Young pregnant patients want trusted, respectful cannabis guidance

Adolescent pregnancy is associated with socioeconomic disadvantages and higher risks of adverse obstetric, fetal, and developmental outcomes. Pregnant adolescents and young adults also use cannabis at a higher rate than older individuals, which may compound these risks. In considering clinical interventions aimed at reducing prenatal cannabis exposure, it is critical to understand the perspectives of young pregnant individuals, including why some individuals in this age group abstain and why others use cannabis but stop for pregnancy. This qualitative study aimed to identify beliefs, attitudes, and perceptions of cannabis use in young pregnant patients. We conducted qualitative semi-structured interviews of young pregnant individuals with and without prenatal cannabis use as part of the YoungMoms study. Interviews were transcribed, coded, and reviewed for patterns and themes. Thirty-eight participants completed the interviews including 12 that continued to use cannabis during pregnancy, 15 that stopped upon pregnancy recognition, and 11 that had never used cannabis. The average age of the participants was 19 years (range: 17-21) and 68% identified as Black/African American. Participants voiced the following themes: 1) using prenatal cannabis to relieve physical symptoms and stress; 2) believing prenatal cannabis to be less harmful than other substances such as prescribed medications, while also voicing concern about potential risks; 3) relying on both non-professional and professional resources to shape their perspectives; and 4) recognizing and asserting autonomy regarding the rationales, decisions, and strategies to continue and/or reduce cannabis use during pregnancy. Young pregnant patients described mixed beliefs about the safety of prenatal cannabis use and felt that cannabis could be helpful to treat symptoms of nausea and stress. Participants highlighted a desire to make their own decisions and sought information from trusted sources. These findings suggest young pregnant patients may be receptive to patient-centered approaches when discussing prenatal cannabis use.