Review calls for more positive health messaging around fertility

The language used to communicate fertility awareness should be more empathetic and target both men and women, finds a new study involving UCL researchers.

The review, published in Human Reproduction Open, gives five recommendations on how to promote fertility awareness in a more positive way.

While education about fertility is not intrinsically controversial, finding the right language to address the topic can be difficult—with the risk of causing negative effects such as anxiety, culpability, and stigma.

After reviewing previous studies and literature on the subject, the team were particularly keen to resolve issues around language that could evoke feelings of personal blame, the marginalization of those struggling to conceive and distress caused by focusing on idealized health situations.

Consequently, they found that it was important to:

• Frame fertility awareness messages with reproductive autonomy in mind and aim to be inclusive of those who do not represent the traditional nuclear family.
• Be empathetic and steer clear of blame.
• Avoid scaremongering and offer a positive angle.
• Give due consideration to both women and men in fertility health messaging.
• Tailor the messages to particular contexts and audiences and develop resources in close collaboration with the target groups.

Professor Joyce Harper (UCL EGA Institute for Women's Health), founder and chair of the International Reproductive Health Education Collaboration who wrote the paper said, "Wording messages about fertility in a way that people are willing to accept and without causing offense is a difficult balance. And, while reproductive health education resources exist, the field of reproductive health promotion is in its infancy and more work needs to be done."

With regards to autonomy, the researchers found that it was important to stress that parenthood is a choice and not everybody may want to have children.

The team also wanted to ensure that reproductive health information was representative of non-binary individuals and those whose sex at birth does not match their gender identity.

Meanwhile, to avoid unnecessary blame or stigma, the researchers say that it may be more useful to offer positive advice about the impact of healthy eating and regular exercise on reproductive health—rather than reinforcing taboos about factors such as weight and obesity, which may cause people to feel shame or distress.

The same positive tone should be used for messaging about the impact of age on fertility. For example, while the chances of having a healthy pregnancy diminish with age, it is not always possible or desirable for people to have children when they are young.

The researchers also recommend not overstating risks to fertility—as this could lead to anxiety.

And they believe it is important to create male-focused messages about how men can contribute to the chance of pregnancy and the health of a future baby—highlighting how reproductive outcomes depend on both sexes.

Finally, in order to tailor health messaging to particular contexts and audiences, the researchers recommend involving those with lived-experience, to ensure that priorities and wording are accurate, helpful and approachable.

Professor Harper said, "Reproductive health communication is a particularly challenging endeavor and needs involvement from different target groups in order to get the messaging right.

"We hope that our five recommendations will provide a basis for more positive communication of reproductive health awareness in the future."