Both clinicians and pregnant women said they value open, nonjudgmental cannabis counseling grounded in shared decision-making, but patients reported that actual clinical conversations fell short of these ideals.
People interested in cannabis use during pregnancy and how health care providers approach the topic.
Patients said real conversations did not match clinician ideals
What the researchers found
Three phases of clinical encounters influenced cannabis decisions: initiating discussion, making sense of information, and the outcome. While clinicians described their approach as reflecting open, patient-centered values, patients reported that actual interactions did not match. Both groups endorsed nonjudgmental conversations exploring reasons for cannabis use against available evidence and known-safe alternatives.
Why it matters
Cannabis use during pregnancy is increasing with legalization, but the counseling gap between what clinicians think they are providing and what patients experience creates missed opportunities for informed decision-making.
The numbers in context
75 participants: 23 clinicians and 52 pregnant/lactating individuals. Study conducted in Canada. Three phases of the clinical encounter identified.
How the study worked
Qualitative descriptive study with semi-structured interviews of 75 individuals in Canada: 23 perinatal clinicians and 52 pregnant or lactating individuals who made cannabis decisions. Data analyzed using inductive content analysis.
What this study cannot tell us
Canadian study may not reflect practices in other countries. Self-selected participants may not represent broader populations. Clinician self-reporting may overestimate the quality of counseling they provide. Qualitative design captures experiences but not prevalence.
How to read the evidence
Qualitative study capturing perspectives of clinicians and patients. Evidence grading does not apply, but the large sample for qualitative research (75 participants) provides robust findings.
When this study was published
Published in 2024 in the journal Birth.
The bigger picture
Legalization has made cannabis more accessible during pregnancy, but clinician training on the topic has not kept pace. This study highlights that even when clinicians have good intentions, patients feel the counseling they receive is inadequate, judgmental, or lacking in nuance.
Questions still open
- What specific training would help clinicians deliver the kind of counseling patients want? Does the quality of cannabis counseling affect whether pregnant women disclose use? Would structured counseling tools improve the patient-clinician interaction?
Common questions
Do doctors counsel pregnant women about cannabis?
What kind of counseling do pregnant cannabis users want?
Read the original research
Counseling About Cannabis Use During Pregnancy and Lactation: A Qualitative Study of Patient and Clinician Perspectives.
Birth (Berkeley, Calif.), 51(4), 867-877
Citation
Cernat, Alexandra; Carruthers, Andrea; Taneja, Shipra; Popoola, Anuoluwa; Greyson, Devon; Panday, Janelle; Darling, Elizabeth; McDonald, Sarah D; Black, Morgan; Murray-Davis, Beth; Vanstone, Meredith. (2024). Counseling About Cannabis Use During Pregnancy and Lactation: A Qualitative Study of Patient and Clinician Perspectives.. Birth (Berkeley, Calif.), 51(4), 867-877. https://doi.org/10.1111/birt.12873
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