Interviews with 16 postpartum women revealed low risk perceptions of prenatal cannabis use, frequent use for mental health and pain, and strong fear that disclosure would trigger child protective services involvement.
Obstetricians, midwives, prenatal health advocates, and policymakers
Fear of child welfare involvement was the top barrier to disclosure
What the researchers found
Women reported mixed perceptions of cannabis harm during pregnancy, often framing it as medicine or acknowledging addiction. The dominant barrier to disclosing cannabis use was fear of child welfare and protective services involvement. Perceived negative provider communication was also identified as a barrier. Most participants used cannabis during pregnancy to manage mental health conditions and pain.
Why it matters
If pregnant women are afraid to disclose cannabis use, providers cannot offer informed counseling or monitor for potential risks. This study identifies the specific fears driving non-disclosure, which are actionable: reforming screening communication and addressing punitive policies.
The numbers in context
16 women interviewed. 75% were 25-34 years old. 75% were Black. 68.75% had less than a bachelor's degree. Women used cannabis for mental health, pain, and reported both medicinal framing and addiction.
How the study worked
Phenomenological qualitative study with semi-structured online interviews of 16 women who gave birth at a US hospital within the past three months. Inductive thematic analysis with two coders. Descriptive statistics for demographics and cannabis use behaviors.
What this study cannot tell us
Very small sample (16 women) from a single US hospital. 75% Black sample may not represent all demographic groups. Women were interviewed postpartum, introducing recall bias. Self-selection may mean participants were more comfortable discussing cannabis.
How to read the evidence
Small qualitative study from a single institution; valuable for understanding lived experiences but not for estimating prevalence.
When this study was published
2024 study
The bigger picture
The tension between public health screening and punitive policy consequences is not unique to cannabis. This study illustrates how the threat of child welfare involvement creates a chilling effect on disclosure, potentially harming both mothers and infants by preventing honest clinical conversations.
Questions still open
- Would decoupling drug screening from mandatory child welfare reporting increase disclosure? How do provider communication styles affect willingness to disclose? Do women who disclose cannabis use receive different prenatal care?
Common questions
Why don't pregnant women tell their doctors about cannabis use?
Why do some women use cannabis during pregnancy?
Read the original research
Perceptions, barriers, and facilitators of cannabis screening during pregnancy and labor: A qualitative study.
Drug and alcohol dependence reports, 12, 100274
Citation
Skelton, K; Nyarko, S; Iobst, S. (2024). Perceptions, barriers, and facilitators of cannabis screening during pregnancy and labor: A qualitative study.. Drug and alcohol dependence reports, 12, 100274. https://doi.org/10.1016/j.dadr.2024.100274
Explore the wider topic
- How to Talk to Your Teenager About Weed (Without Losing Them)
- My Kid's Friends Smoke Weed: A Parent's Guide
- I Smoke Weed But Don't Want My Kids To: Navigating the Hypocrisy
- Quitting Weed as a Parent: Why It Is the Hardest and Most Important Quit
- Quitting Weed as a Teen or Young Adult
- My Kid Is Smoking Weed: A Parent's Guide