While 92% of family physicians providing obstetric care perceived marijuana as unsafe during pregnancy, only 63% consistently screened for it and only 18% screened for all substances consistently.
Read this if you are pregnant or planning pregnancy and want to understand how doctors approach marijuana screening.
92% of doctors viewed marijuana as unsafe in pregnancy but only 63% consistently screened for it
What the researchers found
This survey of 417 US family physicians providing labor and delivery care revealed a gap between awareness and action regarding substance use during pregnancy.
Physicians estimated that roughly 6-25% of their pregnant patients used cigarettes (54% of doctors), marijuana (49%), and electronic cigarettes (24%). Most perceived all of these as unsafe during pregnancy: 99% for cigarettes, 92% for marijuana, 91% for electronic cigarettes.
Despite this awareness, screening was inconsistent. While 85% consistently screened for cigarettes, only 63% consistently screened for marijuana, 48% for secondhand smoke exposure, 33% for electronic cigarettes, and 28% for synthetic marijuana. Only 18% screened consistently for all substances.
A notable knowledge gap existed for synthetic marijuana (58% selected "do not know" for prevalence) and electronic cigarettes (27% "do not know"), suggesting physicians may not be aware of newer substance trends among pregnant women.
Why it matters
If nearly half of physicians believe a significant portion of pregnant patients use marijuana but only 63% screen for it, many exposed pregnancies go unidentified. This screening gap means missed opportunities for intervention and counseling.
The numbers in context
417 obstetric providers. 92% perceived marijuana as unsafe in pregnancy. 63% consistently screened for marijuana use. 32% used laboratory testing for marijuana. 18% screened for all substances consistently.
How the study worked
Web-based cross-sectional survey emailed to 3,750 US physicians in academic family medicine organizations. 1,248 responded (33.3%). Analysis focused on 417 who provided labor and delivery obstetric care. Questions assessed perceived prevalence, safety beliefs, and screening practices for multiple substances during pregnancy.
What this study cannot tell us
Self-reported survey from academic family medicine settings may not represent community practices. 33.3% response rate may introduce response bias. Physician perceptions of prevalence may not reflect actual patient use rates.
How to read the evidence
Cross-sectional survey of academic family physicians. Moderate because it provides systematic data on a clinically important gap.
When this study was published
Published in 2017.
The bigger picture
As cannabis legalization expands, prenatal marijuana use is likely increasing. The gap between physician awareness of the problem and systematic screening highlights a systems-level failure that individual provider education alone may not solve.
Questions still open
- Would universal prenatal substance screening improve detection rates? Should marijuana screening be added to standard prenatal laboratory panels? How can physician education address the knowledge gaps about synthetic marijuana and e-cigarettes?
Common questions
Do doctors screen for marijuana during pregnancy?
Do doctors think marijuana is unsafe during pregnancy?
Read the original research
Family Physicians' Perceived Prevalence, Safety, and Screening for Cigarettes, Marijuana, and Electronic-Nicotine Delivery Systems (ENDS) Use during Pregnancy.
Journal of the American Board of Family Medicine : JABFM, 30(6), 743-757
Citation
Northrup, Thomas F; Klawans, Michelle R; Villarreal, Yolanda R; Abramovici, Adi; Suter, Melissa A; Mastrobattista, Joan M; Moreno, Carlos A; Aagaard, Kjersti M; Stotts, Angela L. (2017). Family Physicians' Perceived Prevalence, Safety, and Screening for Cigarettes, Marijuana, and Electronic-Nicotine Delivery Systems (ENDS) Use during Pregnancy.. Journal of the American Board of Family Medicine : JABFM, 30(6), 743-757. https://doi.org/10.3122/jabfm.2017.06.170183
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