A nationwide U.S. survey reveals a population increasingly aware that maternal health begins long before conception—yet significant blind spots remain about alcohol and pregnancy planning, suggesting that widespread public education campaigns are working in some areas while others cry out for attention.
The Annenberg Science and Public Health (ASAPH) survey, conducted from April 14–28, 2026, among 1,639 U.S. adults, found that 90% of Americans now understand that caring for one's health before getting pregnant directly affects an infant's health. That number marks a notable jump from 86% just one year earlier, and it reflects growing recognition of a fundamental truth that pregnancy health decisions don't begin in a doctor's office—they begin in how people live their daily lives.
Among women of childbearing age (18 to 49 years), the gains are even more striking. Awareness that pre-pregnancy health care matters surged to 86% in 2026 from just 75% the previous year, an 11-percentage-point leap that signals either shifting public conversations or more effective messaging reaching this critical group. The same upward trend holds for understanding that health during pregnancy affects the baby—93% of all adults and 88% of women of childbearing age recognize this link, a figure that has remained consistently strong.
Knowledge of specific maternal health safeguards is generally robust. Seventy-six percent know that people who are or may become pregnant should take daily folic acid supplements, a B vitamin that helps prevent major birth defects of the brain and spine according to CDC guidance. Eighty-three percent correctly identify that pregnant people should be tested for diabetes, with women of childbearing age showing particularly strong confidence: 65% say screening is definitely necessary, up significantly from 54% the previous year. Similarly, awareness that drinking beer or wine during pregnancy is unsafe reached 90% among women of childbearing age—an 8-percentage-point increase from 82% in 2025.
Yet stark gaps persist. Nearly one in three people do not know that those trying to become pregnant should avoid alcohol altogether, a finding that suggests the message about pre-conception health and substance use hasn't penetrated as deeply as warnings about drinking while already pregnant. And iron supplementation remains a source of confusion: only 40% correctly understand that iron supplements are recommended during pregnancy only if a healthcare provider determines anemia is present. Troublingly, 24% incorrectly believe all pregnant people should take iron supplements daily—a misconception that has grown from 19% just a year earlier.
Patrick E. Jamieson, director of the Annenberg Public Policy Center's Health and Risk Communication Institute, emphasized that this knowledge gap matters beyond individual health choices. "Pregnancy health decisions are shaped not only by patients and clinicians, but also by family members, partners, and social networks," he said. "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."
The survey, part of Wave 29 of the ASAPH research series tracking public health knowledge since 2023, suggests that momentum is building on some fronts while other public health messages need sharper focus. As awareness of pre-pregnancy health care climbs toward near-universal levels, the next frontier may be translating that broad understanding into specific, actionable guidance that reaches people before they're planning to conceive.