A University of Massachusetts at Amherst researcher says greater understanding of why expectant mothers choose to use cannabis during their pregnancies, and how they take the drug, are key for health care workers to be able to determine a course of support.
“The motivation and decision to use, or to reduce or stop using, cannabis during pregnancy has clinical import because it is likely related to health outcomes for both the pregnant person and the fetus,” Greyson wrote in the Journal of Midwifery & Women’s Health.
“However, current practice guidelines, as well as much research to date regarding cannabis use during pregnancy, do not differentiate between reasons for cannabis use, nor for the mode of ingestion. This limits the utility of recommendations when faced with complex cannabis use decisions, such as substitution of cannabis for another substance known to cause harm.”
Greyson said understanding the cannabis use decisions faced by pregnant individuals “is important in order for health care providers to offer the most appropriate information and support.”
As the legal use of medicinal, therapeutic and recreational cannabis expands across the United States, Greyson and co-authors found those considering or using it during pregnancy frequently rely on friends, family and online sources for education, as they report experiencing stigma and a lack of information from health care providers.
Greyson describes three types of decisions expectant mothers may be making about cannabis use during their pregnancies – desistance, self-treatment and substitution. It suggests some approaches that health care providers may take to minimize judgment and provide optimal support for their informed cannabis use.
Greyson said that minimizing the risk of appearing judgmental is important to the effectiveness of health care providers. Laying a framework for understanding the various decisions people make during pregnancy involve an understanding by providers about the own assumptions and possible biases.
When supporting individuals making decisions to quit or reduce cannabis use, Greyson writes that attention should be paid to potential adverse consequences, such as withdrawal or the return of symptoms for which cannabis was being used, and that support should be provided for those for whom cannabis was a part of meaningful social interactions.
In cases of self-treatment decisions, Greyson said health care providers should help pregnant individuals explore the full array of treatment options for their symptoms and present evidence of their effectiveness and risks, and should endeavor to help expectant mothers understand the dangers and benefits of the available options regarding substitution decisions Periodically revisiting the topic over time can be helpful.