Survey reveals critical knowledge gaps in maternal health recommendations

Most Americans know that how well a mother takes care of herself before and during pregnancy affects the health of a baby, but many people remain unclear about some specific maternal health recommendations, including when to start avoiding alcohol, according to a new nationally representative survey from the Annenberg Public Policy Center (APPC) of the University of Pennsylvania.

Among both adults and the subgroup of women of childbearing age (18 to 49 years), the survey finds significant increases in the year from April 2025 to April 2026 in knowing that how well a person takes care of their own health before getting pregnant affects the health of their baby.

In addition, the already high proportion of women of childbearing age who know that drinking beer or wine during pregnancy is not safe increased significantly since 2025 by 8 percentage points, to 90% from 82%. However, nearly 1 in 3 people do not know that if you are trying to become pregnant, you should not drink alcohol.

Many other maternal health measures remain unchanged, according to Wave 29 of the Annenberg Science and Public Health (ASAPH) survey, which was conducted April 14-28, 2026, among 1,639 U.S. adults. See the end of this release or the topline for further details.

"Pregnancy health decisions are shaped not only by patients and clinicians, but also by family members, partners, and social networks," said Patrick E. Jamieson, director of APPC's Annenberg Health and Risk Communication Institute, which oversees the survey. "Accurate public understanding of maternal health recommendations – including nutrition and the risks of alcohol use and smoking – is essential to improving outcomes for parents and babies."

Most Americans understand key pregnancy health basics

The survey finds broad awareness of many behaviors and conditions that affect pregnancy outcomes, with general knowledge that one's health affects the health of one's baby – before and during pregnancy – rising to levels previously seen in 2023:

• 90% know that how well a person takes care of their health before getting pregnant affects their infant's health, a statistically significant increase from 86% in 2025. Among the subgroup of women of childbearing age, 86% know that taking care of one's health before pregnancy affects infant health, an 11-point increase from 75% in 2025.
• 93% of adults and 88% of women of childbearing age know that how well someone takes care of their health during pregnancy also affects the health of their baby, statistically unchanged from 2025.
• 83% of adults correctly say pregnant people should be tested for diabetes, reflecting a 3-point statistical increase from 80% in 2025. Among women of childbearing age, 86% say one should be tested for diabetes when pregnant, including 65% who say this is definitely true (a statistically significant increase from 54% in 2025) and 21% who say it is probably true.
• 77% know untreated high blood pressure increases the risk of stroke during pregnancy, statistically unchanged from 2025.
• 76% know that people who are or may become pregnant should take a daily vitamin containing folic acid, which is a B vitamin, up from 71% in 2025.

The CDC recommends folic acid supplements before and during pregnancy because it helps prevent major birth defects of the brain and spine.

Knowledge gaps remain around iron supplements and healthy weight gain

Despite strong knowledge in some areas, uncertainty persists about other recommendations for maternal health:

• Only 40% know that iron supplements are recommended during pregnancy only if a health care provider determines that a patient is anemic. However, nearly 1 in 4 (24%) incorrectly believe that all pregnant people should take iron supplements every day, an increase from 19% in 2025.

The federal Office on Women's Health, part of the U.S. Department of Health and Human Services, recommends that pregnant women talk to their doctor or nurse before taking iron pills, as too much iron can be harmful.

• About half of all adults (48%) and women of childbearing age (53%) correctly identify that a person of normal weight should gain 25–35 pounds during pregnancy, statistically unchanged from prior years.

The CDC recommends that people with a normal pre-pregnancy weight gain between 25 and 35 pounds during pregnancy.

Most know dangers of alcohol use and smoking, but uncertainty remains

After declines for most of the last 50 years, rates of alcohol consumption during pregnancy have been increasing again over the past decade, according to STAT News. Its analysis of 2024 U.S. data shows that "more than 1 in 8 pregnant adults reported drinking in the past month" – and of those who drank, "a quarter reported having four or more drinks in one sitting – binge drinking – in the prior month."

Although the Annenberg survey finds that knowledge of the risks of alcohol use during pregnancy is high, knowledge about alcohol use before pregnancy is somewhat less consistent:

• 90% of women of childbearing age know that the statement, "Drinking wine or beer during pregnancy is safe" is false, up from 82% in 2025; 87% of all adults correctly believe the statement to be false, no change from 2025.
• 66% of all adults and women of childbearing age know that it is most accurate to say that someone trying to become pregnant should stop drinking alcohol before and during pregnancy. But 20% of women of childbearing age and 23% of all adults incorrectly believe it's most accurate to say that alcohol use should stop as soon as someone learns they are pregnant.

According to the American College of Obstetricians and Gynecologists, "If you are trying to get pregnant, you should not drink alcohol." The CDC says there is "no known safe amount of alcohol use during pregnancy."

The survey also shows widespread recognition of the risks associated with smoking during pregnancy, statistically unchanged from 2025:

• 84% know smoking during pregnancy increases the risk of birth defects.
• 81% know smoking increases the chances of early delivery.
• 80% know smoking during pregnancy increases the likelihood that a baby will be underweight at birth.
• 58% of adults know smoking around a baby increases the risk of sudden infant death syndrome (SIDS); 67% of women 18 to 49 know this is true, significantly higher than the general U.S. adult population.

CDC guidance states that smoking during and after pregnancy increases the risk of premature birth, birth defects, low birth weight, and SIDS.

Other maternal health knowledge: Breastfeeding and reducing risk of SIDS

Other areas covered by the survey include the benefits of breastfeeding and reducing the risk of sleep-related infant deaths, such as SIDS and accidental suffocation. The survey shows that:

• 76% of all adults and 77% of women of childbearing age know that breastfeeding benefits both the baby and the breastfeeding parent.

Breastfeeding provides the baby with nutrition, protection against some short- and long-term illnesses and diseases, and a mother's antibodies to help the baby develop a strong immune system, according to the CDC, and also can benefit the mother by reducing her risk of breast cancer, type 2 diabetes, and high blood pressure.

• Women of childbearing age (77%) are significantly more likely than all adults (66%) to know that the correct way to put a new baby down to sleep is on the infant's back.

The CDC supports the 2022 recommendations issued by the American Academy of Pediatrics (AAP) to place infants on their back at all sleep times – for naps and at nighttime – to reduce the risk of sleep-related infant death.

APPC's ASAPH survey

The findings come from Wave 29 of the Annenberg Science and Public Health survey (ASAPH), conducted April 14-28, 2026, among 1,639 U.S. adults. It was conducted for the policy center by SSRS, an independent research company. The nationally representative probability-based panel, first empaneled in April 2021, has a margin of sampling error of ± 3.5 percentage points at the 95% confidence level. All figures are rounded to the nearest whole number and may not add to 100%. Combined subcategories may not add to totals in the topline and text due to rounding.