Awareness of Pregnancy-Associated Health Risks Among Pregnant Women and Male Partners Surveyed in a Prenatal Clinic

Knowledge of pregnancy care behaviors, complications, and urgent maternal warning signs up to one year postpartum among Georgia residents

OBJECTIVES

Maternal mortality in the U.S. continues to increase, and the State of Georgia has one of the highest maternal mortality rates among the 50 states at 33.9 deaths per 100,000 live births, disproportionately affecting Black and rural populations. This study sought to ascertain knowledge of adults living in Georgia about proper pregnancy care behaviors and their ability to identify warning signs and symptoms (WSS) of life-threatening complications during pregnancy and up to 1-year postpartum.

METHODS

In 2022, using a cross-sectional study design, a questionnaire including items from validated instruments was distributed to adults residing in Georgia through social media and email. Questions were grouped into categories: total pregnancy knowledge, general pregnancy care behaviors, and pregnancy and postpartum WSS. Based on correct answer choices, scores were created for each of the four categories and compared by gender, age, education, race, and ethnicity using multiple linear regressions.

RESULTS

Participants (n = 588) ranged from 18 to 76 years old and were primarily female (80%). The vast majority (83.3%) failed to identify important pregnancy care behaviors. More than half of all participants were unable to recognize pregnancy and postpartum WSS of complications, 52% and 56% respectively. Male, Black, and Hispanic self-identified adults exhibited lower recognition of pregnancy care behaviors and WSS of pregnancy and postpartum complications, relative to other genders, races, and ethnic groups, respectively (p < 0.001).

CONCLUSIONS

This research identified important gaps in maternal health knowledge among adults living in the State of Georgia, highlighting specific opportunities for intervention and offering evidence-based information that can help improve health literacy for better maternal outcomes.

Social Media and Black Maternal Health: The Role of Health Literacy and eHealth Literacy

BACKGROUND

Black women experience greater maternal mortality and morbidity than White women. Although there are many causes of this disparity, providing more and better maternal health information to this population may be beneficial. Social media offers a way to easily and quickly disseminate information to empower and educate Black women about health during pregnancy.

OBJECTIVE

This study sought to identify social media use patterns to determine what sources Black women used to obtain information about pregnancy and to explore whether health literacy/eHealth literacy influence those patterns.

METHODS

This cross-sectional, nationally representative survey panel included 404 Black women. Health literacy was measured by the Single Item Literacy Screener, and eHEALS was used to measure eHealth literacy. We examined participants' social media activity, social media use, social media use for support, and sharing of pregnancy-related health information. Relationships between health literacy, eHealth literacy, and social media use were assessed.

KEY RESULTS

Overall, 67.5% of participants had high health literacy, and the average eHealth literacy score was high (34.5). Most women (71.6%) reported using more than three social media accounts as a source for pregnancy information. Women with low health literacy searched social media for general and specific pregnancy health information, reported more social media use during pregnancy in general (p < .001), and more use of social media for giving and getting support (p = .003). Women with higher eHealth literacy were more likely to report more social media use (r = 0.107, p = .039) and often used social media to give and get support (r = 0.197, p = .0001). Women with high health literacy more often reported sharing the pregnancy information they found on social media with their nurse (χ² = 7.068, p = .029), doula (χ² = 6.878, p = .032), and childbirth educator (χ² = 10.289, p = .006). Women who reported higher eHealth literacy also reported more often sharing the pregnancy information they found on social media with their doctor (r = 0.115, p = .030), nurse (r = 0.139, p = .001), coworkers (r = 0.160, p = .004), and family or friends (r = 0.201, p = .0001).

CONCLUSION

Substantial numbers of Black women use social media to find pregnancy health information. Future studies should elicit more detailed information on why and how Black women use social media to obtain pregnancy information and support as well as what role health literacy and eHealth literacy may have on birth outcomes. [HLRP: Health Literacy Research and Practice. 2023;7(3):e119-e129.].

Awareness of the non-contraceptive benefits of reversible contraceptive methods in a cohort of Brazilian women: an exploratory study

PURPOSE

We assess the awareness of Brazilian women about non-contraceptive benefits of contraceptives and compare non-health with health care providers.

MATERIAL AND METHODS

We conducted a survey in Brazil using a questionnaire administered via Google Forms asking women to respond about the awareness of non-contraceptive benefits of combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS), etonogestrel (ENG)-implant, copper intrauterine device (Cu-IUD), and male condom.

RESULTS

We received 2,068 completed questionnaires, 720 women (34.8%) aged ≤ 29 years and 236 (11.4%) were physicians or nurses. Only one third of the respondents were aware that COC use is associated with decreased risks of ovarian and endometrial cancers; 296 (16.1%) about that the use of DMPA is associated with a decreased risk of endometrial cancer, and 253 (13.8%) were aware about that the users of the Cu-IUD present lower risk of cervical cancer. We identified significant differences between non-health care providers when compared to physicians or nurses.

CONCLUSIONS

We found low awareness regarding the associated lower risk of ovarian, endometrial and cervical cancer associated with the use of some contraceptives, evidencing the need to provide more information about the non-contraceptive benefits during training for health care providers.

'I wish my body was stronger': A qualitative study of attitudes and behaviours regarding treatment of hypertensive disorders of pregnancy

OBJECTIVES

To investigate pregnant women's attitudes and behaviours towards hypertensive disorders of pregnancy and their treatment.

METHODS

Face-to-face, in-depth interviews were undertaken with 27 pregnant women diagnosed with and being treated for hypertensive disorders of pregnancy to investigate attitudes and behaviours regarding the conditions and their treatment. Written consent was obtained individually from each participant, and the interviews ranged from 16 to 54 minutes. Data collection was continued until thematic saturation was reached. Thematic analysis was employed to interpret the data.

RESULTS

Four major themes emerged around beliefs and behaviours of pregnant women regarding treatment of their hypertension: understanding of hypertensive disorders of pregnancy and their implications, risks versus benefits of antihypertensive medication during pregnancy, trust in medical professionals and adherence to medication. The women's level of understanding of hypertensive disorders of pregnancy and their implications determined whether they were able to make informed decisions about their treatment. Prior experiences and concern for preservation of the pregnancy played major roles in the perception of the risk/benefit balance of using antihypertensive medication during pregnancy. The degree of trust in the treating medical professionals varied according to the perception of their confidence and knowledge.

CONCLUSIONS

Sound understanding of the condition, a positive risk/benefit balance regarding antihypertensive medication use during pregnancy, and trust in medical professionals contributed to adherence to medication. Good communication with healthcare professionals is important to achieve optimal treatment.