found on Exodus 1:20-22:

Then Pharaoh gave this order to all his people: “Every Hebrew boy that is born you must throw into the Nile, but let every girl live.”

This could possibly signify Eminem as the Pharaoh, as he wants to kill the unborn child, but he’s in denial. This ties in to the fact that he mentions swimming in that river to signify his repentance, as he mentioned on “Need Me”:

I’m swimmin' in that Egyptian river, ‘cause I’m in denial

On February 14th, 2018, Eminem released a cinematic music video for the song, which features interviews of Marshall, Suzanne, and her boyfriend, Trevor. Em explains that this song was “something [he] needed to get off [his] chest.”