American Indian women who used cannabis while pregnant or postpartum viewed it as medicinal and safer than other substances, and interpreted minimal pushback from healthcare providers as approval.
Prenatal care providers serving Indigenous communities, public health researchers, maternal health advocates
Minimal provider discussion perceived as approval of cannabis use
What the researchers found
Four themes emerged: (1) cannabis viewed as better than methamphetamine, heroin, alcohol, and prescriptions, (2) cannabis used medicinally for pregnancy symptoms, (3) uncertainty about breastfeeding effects, and (4) minimal healthcare provider discussion perceived as endorsement of use.
Why it matters
American Indian women face higher cannabis use rates and lower access to mental health treatment. Understanding how they perceive perinatal cannabis use reveals critical gaps in healthcare communication and culturally appropriate education.
The numbers in context
10 American Indian women from 3 legal cannabis states. All used cannabis at least weekly during pregnancy or postpartum. Cannabis was perceived as safer than methamphetamine, heroin, alcohol, and prescription drugs.
How the study worked
Qualitative descriptive study of 10 American Indian perinatal women from Washington, Oregon, and California who used cannabis at least weekly while pregnant or postpartum. Semi-structured interviews analyzed using principles of Indigenous research frameworks.
What this study cannot tell us
Very small sample size (n=10). All participants from states where cannabis is legal. Qualitative design cannot establish prevalence of these views. May not represent perspectives across all American Indian communities.
How to read the evidence
Preliminary: small qualitative study providing in-depth perspectives but limited generalizability
When this study was published
Published in 2025
The bigger picture
When healthcare providers don't actively discuss cannabis during prenatal care, patients may interpret silence as approval. In communities where other substance use is more visible, cannabis may be seen as relatively harmless by comparison.
Questions still open
- How should healthcare providers address perinatal cannabis use in a culturally sensitive way? Would targeted education change these perceptions? What training do providers need?
Common questions
Why did these women use cannabis during pregnancy?
Why did they think their doctors approved of cannabis use?
Read the original research
American Indian women's perceptions of perinatal cannabis use.
The American journal of drug and alcohol abuse, 51(2), 254-262
Citation
Barbosa-Leiker, Celestina; Brooks, Olivia; Smith, Crystal Lederhos; Reid, Shayla C; Fatima, Gusti Lulu; Hirchak, Katherine A; Arias-Losado, Randi; Cabell, Margaret. (2025). American Indian women's perceptions of perinatal cannabis use.. The American journal of drug and alcohol abuse, 51(2), 254-262. https://doi.org/10.1080/00952990.2025.2473399
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