13% of Colorado Birthing Individuals Used Cannabis Perinatally, with Depression Doubling the Odds | Research

The takeaway

Among 117,812 Colorado birthing individuals, 13.3% reported perinatal cannabis use, with depression during pregnancy doubling the odds. Most used cannabis for medical reasons during pregnancy but shifted to recreational use postpartum.

obstetricians, midwives, maternal mental health specialists, public health policymakers

What the researchers found

13.3% (15,585) reported perinatal cannabis use. 35.5% used during pregnancy, 87.3% used postpartum. Depression during pregnancy increased odds of use 2.2-fold (95% CI: 1.5-3.3). During pregnancy, 92% cited medical reasons; by 12-14 months postpartum, only 43% cited medical reasons. Use varied significantly by demographics and social factors.

Why it matters

In a state with legalized recreational cannabis, more than 1 in 10 pregnant individuals use cannabis perinatally. The strong link to depression suggests self-medication, and the shift from medical to recreational reasons postpartum suggests evolving motivations.

The numbers in context

117,812 birthing individuals. 15,585 (13.3%) perinatal cannabis use. 35.5% during pregnancy, 87.3% postpartum. Depression: aOR 2.2 (CI 1.5-3.3). Medical reasons: 92% during pregnancy, 43% at 12-14 months postpartum.

How the study worked

Analysis of Health eMoms, Colorado's statewide perinatal longitudinal electronic surveillance system. Weighted sample of 117,812 birthing individuals (2018-2021). Bivariate and multivariable logistic regression.

What this study cannot tell us

Self-reported use likely underestimates true prevalence. State-level data from Colorado may not generalize to states without legal recreational cannabis. Cannot determine causal direction between depression and cannabis use. Survey response bias possible.

How to read the evidence

Large statewide surveillance system with adjusted analyses, but self-reported data and state-specific context (legal recreational cannabis) limit generalizability.

When this study was published

2025 publication with 2018-2021 data.

The bigger picture

Colorado's legalized cannabis environment provides a window into what other states may see as legalization expands. The high prevalence of perinatal use, combined with inconsistent healthcare guidance, highlights an urgent need for evidence-based prenatal counseling.

Questions still open

Are depressed pregnant women using cannabis as self-medication for inadequately treated depression?
What evidence-based guidance should healthcare providers give about perinatal cannabis use?

Common questions

How common is cannabis use during pregnancy?

In Colorado, where recreational cannabis is legal, 13.3% of birthing individuals reported perinatal cannabis use (2018-2021). About one-third used during pregnancy, with 92% citing medical reasons such as nausea, pain, or anxiety.

Is depression linked to cannabis use during pregnancy?

Yes. This study found depression during pregnancy more than doubled the odds of perinatal cannabis use (2.2x). This suggests some individuals may be self-medicating with cannabis for inadequately treated depression during pregnancy.

Read the original research

Predictors of perinatal cannabis use in colorado and the association with depression during pregnancy.

Archives of women's mental health, 28(3), 603-611

View on PubMed ↗Publisher’s paper ↗

Citation

Teano, Valerie J; Weikel, Blair W; Hwang, Sunah S; Wymore, Erica M; Blackwell, Sarah; Bourque, Stephanie L. (2025). Predictors of perinatal cannabis use in colorado and the association with depression during pregnancy.. Archives of women's mental health, 28(3), 603-611. https://doi.org/10.1007/s00737-024-01515-4