In focus groups with 53 pregnant cannabis users, most perceived cannabis as safer than prescription medications for managing mood, nausea, pain, and sleep, and wanted open, non-judgmental conversations with their obstetricians.
Read this if you are pregnant and using cannabis, or if you are a clinician seeking to improve conversations about prenatal cannabis use.
69.8% daily useProportion of pregnant participants using cannabis daily at prenatal care entry
What the researchers found
Among 53 pregnant participants (70% daily users, 25% weekly), many perceived a lack of scientific evidence about prenatal cannabis risks or believed it was safe. Participants preferred cannabis over OTC or prescription medications for mood, morning sickness, pain, and sleep. They valued open interactions with obstetricians that acknowledged their motivations for use and desired information about risks through conversations and educational materials. White and Black participants had generally similar perspectives, but some Black participants uniquely described concerns about racial bias related to their cannabis use.
Why it matters
Understanding why pregnant women continue using cannabis is essential for developing effective clinical communication strategies. The finding that women prefer cannabis to prescribed medications suggests they may be open to alternative treatments if presented respectfully.
The numbers in context
- 53 participants in 18 focus groups
- 30 White, 23 Black participants
- Mean age: 30.3 years (SD 5.2)
- Mean gestational age: 20.9 weeks
- 69.8% daily use, 24.5% weekly, 5.7% monthly or less
- Race-concordant focus groups
How the study worked
Qualitative study with 18 semi-structured, race-concordant virtual focus groups. Participants self-reported cannabis use at prenatal care entry in Kaiser Permanente Northern California. Thematic analysis of recorded and transcribed data.
Who was studied
53 pregnant cannabis users (30 White, 23 Black) in Northern California
What this study cannot tell us
Qualitative study cannot quantify prevalence of views. All participants from one healthcare system in California. Self-selected sample of women willing to discuss cannabis use. Focus groups may reflect social desirability bias.
How to read the evidence
Qualitative focus group study. Provides rich patient perspective data but cannot be generalized to all pregnant cannabis users.
When this study was published
Published in 2023. Addresses an increasingly relevant clinical communication challenge.
The bigger picture
The disconnect between medical recommendations to avoid cannabis during pregnancy and patients' lived experience creates a clinical communication challenge. Bridging this gap requires understanding patients' reasoning and addressing it directly rather than dismissing it.
Questions still open
- Would providing evidence-based educational materials reduce prenatal cannabis use?
- How can obstetricians address cannabis use without triggering concerns about CPS involvement?
- Do racial disparities in drug testing during pregnancy affect willingness to disclose cannabis use?
Read the original research
Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians.
Obstetrics and gynecology, 142(5), 1153-1161
Citation
Foti, Tara R; Green, Andrea; Altschuler, Andrea; Iturralde, Esti; Does, Monique B; Jackson-Morris, Melanie; Adams, Sara R; Goler, Nancy; Ansley, Deborah; Conway, Amy; Young-Wolff, Kelly C. (2023). Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians.. Obstetrics and gynecology, 142(5), 1153-1161. https://doi.org/10.1097/AOG.0000000000005295