Reproductive health mystery to many women

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Photo by Annelisa Leinbach.

Among many other misconceptions about female reproductive health, more than a third of women believe that certain sex positions can improve chances of conception, according to a new study by researchers at the Yale School of Medicine.

In a survey sent out to 1,000 women ages 18 to 40, the researchers found that many females were unaware of basic principles of fertilization, pregnancy and reproductive health. For study co-author and professor of obstetrics at the Yale School of Medicine Lubna Pal, the results suggest that women fail to discuss reproductive health with their doctors and are not exposed to appropriate women’s health education at a young age.

“We wanted to know where we stand with women’s knowledge of reproductive health,” Pal said. “There were quite a few things which were surprisingly concerning from the survey such as women’s lack of awareness that irregular periods may mean something for ability to get pregnant, or history of sexually transmitted infections may have implications for fertility, or how advancing age relates to ability to achieve pregnancy.”

While 75 percent of women surveyed relied on their women’s health doctor as their primary means of education about reproductive issues, over one third of those surveyed visited this specialist either never or less frequently than once a year. Those women who did visit their doctors still scored poorly on the survey questions, said Mary Jane Minkin, a professor of Obstetrics at the Yale School of Medicine who was not an author of the study. She added this counterintuitive result could be a product of decreasing doctor visit times.

More than 1 in 4 women surveyed did not realize that obesity, smoking or sexually transmitted diseases could negatively impact reproductive health. About 80 percent of women surveyed had some form of college education, and Pal said the misconceptions were surprising for such a relatively well-educated group.

Specific misconceptions were more common among certain age groups. Women aged 18 to 24 tended to believe having sex multiple times a day would increase the chance of pregnancy, while those in the 35 to 40 age group were more likely to believe that women continue to produce new eggs throughout their lifetime, said Pal.

“There was a significant percentage of women with misconceptions,” Pal said. “Some of those misconceptions were trivial in the big picture, for example position at the time of intercourse having an impact on the ability to conceive — it’s a misconception but it’s a misconception that has no negative connotations in the terms of health. Now, if women believe that they continue producing eggs, then women think they can postpone pregnancy and that could have serious implications for the health of the baby and possibilities of infertility.”

Approximately 60 percent of women surveyed believed that having sex after ovulation would increase the probability of conception, even though the two days prior to ovulation are peak days of fertility. Only 10 percent of those surveyed accurately reported that sex should occur before ovulation for conception, said Lisbet Lundsberg, study co-author and research scientist in Obstetrics at the Yale School of Public Health.

Pal said another concerning misconception is that 37 percent of women believe folic acid supplements are only necessary a few months into pregnancy, when in fact they should be taken even before conception to prevent defects in the early development of the fetal neural tube. In the study, 44 percent were completely unaware that folic acid could prevent such critical birth defects. Since half of pregnancies in the United States are unplanned, any woman not using birth control should be taking folic acid in case they do conceive, Pal said.

Minkin said she hopes the study will encourage insurance companies to continue paying for annual exams by a reproductive health specialist, as well as promote education about these issues.

“A lot of [parts of the country] are still afraid to even mention the word sex.” Minkin said. “Also, 40 percent of women said they use web as a means of education, but there is not always correct information on the web. So, we are trying hard to get good information out there because sometimes there is a lot of bad advice.”

According to the March of Dimes Foundation, neural tube defects occur in about 3,000 pregnancies in the United States each year.

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