Violence and Unstable Housing Were Linked to Higher Cannabis Use During Pregnancy

Past-year violence and unsafe/unstable living situations were associated with higher prenatal cannabis use in adjusted analyses. Current IPV, past-year violence, and unstable housing were all associated in unadjusted analyses. Over two-thirds (69.1%) of pregnancies with current IPV also reported past-year physical violence or unsafe living situations. Cannabis was used during 7.2% of pregnancies.

Retrospective cohort study using data from 303,178 California pregnancies (2014-2023). Chi-square tests and modified Poisson regression estimated associations between experiences of current IPV, past-year violence, and unsafe/unstable living situations with cannabis use during early pregnancy.

Understanding why pregnant women use cannabis requires looking beyond individual choice to social determinants. This large-scale study shows that violence and housing instability are associated with prenatal cannabis use, suggesting that addressing these root causes could be more effective than simply telling women to stop using cannabis.

This study shifts the prenatal cannabis conversation from individual behavior to structural factors. By linking cannabis use to violence and housing instability, it supports integrated approaches that address safety, housing, and substance use together rather than in silos.

Self-reported violence and cannabis use likely underestimate true prevalence. Cannot establish causation. California-specific sample may not generalize to other states. Very low reported IPV rates (<1%) suggest significant underreporting. Cannot determine whether cannabis is used as a coping mechanism or whether the association is driven by other factors.