Perceptions about cannabis use among females of reproductive age who use medical cannabis.

Context Δ-9-tetrahydrocannabinol (THC) can cross the placenta and pass through breast milk. Limited research suggests potential harms to fetal/child development after an in-utero or breastmilk exposures, but the extent of such exposure is not well-understood.

Objective To assess the extent, experiences and perceptions related to cannabis use during pregnancy and lactation among reproductive age females who use medical cannabis.

Study Design An anonymous online survey was administered to medical cannabis dispensary clients between August and October 2023. Descriptive statistics were used to characterize the sample, and chi square or independent sample t tests were used to complete between-group comparisons.

Setting Medical cannabis dispensary in south-central Pennsylvania.

Population Reproductive age (18-55 years old) females, clients of medical cannabis dispensary.

Instrument Online RedCap survey collecting data on demographics, and cannabis-related use, experiences and perceptions, especially during pregnancy and lactation.

Outcome Measures N/A Results Among 847 respondents (87.1% white, average age 36.2 ± standard deviation 9.5 years old), almost one-half believed that cannabis was safe (44.0%) during pregnancy or lactation, while 22.3% viewed is as unsafe, and 33.7% were unsure. In this sample, 264 (31.2%) reported a history of pregnancy or lactation (PL group).

Within the PL group (n=264), the majority viewed cannabis use as safe during pregnancy or lactation (n=183, 69.8%), while the rest viewed it as unsafe (n=23, 8.8%) or were not sure about it (n=11, 21.4%). Females who perceived cannabis use as unsafe, reported decreased cannabis use during pregnancy or lactation compared to those who did not view it as unsafe (p<0.001). Those who recalled receiving counseling regarding cannabis safety during their pregnancy or lactation (n=103, 39.0%) were more likely to view cannabis as safe (p=0.01) and increase/not change their cannabis use (p=0.01) during pregnancy or lactation, compared to those who did not report any counseling (n=161, 60.9%).

Conclusions Medical cannabis use is common among females of reproductive age who often perceive it as safe during pregnancy and lactation. Safety perceptions can impact cannabis use during pregnancy or lactation. Development and universal implementation of evidence-based, effective counseling could help shape safety perceptions and reduce unsafe use of cannabis during pregnancy and lactation.