Report led by UMass Amherst’s Devon Greyson says a better understanding of why – and how – women use cannabis during pregnancy is key to providing the right support
AMHERST, Mass. – A 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, according to a new article authored by Devon Greyson of the University of Massachusetts Amherst.
As the legal use of medicinal, therapeutic and recreational cannabis expands across the United States, Greyson and co-authors found that those considering or using it during pregnancy frequently rely on their friends, family and the internet for education, as they report experiencing stigma and a lack of information from health care providers. The new article describes the three types of decisions expectant mothers may be making about cannabis use during their pregnancies – desistance, self-treatment and substitution – and suggests approaches health care providers may take to minimize judgment and provide optimal support for their informed cannabis use.
“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 writes in the article, which appears online and in the latest issue of 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 harms. 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.”
To minimize the risk of appearing judgmental, health care providers should examine their own biases and assumptions about cannabis use during pregnancy and lay a framework for understanding the various desistance, self-treatment and substitution decisions people make during pregnancy, writes Greyson, an assistant professor of communication at UMass Amherst.
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, 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 Greyson writes that they should endeavor to help expectant mothers understand the dangers and benefits of the available options regarding substitution decisions, and be open to revisiting the topic over time.
“Health care providers should be able to acknowledge the various reasons for use and provide the most appropriate information and support for each individual’s circumstances,” Greyson concludes. “Use of this proposed typology will help health care providers in this process.”
The complete report, “Desistance, Self-treatment, or Substitution: Decisions about Cannabis Use During Pregnancy,” is available online from the Journal of Midwifery & Women’s Health.