“Anything above marijuana takes priority”: Obstetric providers’ attitudes and counseling strategies regarding perinatal marijuana use

Abstract

Objective To describe obstetric provider attitudes, beliefs, approaches, concerns, and needs about addressing perinatal marijuana use with their pregnant patients. Methods We conducted individual semi-structured interviews with obstetric providers and asked them to describe their thoughts and experiences about addressing perinatal marijuana use. Interviews were transcribed verbatim, coded and reviewed to identify themes. Results Fifty-one providers participated in semi-structured interviews. Providers admitted they were not familiar with identified risks of marijuana use during pregnancy, they perceived marijuana was not as dangerous as other illicit drugs, and they believed patients did not view marijuana as a drug. Most provider counseling strategies focused on marijuana’s status as an illegal drug and the risk of child protective services being contacted if patients tested positive at time of delivery. Conclusions When counseling about perinatal marijuana use, obstetric providers focus more on legal issues than on health risks. They describe needing more information regarding medical consequences of marijuana use during pregnancy. Practice Implications Provider training should include information about potential consequences of perinatal marijuana use and address ways to improve obstetric providers’ counseling. Future studies should assess changes in providers’ attitudes as more states consider the legalization of marijuana.

Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review

“…In a state with legalised recreational cannabis use, 69% of cannabis dispensaries suggested the treatment of morning sickness with cannabis products and 65% of these recommendations were based on personal opinion . This is crucial as obstetric providers continue to perceive cannabis as less dangerous than other substances and admit to deprioritising the topic of perinatal cannabis use during the first obstetric visit . As legalisation expands and the perception of risk declines, we require better education and awareness regarding the risks of prenatal cannabis use to combat the potential anticipated increase in use.…”

Health Care Encounters of Pregnant and Postpartum Women with Substance Use Disorders

“…A study by Holland et al (2016) found that obstetric providers of women who used marijuana were more likely to focus on the legal rather than the health-related consequences of substance use, such as when providers warned women that child protective services (CPS) could be called at delivery. These findings of the current study The current finding that many pregnant and postpartum women with SUDs desire more control over their health care can be viewed through the lens of the concept of patient activation, which is the ability of patients to actively engage in managing their own health and navigating the health care system (Hibbard et al, 2004).…”

“…Holland et al (2016) study, therefore, indicate that health care providers need to carefully consider that discussion on legal consequences may be perceived as threatening by pregnant and postpartum women. Health care providers play a significant role in detecting substance use during pregnancy and referring women to appropriate resources within their community.…”

Cannabis Use in Pregnant and Breastfeeding Women: Behavioral and Neurobiological Consequences

“…Consequently, it is necessary to screen and detect the consumption of any substance of abuse among pregnant women attending prenatal units. Although its identification is still difficult, there are evidence supporting the efficacy of routine screening in clinical history or structured questionnaires in this regard (108). It is worth to mention that screening tools should be used multiple times during gestation as the patient-physician relationship progresses.…”