Women's Questions About Perinatal Cannabis Use and Health Care Providers' Responses

Abstract

Background: Cannabis use is common among individuals of reproductive age. We examined publicly posted questions about perinatal cannabis use and licensed United States health care provider responses. Materials and Methods: Data were medical questions on perinatal cannabis use posted online from March 2011 to January 2017 on an anonymous digital health platform. Posters were able to ''thank'' health care providers for their responses and providers could ''agree'' with other provider responses. We characterized 364 user questions and 596 responses from 277 unique providers and examined endorsement of responses through provider ''agrees'' and user ''thanks.'' Results: The most frequent questions concerned prenatal cannabis use detection (24.7%), effects on fertility (22.6%), harms of prenatal use to the fetus (21.3%), and risks of baby exposure to cannabis through breast milk (14.4%). Provider sentiment in responses regarding the safety of perinatal cannabis use were coded as 55.6% harmful, 8.8% safe, 8.8% mixed/unsure, and 26.8% safety unaddressed. Half of providers (49.6%) discouraged perinatal cannabis use, 0.5% encouraged use, and 49.9% neither encouraged nor discouraged use. Provider responses received 1,004 provider ''agrees'' and 583 user ''thanks.'' Provider responses indicating that perinatal cannabis use is unsafe received more provider ''agrees'' than responses indicating that use is safe (B = 0.42, 95% CI 0.02-0.82, p = 0.04). User ''thanks'' did not differ by provider responses regarding safety or dis/ encouragement. Conclusion: The data indicate public interest in cannabis use effects before, during, and after pregnancy. While most health care providers indicated cannabis use during pregnancy and breastfeeding is not safe, many did not address safety or discourage use, suggesting a missed educational opportunity.

Prenatal Cannabinoid Exposure: Emerging Evidence of Physiological and Neuropsychiatric Abnormalities

“…In particular, women who reside in areas where recreational cannabis is legalized and those who report regular cannabis use prior to pregnancy perceive far less risk of continued use during pregnancy, possibly owing to a positive perception of therapeutic effects and a lack of communication with health care providers regarding the risks ( 5 , 7 , 8 ). Indeed, in an online survey approximately half of the health care provider participants did not explicitly discourage prenatal cannabis use ( 9 ). This lack of perceived risk is reflected in the increasing rates of prenatal cannabis use.…”

Impact of Acute and Chronic Cannabis Use on Stress Response Regulation: Challenging the Belief That Cannabis Is an Effective Method for Coping

“…Like the general population, one of the most common reasons pregnant women report using cannabis during pregnancy is to manage stress, to calm down, or to relax (Ko et al, 2018;Chang et al, 2019). Indeed, cannabis use during pregnancy is more common in women with anxiety disorders, history of trauma, and symptoms of stress (Young-Wolff et al, 2020). Our prior research indicates that women who experienced a stressful life event (e.g., divorce, job loss) in the year prior to childbirth were at higher odds for reporting cannabis use during pregnancy (Allen et al, 2020).…”

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

“…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.…”

“…This group of studies was unique in its description of the perceived benefits of cannabis use in pregnancy. These benefits included managing conditions that pre-existed pregnancy including anxiety, depression, bipolar disorder, substance use disorders, PTSD, insomnia, anemia, chronic pain, Helicobacter pylori, osteoarthritis, fibromyalgia 20,54,61 , or improving general health and mental, physical, and spiritual well-being 56, 61 . Benefits also included managing conditions related to pregnancy, including nausea and vomiting, weight gain, sleep, pain related to the physical toll of pregnancy or labour, stress related to pregnancy and parenting 8, 20, 54-56, 60, 61 .…”

“…The sources, types, and evaluation of information was a common topic in this group of papers. Pregnant people sought information from healthcare providers 53,55 , the internet 20,55,59,61 , and friends and family 55, 59 , as well as cannabis retailers 20,53 . Reconciling diverse and conflicting information was necessary, and participants described contradictions between what they heard from healthcare providers, read about online, and experienced personally or heard anecdotally from others 20,59 .…”