Perceptions About Cannabis Following Legalization Among Pregnant Individuals With Prenatal Cannabis Use in California

Abstract

ImportanceAs rates of prenatal cannabis use increase and cannabis legalization spreads across the US, studies are needed to understand the potential impacts of legalization from the perspectives of pregnant individuals who use cannabis.ObjectiveTo characterize pregnant individuals’ perspectives on legalization of cannabis for adult use in California (effective in 2018) in relation to prenatal cannabis use behaviors and beliefs.Design, Setting, and ParticipantsThis qualitative study was conducted in Kaiser Permanente Northern California, a large health care system with universal screening for self-reported cannabis use at entrance to prenatal care. Eighteen semistructured focus groups were conducted from November 17 to December 17, 2021, using a secure video conferencing platform with Black and White pregnant participants who self-reported cannabis use during early pregnancy. Data were analyzed from March to June 2022.Main Outcomes and MeasuresVideo-recorded interviews were transcribed and analyzed using thematic analysis to identify major themes and subthemes.ResultsAmong 53 participants (mean [SD] age, 30.3 [5.2] years), 23 (43%) identified as non-Hispanic Black and 30 (57%) identified as non-Hispanic White; 16 participants (30%) reported continued cannabis use at the time of recruitment. Major themes regarding the perceived impact of legalization included easier access (via retailers and delivery), greater acceptance (including reduced stigma and more discussions about prenatal cannabis use with health care practitioners), and trust in cannabis retailers (including safety and effectiveness of diverse products sold and perceptions of cannabis retailer employees as knowledgeable, nonjudgmental, and caring). Responses were mixed about whether retailer marketing and advertising were associated with prenatal cannabis use and whether legalization resulted in reduced concerns about Child Protective Services involvement.Conclusion and RelevanceThe findings of this qualitative study suggest pregnant individuals perceive cannabis legalization as having reduced barriers to prenatal cannabis use and that legalization has created challenges and opportunities for supporting the health of pregnant individuals. The results of this qualitative study highlight key areas that can be further explored in future educational materials, public health campaigns, and policy adaptations to address increasing rates of prenatal cannabis use.

Prenatal delta-9-tetrahydrocannabinol exposure is associated with changes in rhesus macaque DNA methylation enriched for autism genes

“…Cannabis, commonly known as marijuana, refers to a group of plants with psychoactive and medicinal properties. Use of cannabis and cannabis-derived products in the USA has increased as a greater number of states have legalized both recreational and medicinal cannabis use, which has resulted in diminished public perception of potential physiological risks of cannabis use [8]. Cannabis use among pregnant individuals [9], especially during the critical developmental window in the first trimester to mitigate morning sickness symptoms, has doubled in the past decade [10] and half of those that use cannabis will continue to use throughout pregnancy [11][12][13].…”

Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians

“…33 In California, clinicians are not required to contact Child Protective Services or law enforcement solely because of prenatal cannabis use, but some pregnant individuals continue to express these concerns. [34][35][36] Patient-clinician interaction may benefit from approaching conversations about cannabis use collaboratively and with curiosity and openness. Building on participant feedback, we highlight potential recommendations for clinicians around discussing prenatal cannabis use with their patients in Box 3.…”

Proceedings of the 2023 Cannabis Clinical Outcomes Research Conference

“…The conference also addressed unique considerations and challenges associated with cannabis use in specific populations and clinical settings, such as use during pregnancy. Dr. Kelly Young-Wolff from the Center for Addiction and Mental Health Research at Kaiser Permanente Northern California delivered a keynote presentation, highlighting her current research regarding increasing cannabis use trends during pregnancy [ 7 , 8 ]. The effects on offspring when exposed to cannabis in utero , and the policy and clinical implications thereof.…”