An analysis of 364 online questions about perinatal cannabis found that while most provider responses called it harmful, nearly half did not discourage use, and about 9% described it as safe.
Obstetricians and midwives, telehealth providers, and public health officials designing perinatal cannabis education.
49.9% of providers neither encouraged nor discouraged perinatal cannabis use
What the researchers found
The most common questions concerned drug test detection (24.7%), fertility effects (22.6%), fetal harms (21.3%), and breastfeeding exposure (14.4%). Provider responses were 55.6% harmful, 8.8% safe, 8.8% mixed, and 26.8% did not address safety. 49.6% discouraged use, 0.5% encouraged it, and 49.9% neither encouraged nor discouraged. Responses calling cannabis unsafe received more peer provider endorsements.
Why it matters
Pregnant and breastfeeding individuals increasingly seek cannabis information online. When nearly half of licensed provider responses fail to discourage perinatal cannabis use, it represents a significant missed opportunity for public health education.
The numbers in context
364 questions, 596 responses from 277 providers. Safety: 55.6% harmful, 8.8% safe, 8.8% mixed, 26.8% unaddressed. Discouragement: 49.6% discouraged, 0.5% encouraged, 49.9% neutral. 1,004 provider agrees, 583 user thanks.
How the study worked
Analysis of 364 user questions and 596 health care provider responses posted on an anonymous digital health platform from March 2011 to January 2017. Provider sentiment coded for safety messaging and encouragement/discouragement. Endorsement measured through provider "agrees" and user "thanks."
What this study cannot tell us
Online platform responses may not represent in-person clinical advice. Questions were posted 2011-2017 and attitudes may have shifted. Coding of provider sentiment involves subjective judgment. Platform users may not be representative of all pregnant individuals.
How to read the evidence
Systematic content analysis of a large digital dataset, but limited by platform-specific context and outdated time period.
When this study was published
2020 publication analyzing 2011-2017 online posts. Provider attitudes toward perinatal cannabis may have evolved since data collection.
The bigger picture
As cannabis normalization increases, the inconsistency in provider messaging about perinatal safety becomes more consequential. Standardized clinical guidelines and provider training could help close this gap.
Questions still open
- Have provider responses become more or less cautious since 2017? Would standardized clinical messaging about perinatal cannabis change patient behavior? Do patients who receive clearer safety messaging make different choices?
Common questions
What did pregnant people most commonly ask about cannabis?
Did providers agree with each other?
Read the original research
Women's Questions About Perinatal Cannabis Use and Health Care Providers' Responses.
Journal of women's health (2002), 29(7), 919-926
Citation
Young-Wolff, Kelly C; Gali, Kathleen; Sarovar, Varada; Rutledge, Geoffrey W; Prochaska, Judith J. (2020). Women's Questions About Perinatal Cannabis Use and Health Care Providers' Responses.. Journal of women's health (2002), 29(7), 919-926. https://doi.org/10.1089/jwh.2019.8112
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