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

Background: Underestimation of pregnancy-associated health risks could compromise informed decision-making and reduce demand for preconception care. We assessed the knowledge of pregnant women and male partners about several health risks posed by pregnancy to identify potential gaps in reproductive health literacy. Materials and Methods: Pregnant women and male partners were surveyed about their knowledge of seven common health risks associated with pregnancy (venous thromboembolism [VTE], diabetes, gallstones, hemorrhoids, hypertension [HTN], kidney infection, and anemia) in either English or Spanish in a prenatal clinic at Harbor-UCLA Medical Center in Torrance, California. Results: The response rate for women was estimated to be 66% and was 85% for men. Of the 285 respondents, 5.0% of women and 5.6% of men were able to correctly report that all seven health risks increased during pregnancy. Overall, 30.6% of women and 24% of men recognized that pregnancy increased the risks of the three most serious conditions (VTE, diabetes, and HTN). While higher education was associated with a higher awareness of these three serious risks, the majority of individuals with the highest education nonetheless incorrectly reported that these risks were reduced or unchanged in pregnancy. Age, parity, language, gender, and gestational age did not impact study findings. Overall, 77.9% of respondents rated oral birth control pills more hazardous to a woman's health than pregnancy. Conclusions: Surveyed pregnant women and male partners have significant knowledge deficiencies concerning common and serious health hazards associated with pregnancy that may hamper women's ability to make informed choices about their reproductive health options.

Perceptions of health risks associated with pregnancy compared to oral contraceptive use.

OBJECTIVE: To assess beliefs about the safety of oral contraceptives compared to pregnancy to determine if men and women possess accurate information to make informed choices. STUDY DESIGN: In each of six surveys conducted in Southern California from 2008 to 2017, participants were asked "Which do you think is more hazardous to a woman's health - birth control pills or pregnancy?" RESULTS: A total of 28.4% of all 1839 male and female respondents and 29.1% of the 1712 female respondents answered correctly that the health risks posed by pregnancy were greater. In subgroup analyses, 64.4%-81.9% rated oral contraceptives at least as hazardous to a woman's health as pregnancy. CONCLUSION: The vast majority of respondents incorrectly believed that oral contraceptives are more hazardous than pregnancy. IMPLICATIONS: Health decision making relies upon patients' understanding of the relative risks and benefits of each available option. Most sexually active women do not understand that there is no contraceptive method current guidelines would offer them that is as hazardous to their health as pregnancy. Such misconceptions can lead to risky decisions. Clinicians need to explicitly provide their sexually active patients more accurate and balanced information, putting contraception in the context of its probable alternative - pregnancy.

Illustrating the coupled human-environment system for vulnerability analysis: three case studies.

The vulnerability framework of the Research and Assessment Systems for Sustainability Program explicitly recognizes the coupled human-environment system and accounts for interactions in the coupling affecting the system's responses to hazards and its vulnerability. This paper illustrates the usefulness of the vulnerability framework through three case studies: the tropical southern Yucatán, the arid Yaqui Valley of northwest Mexico, and the pan-Arctic. Together, these examples illustrate the role of external forces in reshaping the systems in question and their vulnerability to environmental hazards, as well as the different capacities of stakeholders, based on their access to social and biophysical capital, to respond to the changes and hazards. The framework proves useful in directing attention to the interacting parts of the coupled system and helps identify gaps in information and understanding relevant to reducing vulnerability in the systems as a whole.

A framework for vulnerability analysis in sustainability science.

Global environmental change and sustainability science increasingly recognize the need to address the consequences of changes taking place in the structure and function of the biosphere. These changes raise questions such as: Who and what are vulnerable to the multiple environmental changes underway, and where? Research demonstrates that vulnerability is registered not by exposure to hazards (perturbations and stresses) alone but also resides in the sensitivity and resilience of the system experiencing such hazards. This recognition requires revisions and enlargements in the basic design of vulnerability assessments, including the capacity to treat coupled human-environment systems and those linkages within and without the systems that affect their vulnerability. A vulnerability framework for the assessment of coupled human-environment systems is presented.