Pregnant Cannabis Users Have Varied Plans for Postpartum Use, With Most Intending to Reduce

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.

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.

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 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.

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.