Congenital syphilis is a sexually transmitted infection (STI) that is acquired through placental transmission in utero when a pregnant woman has untreated or inadequately treated syphilis. Left untreated, congenital syphilis can lead to pregnancy complications and adverse health outcomes for the baby. Fortunately, congenital syphilis can be prevented with timely screening for syphilis and treatment of infected individuals, generally through administration of penicillin. Despite treatment availability and efficacy (98%) in treating syphilis during pregnancy, congenital syphilis has become a significant and growing public health problem in the United States.

Finding the appropriate congenital syphilis reduction strategies requires a better understanding of the lived experiences of pregnant women who engage in prenatal care, including the barriers and facilitators to care during pregnancy, especially among those at highest risk for congenital syphilis. A study was conducted among women who received prenatal care in a current or recent pregnancy to: 

• Understand knowledge and attitudes toward congenital syphilis.
• Elicit feedback about prenatal care experiences, including barriers and facilitators.
• Examine messaging preferences.

Key Findings:

• Most participants* were aware of syphilis and understood it as an STI that can be passed from a pregnant person to their fetus; however, fewer knew it could be cured.
• There were inconsistencies in syphilis or congenital syphilis patient-provider discussions during prenatal care. Less than half the women reported talking with a health care provider about congenital syphilis or testing for syphilis during pregnancy.
• Participants reported few barriers and widespread facilitators to getting care, and generally positive medical experiences.
• Women noted that messages about the importance of prenatal care should be positively framed and focus on the following topics:
  • Health and safety of mom and baby
  • Benefits of establishing care early
  • Informed decision-making
  • Feeling empowered to advocate for self and baby

Implications and recommendations: 

• Messages should be tailored to populations
• Improvements in healthcare provider messaging and patient-provider conversations about congenital syphilis are needed.
• While pregnancy-related health information is consumed through various sources, healthcare providers are the most trusted source. 

The full report is available here.

*Remesh Participants (n=88):

• 89.8% 21-39 years old
• 56.8% Black or African American
• 30.7% Hispanic or Latino
• 100% Female
• 79.5% Straight, Not Gay or Lesbian
• 86.4% At Least a High School Diploma or GED
• 47.7% Urban Setting
• 40.9% Michigan
• 71.6% Received Routine Healthcare Prior to Pregnancy