Pregnant People Avoid Telling Providers About Cannabis Use Due to Fear of Judgment and Reporting

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.

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.

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 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.

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.