In interviews with 34 pregnant or recently pregnant cannabis users, most said providers never asked about cannabis, and those who used it feared being reported to child welfare if they disclosed.
OB-GYN providers, prenatal care teams, public health professionals, pregnant individuals
What the researchers found
Most of the 34 interview participants reported that healthcare providers never initiated conversations about cannabis use. Participants distrusted providers as accurate cannabis information sources, viewing provider messaging as unfairly grouping cannabis with alcohol and harder drugs. Fear of judgment and child welfare reporting were the primary barriers to disclosure. Many used cannabis for medical reasons but rarely experienced providers discussing risks versus benefits of cannabis compared to alternative treatments.
Why it matters
When patients hide substance use from providers, it creates blind spots in prenatal care. This study reveals the specific trust barriers that prevent open communication, pointing to opportunities for more effective clinical approaches.
The numbers in context
34 interview participants; most reported no provider-initiated cannabis discussions; few disclosed use voluntarily; primary barriers: distrust of provider information, fear of judgment, fear of child welfare reporting
How the study worked
Qualitative study with in-depth interviews of 34 individuals who were pregnant or had been pregnant within the past two years and who used cannabis before or during pregnancy. Interviews explored experiences with and perspectives on provider communication about cannabis.
What this study cannot tell us
Small qualitative sample cannot be generalized to all pregnant cannabis users. Participants were recruited in areas where cannabis was legal, which may affect attitudes. Self-selection bias likely.
How to read the evidence
Preliminary: small qualitative study capturing perspectives of a self-selected group.
When this study was published
2025 publication
The bigger picture
The gap between public perception of cannabis (as relatively benign) and clinical messaging (grouping it with harmful drugs) creates a communication breakdown that affects prenatal care quality. Resolving this requires providers to engage with patient perspectives rather than simply issuing warnings.
Questions still open
- Would a risk-benefit conversation framework increase disclosure rates?
- How do child welfare reporting policies affect prenatal cannabis screening?
Read the original research
Mistrust Limits Possibilities for Patient-Provider Discussions Regarding Cannabis Use During Pregnancy.
Women's health issues : official publication of the Jacobs Institute of Women's Health, 35(6), 450-457
Citation
Gould, Heather; Zaugg, Claudia; Scott, Karen A; Roberts, Sarah C M. (2025). Mistrust Limits Possibilities for Patient-Provider Discussions Regarding Cannabis Use During Pregnancy.. Women's health issues : official publication of the Jacobs Institute of Women's Health, 35(6), 450-457. https://doi.org/10.1016/j.whi.2025.09.002
Explore the wider topic
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