Pregnant Women Fear Disclosing Cannabis Use Due to Child Welfare Consequences

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.

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.

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 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.

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.