Daily Cannabis Use During Pregnancy and Postpartum in a State With Legalized Recreational Cannabis

Abstract

Objective: To identify perceptions of risks and benefits of cannabis use during pregnancy and postpartum from the patient perspective. Methods: Pregnant and postpartum (up to 3 months) women residing in a state that legalized the sale of recreational cannabis in 2012 were interviewed to determine their perceptions of risks and benefits of cannabis use during pregnancy and postpartum. Qualitative description methodology was used to identify common themes in the data. Nineteen (n = 14 pregnant; n = 5 post-partum) women who used cannabis daily while pregnant were interviewed about perceptions of risks and benefits of cannabis use during pregnancy and postpartum. Results: Five themes, describing the participants’ cannabis use while pregnant and postpartum, emerged from the data. These themes include (1) continued use for health management, (2) ongoing evaluative process, (3) mixed messages, (4) wanting more information, and (5) legal considerations. All 5 of these themes contributed to the overarching theme of Taking Care of Mom and Baby , which encompasses the mother's need and struggle to care for her own health and wellness, as well as that of her unborn baby. Conclusions: In a state with legalized recreational cannabis, pregnant and postpartum women reported continuing daily cannabis use during pregnancy to take care of themselves and their baby. It is crucial for healthcare providers to follow national guidelines and explain risks of cannabis use during pregnancy and postpartum, while also managing expectations based on patient history. A harm reduction approach to decrease cannabis use is vital to help pregnant women who are using cannabis for health management to continuously evaluate their use during pregnancy and postpartum.

Pregnant people’s perspectives on cannabis use during pregnancy: A systematic review and integrative mixed-methods research synthesis

“…There were 12 studies that examined perspectives on cannabis use in pregnancy in isolation from any other substances 8, 20, 52-61 . These studies were conducted in the US, Canada, and Jamaica, in jurisdictions where recreational cannabis was legal or decriminalized 8,20,53,54,60 as well as jurisdictions where it was illegal [55][56][57][58][59] .…”

“…Across these 12 papers, participants considered how to modulate their cannabis use to maximize benefit and minimize risk. Participants discussed changing the form of cannabis they used 20,55,56 , the amount 20,54,56 , or using cannabis at particular stages of pregnancy 8,60 to attain the perceived benefits while minimizing perceived risk.…”

“…Participants were consistently concerned about the risk of potential harms to their baby, both from the consumption of cannabis but also from the cessation or replacement of cannabis with a substance they deemed to be more harmful 8,20,53,54,56,59,60 . It is relevant here that many participants evaluated cannabis to carry less risk than over-the-counter or prescribed pharmaceuticals 20,54,55,59 . Participants also noted involvement with criminal justice or child welfare services as a risk of using cannabis 8,20,[53][54][55][59][60][61] .…”

“…It is relevant here that many participants evaluated cannabis to carry less risk than over-the-counter or prescribed pharmaceuticals 20,54,55,59 . Participants also noted involvement with criminal justice or child welfare services as a risk of using cannabis 8,20,[53][54][55][59][60][61] . This group of studies was unique in its description of the perceived benefits of cannabis use in pregnancy.…”

“…Pregnant and lactating people use cannabis for a variety of reasons, including to treat conditions which both pre-exist and are related to the perinatal period 7,8,11,[15][16][17][18][19] . Pregnant people report using cannabis to alleviate pregnancy-related conditions such as nausea, vomiting, pain and fatigue 16,17,20 . Others continue cannabis use for reasons which pre-existed pregnancy such as pain, anxiety, sleep, to control seizures, or for skin and hair treatment 7,8,11,[15][16][17][18] .…”