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

Retrospective CohortStrong evidence
The takeaway

In a study of over 303,000 California pregnancies, experiences of past-year violence and unsafe or unstable living situations were associated with higher cannabis use during early pregnancy.

Prenatal care providers, social workers, intimate partner violence researchers, public health policymakers.

69% of pregnancies with current IPV also involved past-year violence or unstable housing

What the researchers found

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.

Why it matters

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.

The numbers in context

n=303,178 pregnancies in California (2014-2023); 7.2% (n=21,868) used cannabis during pregnancy; <1% reported current IPV (n=324) or past-year violence (n=979); ~2% (n=6,284) reported unsafe/unstable living; 69.1% of IPV-exposed pregnancies also had violence or unstable housing.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Strong: Very large population-based sample (303,178 pregnancies) from a major health system with nearly a decade of data and adjusted regression models.

When this study was published

Published in 2025 with data from 2014-2023.

The bigger picture

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.

Questions still open

  • Is cannabis being used as a coping mechanism for trauma and stress? Would addressing violence and housing instability reduce prenatal cannabis use? How can screening for violence, housing, and substance use be better integrated in prenatal care?

Common questions

Why might violence be linked to cannabis use during pregnancy?
Women experiencing violence may use cannabis as a coping mechanism for trauma, stress, pain, or sleep difficulties. The study cannot confirm this mechanism but suggests that addressing the root causes of violence and housing instability could be more effective than focusing solely on substance use.
How common is cannabis use during pregnancy?
In this California sample, 7.2% of pregnancies involved cannabis use. This is consistent with other recent estimates showing prenatal cannabis use has been rising, particularly in states where cannabis is legal.

Read the original research

Associations Between Violence and Unsafe Living Situations With Cannabis Use During Early Pregnancy.

Substance use & addiction journal, 29767342251371802

Citation

Ogden, Shannon N; Watson, Carey R; Adams, Sara R; Ansley, Deborah; Castellanos, Carley; Young-Wolff, Kelly C. (2025). Associations Between Violence and Unsafe Living Situations With Cannabis Use During Early Pregnancy.. Substance use & addiction journal, 29767342251371802. https://doi.org/10.1177/29767342251371802

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