How to talk to pregnant cannabis users about health risks

Perinatal cannabis use has become more common in the United States. However, the evidence that associates prenatal cannabis use with increased risk for adverse maternal and child health outcomes is also growing. Therefore, it is important to include perinatal cannabis risks in standard health warnings to perinatal patients. As health messaging that resonates with perinatal individuals who use cannabis regularly has not yet been identified, further testing is needed. Therefore, we sought to gain perspectives from postpartum individuals who used cannabis regularly in early pregnancy on perinatal cannabis use health messages. This analysis used data from a larger qualitative study that recruited participants who were 4 to 12 months postpartum and self-reported daily or weekly cannabis use during early pregnancy (at ~8 weeks gestation) at prenatal care entry. We used a semi-structured interview guide to solicit participants' thoughts on 4 different messages containing perinatal cannabis use health information and warnings. We conducted interviews in April to May 2022. We used thematic analysis to identify key aspects of acceptable perinatal cannabis health messaging. Sixteen participants provided feedback on the health messages. Participants were 21 to 33 years old, 6 to 11 months postpartum, and self-identified as black (n = 4), Hispanic (n = 4), and white (n = 8). None of the messages were wholly accepted across participants, but we identified 3 key aspects of acceptable health messaging for perinatal cannabis use: (1) use of neutral language and images, (2) inclusion of evidence for health risks, (3) present options or alternatives for cannabis use. Findings provide evidence for perinatal cannabis use clinical health messaging that could resonate with perinatal patients who use cannabis and encourage open dialogue with their health care providers. Further research is needed to understand the actual impact of message exposure on perinatal cannabis use.