Cannabis legalization may have made use easier in pregnancy – NCAL Research Spotlight

Kaiser Permanente researchers conduct focus groups with pregnant patients who say California law has reduced cannabis stigma

Jean Green

California’s legalization of adult-use cannabis may have reduced the stigma and increased availability of cannabis products during pregnancy, according to new research by investigators at Kaiser Permanente.

Dr. Kelly Young-Wolfe, M.P.H.

Their study, published Dec. 14 at JAMA Network Open, reported insights from 18 virtual 90-minute focus groups involving 53 black and white pregnant patients who said they had used cannabis during their first trimester of pregnancy. Did.

Many women say that the reduced stigma not only made them more likely to use cannabis during pregnancy, but also made them more comfortable talking about it with their doctors. does not endorse prenatal cannabis use due to the potential harm it can cause to the baby after birth, including low birth weight and potential neurodevelopmental disorders.

“This focus group study is very important because we were able to hear directly from patients who use cannabis during pregnancy and it provided us with rich, valuable and actionable qualitative data.” Kaiser Permanente Research Department. “These findings can be used to improve patient-physician communication, inform health-promoting cannabis regulations, and educate cannabis retailers.”

Understanding Increased Use

Young-Wolff and her research team published a study documenting an increase in prenatal cannabis use over the past decade, among pregnant patients experiencing nausea, depression, anxiety and trauma. I have found that it is more likely. Their study used unique data from routine prenatal substance use screening of a large, diverse population at Kaiser Permanente Northern California (KPNC).

For this qualitative study, the research team recruited women who used cannabis prenatally and interviewed them firsthand about how and why they use cannabis, with a focus on the impact of California’s legalization. Recreational cannabis use was approved by her voters in 2016 and legal sales began in 2018. Researchers included pregnant patients who self-reported daily or weekly cannabis use during pregnancy to reach people for whom cannabis may play an important role in their lives. rice field.

It was clear that patients wanted more specific information about how cannabis might affect their health and that of their babies.

-Dr. Esti Iturralde

Participants consistently stated that since legalization, cannabis use has increased among pregnant individuals they know, making cannabis use more acceptable both generally and during pregnancy. Legalization has also made some women more willing to discuss cannabis use with their female health care providers. One participant said she stopped using it during pregnancy as a result of a conversation with her obstetrician.

Andrea Green, PsyD

Findings suggest that legalization has not only reduced barriers to prenatal cannabis use but also created opportunities to better support pregnant patients who use cannabis.

“For some people, cannabis is so ingrained in their lives that we need to be able to talk about it,” said Kaiser Permanente psychologist Andrea Green, who led the black women focus group. Green is working on a KPNC Early Start program that supports pregnant patients: “They want to feel like they can have these conversations with their doctors without being judged.” “They may go into labor and delivery and have cannabis use listed on their charts, but they simply don’t want to be treated differently. It’s especially important for black women who have a hard time making fun of whether they’re being treated differently because they’re, or otherwise, because they want to be treated with respect.”

Participants also voiced how legalization has contributed to greater access to cannabis through ubiquitous cannabis retailers, delivery options, marketing and advertising. In general, participants trusted cannabis retailers to offer safe products and provide expert advice on the types of cannabis products to use for pregnancy-related symptoms. They described their relationship with Battender as providing a sense of community rather than being judgmental.

Dr. Tara Foti

Dr. Tara Foti, M.P.H., a research fellow in the research division who led the focus group on white women, said many of them were skeptical about using legitimate products that researchers thought would be beneficial. “For some women, there is a sense of being pioneers and lighting the way to better acceptance of cannabis use,” she said. she said.

“These focus groups have provided us with important insights into how rapidly changing cannabis policies affect the lives of pregnant people,” said senior author Esti Iturralde, Ph.D. “It was clear that patients wanted more specific information about how cannabis could affect their health and that of their babies.”

Regulation, education may follow

Armed with focus group insights, the authors developed a list of potential interventions and research opportunities to reduce cannabis-related harm for pregnant individuals. restrictions, billboard advertising restrictions, and prohibitions on health claims related to pregnancy or breastfeeding. They also emphasized the need for more research to know the risks of different products and methods of use during pregnancy.

Dr. Esti Iturralde

The researchers also propose research and education focused on individuals working in cannabis retailers known as batenders, learn about their attitudes toward prenatal cannabis use, and learn about the latest research on health effects. offered to offer. “It will be important to leverage battening relationships with customers to support future public health interventions,” said Young-Wolff.

The research team plans to publish further qualitative research on desirable information on perceptions and risks of potential harm in pregnant women, the balance of advantages and disadvantages of different dosing regimens, and the impact of the COVID-19 pandemic. .

This study was funded by the National Institute on Drug Abuse and the Research Health Equity Research Supplement Division, which is supported by Kaiser Permanente Northern California Community Health.

Additional co-authors were Andrea Altschuler, PhD, Monique B. Does, MPH, Melanie Jackson-Morris, MS, Sara R. Adams, MPH, and Maha N. Mian, PhD from the Research Department. Deborah Ansley, MD, Amy Conway, MPH, and Nancy Goler, MD of The Permanente Medical Group.

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About the Kaiser Permanente Research Division

Kaiser Permanente’s Research Division conducts, publishes and disseminates epidemiological and health services research to improve the health and care of Kaiser Permanente members and society at large. We aim to understand the determinants of disease and well-being to improve the quality and cost-effectiveness of healthcare. Currently, DOR has more than 600 staff working on more than 450 epidemiological and health services research projects. For more information, visit or follow @KPDOR.

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