Abstract
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality, yet women's awareness during pregnancy and postpartum is not well characterized. OBJECTIVES: To assess education and awareness of pregnancy-associated VTE across countries and healthcare systems, including sources of information, perceived understanding, and experiences with anticoagulation. METHODS: We conducted a cross-sectional online survey (15 languages), endorsed by the World Thrombosis Day campaign, of females who were pregnant or ≤12 months postpartum (October 2024 and September 2025). Descriptive analyses and subgroup comparisons were performed. RESULTS: Of 3043 responses, 3025 were analyzed. Overall, 69.8% reported no VTE education during pregnancy or the postpartum period, and 1.1% received education only at diagnosis, resulting in 70.9% with no or delayed VTE education. Upon delivery, comprehension was limited, with 36.2%, 46.8%, and 9.2% of females reporting full, partial, and poor understanding, respectively. Only 10.9% of females received instructions on VTE manifestations; among these, 16.3% were not advised to seek urgent care for suspected VTE events. Knowledge of pulmonary embolism-related signs was particularly poor. Prior VTE was reported in 13.3%, and 21.4% had ever used anticoagulants. Among participants who had discussed thromboprophylaxis and/or received anticoagulants, 32.4% were unaware of bleeding risks. Approximately 20% of those informed reported psychological distress related to VTE information. Education rates differed by age, education level, ethnicity, region, and reproductive factors. CONCLUSION: VTE education during pregnancy and postpartum is infrequent and unevenly distributed. Enhanced educational interventions embedded within antenatal and postnatal care pathways are urgently needed to improve VTE awareness, symptom recognition, and informed decision-making.