Why nurses struggle to ask about prenatal cannabis use

This qualitative study examined perinatal nurses' perspectives on screening for prenatal cannabis use during hospital admission for birth. Researchers conducted 22 virtual interviews with nurses across 15 U.S. states who worked in labor and delivery or postpartum units. The study identified five key barriers to screening: patient fear of legal consequences, inadequate screening environments, lack of patient-centered approaches, concerns about credibility of patient reports, and clinician avoidance of the topic. These barriers reveal systemic challenges that prevent effective, compassionate assessment of cannabis use in pregnant individuals.

The research also identified five important facilitators that can improve screening practices: implementing patient-centered approaches, explaining the clinical rationale for screening, leveraging experienced nurses' expertise, establishing formal screening protocols, and recognizing how cannabis legalization changes the context of care. The study emphasizes that trauma-informed care and motivational interviewing techniques are essential skills for nurses conducting these sensitive assessments. By adopting patient-centered screening methods, healthcare providers can reduce discriminatory practices and ensure pregnant individuals receive appropriate medical assessment and support.

The findings underscore a critical gap between current practice and evidence-based care. Perinatal nurses require targeted education in communication techniques that build trust while gathering accurate information about cannabis use. Addressing these barriers has direct implications for maternal and fetal health monitoring, as healthcare providers need accurate information to deliver safe, informed prenatal and postnatal care. The study suggests that organizational support—through clear protocols and clinician training—can transform screening from an adversarial process into a supportive clinical interaction.