In focus groups with 53 pregnant cannabis users, most planned to use cannabis postpartum but less frequently than before pregnancy, with many motivated to abstain during breastfeeding despite wanting more safety data.
Prenatal and postpartum care providers; lactation consultants.
70% of prenatal cannabis users reported daily use at entrance to care
What the researchers found
Most participants planned postpartum cannabis use at reduced frequency with harm reduction approaches (e.g., smoking outside). Many were motivated to abstain during breastfeeding. Some believed "pump and dump" would reduce THC transfer to infants. White participants were more likely to plan cannabis use during breastfeeding and to want breastfeeding safety information. Some viewed cannabis as critical for coping with postpartum challenges.
Why it matters
Understanding what pregnant cannabis users plan to do postpartum is essential for designing effective interventions. The finding that most plan to reduce but not stop, and that many rely on unvalidated harm reduction strategies like "pump and dump," reveals specific knowledge gaps that clinicians can address.
The numbers in context
53 participants (23 Black, 30 White). Mean age 30.3 years. Usage at prenatal care entry: 70% daily, 25% weekly, 6% monthly or less. 18 focus groups conducted. White participants more likely to plan breastfeeding cannabis use and request safety data.
How the study worked
Eighteen virtual focus groups conducted November-December 2021 with 53 pregnant adults (23 Black, 30 White) from Kaiser Permanente Northern California who self-reported prenatal cannabis use. Focus groups were recorded, transcribed, and analyzed using thematic analysis.
What this study cannot tell us
Qualitative study of 53 women from one health system cannot capture the full range of experiences. Women who agreed to participate may differ from those who declined. Plans stated during pregnancy may not match actual postpartum behavior.
How to read the evidence
Preliminary: well-conducted qualitative study with both Black and White participants, but small sample from one health system and based on plans rather than actual behavior.
When this study was published
2024 study using 2021 focus group data.
The bigger picture
The misconception about "pump and dump" is particularly notable. Unlike alcohol, THC is lipophilic and stored in body fat, so discarding a single pumped sample does not meaningfully reduce infant exposure. This specific misunderstanding represents a concrete target for clinical education during prenatal care.
Questions still open
- Do women follow through on their stated plans to reduce postpartum cannabis use? Would providing concrete data on THC transfer during breastfeeding change behavior more effectively than general warnings?
Common questions
Does "pump and dump" remove THC from breast milk?
Were there differences between Black and White participants?
Read the original research
Intentions to Use Cannabis Postpartum: A Qualitative Study of Pregnant Individuals Who Used Cannabis During Early Pregnancy.
Journal of women's health (2002), 33(4), 435-445
Citation
Young-Wolff, Kelly C; Green, Andrea; Iturralde, Esti; Altschuler, Andrea; Does, Monique B; Jackson-Morris, Melanie; Adams, Sara R; Ansley, Deborah; Conway, Amy; Goler, Nancy; Skelton, Kara; Foti, Tara R. (2024). Intentions to Use Cannabis Postpartum: A Qualitative Study of Pregnant Individuals Who Used Cannabis During Early Pregnancy.. Journal of women's health (2002), 33(4), 435-445. https://doi.org/10.1089/jwh.2023.0066
Explore the wider topic
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