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.

Background Psychological stress and coping experienced during pregnancy can have important effects on maternal and infant health, which can also vary by race, ethnicity, and socioeconomic status. Therefore, we assessed stressors, coping behaviors, and resources needed in relation to the COVID-19 pandemic in a sample of 162 perinatal (125 pregnant and 37 postpartum) women in the United States. Methods A mixed-methods study captured quantitative responses regarding stressors and coping, along with qualitative responses to open-ended questions regarding stress and resources needed during the COVID-19 pandemic. Logistic and linear regression models were used to analyze differences between pregnant and postpartum participants, as well as differences across key demographic variables. Qualitative content analysis was used to analyze open-ended questions. Results During the COVID-pandemic, food scarcity and shelter-in-place restrictions made it difficult for pregnant women to find healthy foods. Participants also reported missing prenatal appointments, though many reported using telemedicine to obtain these services. Financial issues were prevalent in our sample and participants had difficulty obtaining childcare. After controlling for demographic variables, pregnant women were less likely to engage in healthy stress-coping behaviors than postpartum women. Lastly, we were able to detect signals of increased stressors induced by the COVID-19 pandemic, and less social support, in perinatal women of racial and ethnic minority, and lower-income status. Qualitative results support our survey findings as participants expressed concerns about their baby contracting COVID-19 while in the hospital, significant others missing the delivery or key obstetric appointments, and wanting support from friends, family, and birthing classes. Financial resources, COVID-19 information and research as it relates to maternal-infant health outcomes, access to safe healthcare, and access to baby supplies (formula, diapers, etc.) emerged as the primary resources needed by participants. Conclusions To better support perinatal women’s mental health during the COVID-19 pandemic, healthcare providers should engage in conversations regarding access to resources needed to care for newborns, refer patients to counseling services (which can be delivered online/via telephone) and virtual support groups, and consistently screen pregnant women for stressors.

Objective: To explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R).Study design: A quantitative survey using the BSS and BSS-R were employed.Additional demographic data were collected using electronic linkages (Qualtrics TM ).Participants: A convenience sample of childbearing women (n=2229) who had planned to birth in their home or birth center from the US (United States) participated.Participants were recruited via professional and personal contacts, primarily their midwives. Results:The total 30-item BSS score mean was 128.98 (SD 16.92) and the 10-item BSS-R mean score was 31.94(SD 6.75). Sub-scale mean scores quantified the quality of care provision, women's personal attributes, and stress experienced during labor. Satisfaction was higher for women with vaginal births compared with caesareans deliveries. In addition, satisfaction was higher for women who had both planned to deliver in a home or a birth center, and who had actually delivered in a home or a birth center.Key conclusions: Total and subscale birth satisfaction scores were positive and high for the overall sample Implications for practice: The BSS and the BSS-R provide a robust tool to quantify women's experiences of childbirth between variables such as birth types, birth settings and providers.

This review of contingency management (CM; the behavior-modification method of providing reinforcement in exchange for objective evidence of a desired behavior) for the treatment of substance-use disorders (SUDs) begins by describing the origins of CM and how it has come to be most commonly used during the treatment of SUDs. Our core objective is to review, describe, and discuss three ongoing critical advancements in CM. We review key emerging areas wherein CM will likely have an impact. In total, we qualitatively reviewed 31 studies in a systematic fashion after searching PubMed and Google Scholar. We then describe and highlight CM investigations across three broad themes: adapting CM for underserved populations, CM with experimental technologies, and optimizing CM for personalized interventions. Technological innovations that allow for mobile delivery of reinforcers in exchange for objective evidence of a desired behavior will likely expand the possible applications of CM throughout the SUD-treatment domain and into therapeutically related areas (eg, serious mental illness). When this mobile technology is coupled with new, easy-to-utilize biomarkers, the adaptation for individual goal setting and delivery of CM-based SUD treatment in hard-to-reach places (eg, rural locations) can have a sustained impact on communities most affected by these disorders. In conclusion, there is still much to be done, not only technologically but also in convincing policy makers to adopt this well-established, cost-effective, and evidence-based method of behavior modification.

Tobacco, alcohol and cannabis use are common in youth seeking treatment for FEP. Tobacco smoking was associated with more negative clinical outcomes. These findings have implications for including interventions targeting these areas of substance use within current CSC models.