Only One-Third of Postpartum Mothers Received Any Provider Counseling About Marijuana

In a multi-site survey of 484 postpartum mothers, 59.9% reported any lifetime marijuana use and 9.3% used during their current pregnancy. Nearly 40% described marijuana use among breastfeeding mothers as common or somewhat common. Only one-third received any provider counseling about marijuana. After adjusting for covariates, counseling was associated with nearly double the odds of mothers knowing about risks to children's learning (aOR 1.93, 95% CI: 1.13-3.29).

Multi-state cross-sectional survey at 15 US hospitals in the BORN network (June 2021 to August 2022). Convenience sample of postpartum mothers aged 21+ with newborns 34+ weeks gestational age. 48-item survey assessing demographics, use, attitudes, knowledge, and provider counseling. Chi-square and multivariable logistic regression analyses.

When most mothers have tried marijuana but few have been counseled by providers, there is a significant missed opportunity. The finding that counseling nearly doubles knowledge of learning risks suggests provider conversations can be effective when they happen.

As marijuana becomes more normalized, the gap between widespread use and sparse clinical counseling represents a systemic failure in prenatal and postpartum education.

Convenience sample may not be representative. Self-report subject to social desirability bias. Cross-sectional design cannot determine if counseling caused improved knowledge. Survey at academic medical centers may not reflect community practice.