A pretty important one, I think. Paramount to, "Would you like to live in hell?" And especially having children - you'd need to be extremely stupid or sadist to have a child in such a world, especially knowing the high chances of them being born malformed etc.
I mean, you don't? One dude, a family, or even a small community cannot hope replicate all the stuff that comes from modern supply chains. Surviving a civilization-ending catastrophe would basically mean navigating the glide path down to a poor subsistence lifestyle that lacks a huge amount of technology we take for granted. People got by without that stuff for pretty much all of human history.
The best survivalist could probably do is compile traditional/herbal remedies that are at least somewhat effective, but there would still be huge gaps.
So
birth control: abstinence, keeping an unplanned baby, infanticide, or some herbal abortifacient.
antibiotics: hope you can fight off that infection or we'll have to amputate
anesthetic: alcohol or a stick in the mouth
Lucky if you stashed or found some leftovers. We'd be back to some available herbal remedies.
And birth control? You'll want the opposite if you want your clan to survive. Without antibiotics & other modern medicine, or even soaps (anyone in your group know how to make that?), you'll be back to having a dozen children and being lucky if one or two survive to adulthood.
The most common first impression does seem to be that "of course it's not survivable, why even think about it?".
However, a quick look at any map of effects shows that the zone of survivable effects extends far beyond the reach of lethal effects, to the extent that 90%+ of the total affected zone is quite survivable for those who manage to avoid the initial thermal radiation and flying debris from the shock wave. Of course there are many who wouldn't want to live in the aftermath, but that is a different question.