Interviews with 19 BIPOC pregnant individuals in California who used cannabis during pregnancy found they actively made harm-reduction decisions, including reducing amounts, switching to edibles or topicals, and seeking cleaner product sources.
OB-GYN providers working with pregnant patients who use cannabis; public health researchers developing prenatal harm reduction frameworks.
Pregnant cannabis users actively sought harm reduction but found no guidance
What the researchers found
Three themes emerged for how pregnant cannabis users modified their behavior: (1) changing the amount of cannabis used (reducing frequency or quantity), (2) changing types of products (switching from smoking to edibles, topicals, or lower-THC products), and (3) changing procurement sources (seeking regulated dispensaries over illicit sources). Participants were actively seeking evidence-based harm reduction information but could not find trustworthy guidance.
Why it matters
Rather than choosing between "use" and "don't use," pregnant cannabis users are already practicing harm reduction. Understanding their decision-making can inform clinical approaches that meet patients where they are rather than simply advising abstinence.
The numbers in context
19 BIPOC participants in California. Three harm reduction themes identified. All participants reported conscious decisions to modify cannabis use during pregnancy.
How the study worked
Qualitative constructivist grounded theory. 19 semi-structured interviews (December 2022-March 2023) with BIPOC individuals over 21 who used cannabis during pregnancy within the past 0-2 years in California.
What this study cannot tell us
Small qualitative sample from California. BIPOC participants only; findings may not generalize across demographics. Self-reported behaviors. Retrospective recall of pregnancy decisions (0-2 years post). No health outcome data for mothers or infants.
How to read the evidence
Small qualitative study providing rich descriptive data about decision-making but no outcome measures.
When this study was published
2024 study
The bigger picture
The gap between patients' desire for evidence-based harm reduction guidance and the absence of such information from healthcare providers represents a missed opportunity. A harm reduction framework for prenatal cannabis use could improve outcomes even when abstinence is unrealistic.
Questions still open
- Do harm reduction modifications (like switching from smoking to edibles) actually reduce fetal risk? Can clinicians provide evidence-based harm reduction guidance without being perceived as endorsing prenatal cannabis use?
Common questions
Is it safe to use cannabis during pregnancy?
Why do some pregnant people use cannabis?
Read the original research
"I don't need my kid to be high": prioritizing harm reduction when using cannabis during pregnancy.
Harm reduction journal, 21(1), 166
Citation
Gould, Erin E; Ganesh, Siddhi S; Ceasar, Rachel Carmen. (2024). "I don't need my kid to be high": prioritizing harm reduction when using cannabis during pregnancy.. Harm reduction journal, 21(1), 166. https://doi.org/10.1186/s12954-024-01046-2
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