Effects of framing on teratogenic risk perception in pregnant women.

We examined the effects of framing on women's fetal risk perception and subsequent intentions regarding the use of a safe drug during pregnancy. Half the women received information in the negative frame (1–3% chance of having a malformed child), and the other half received the information in the positive frame (97–99% chance of having a normal child). Women in the negative frame had a significantly higher perception of teratogenic risk (14·9%) than those in the positive frame (8·3%; (p<0·05), and were less likely to contemplate taking their medication. These findings call for further research and suggest that health professionals and policy makers need to consider carefully the way in which information is best presented. Since the thalidomide disaster, there has been a predominant perception that every drug may adversely affect the fetus. In reality, though, less than 30 medicinal drugs have been shown to be teratogenic when used in the recommended doses. Services like Motherisk are faced with the daunting task of distributing this information to the public. The Motherisk Program is a counselling service based in Toronto, Canada, that provides evidence-based information to pregnant women (or women contemplating pregnancy) and their health-care professionals about fetal and maternal safety and risks associated with exposure to drugs, chemicals, radiation, and infections during pregnancy and lactation. This information is delivered to 150–200 women daily largely via the telephone by specially trained counsellors or information specialists. One of the primary objectives of Motherisk is to assist women and their associated health-care professionals in understanding risk information in the hope that they will make better and more informed decisions. The consequences of making poor decisions are at times severe and include such things as fetal malformations (if women are exposed to a teratogenic agent), psychological and physiological maternal harm (eg, if women choose to discontinue their medication abruptly 1), and the termination of healthy and otherwise wanted pregnancies. 2 Therefore, presenting accurate information in a way that is comprehensible and convincing is essential. Research has shown that slight changes in the way information is presented can have large effects on human behaviour. For example, the framing of information has been shown across a variety of situations to affect perceptual judgment as well as medical and clinical decisions in both patients and physicians. 3 The classic study in attribute framing, 4 for instance, demonstrated that ground beef labelled as " 75% lean " (the positive …