University of Pittsburgh Everybody says weed is good for the baby: Beliefs and attitudes regarding perinatal marijuana use from the perspectives of pregnant women who report continued use. Chang JC, Tarr JA, Holland CL, Rodriguez KL, Sheeder J, Kraemer K, Day N, Rubio D, Arnold RM University of Pittsburgh Study Funded by the National Institute of Drug Abuse (NIDA) R01DA026410-03SI

Background Marijuana is the most commonly used illicit drug during pregnancy in the United States. Two states have recently legalized recreational marijuana use (Colorado & Washington) In 11 states, 50% residents support legalizing marijuana Limited information is known about women’s attitudes & concerns about perinatal marijuana use

Objectives To describe what pregnant women who use marijuana think about marijuana use during pregnancy, their reasons for use, and their concerns for potential consequences.

Study Setting Hospital-based clinic in an urban academic medical center Marijuana use is currently illegal in Pennsylvania

Methods Semi-structured interviews with pregnant women who used marijuana to explore: Use prior to pregnancy compared to use during pregnancy Reasons and concerns about use during pregnancy

Participant Characteristics 17 women Age: 19-36 years; Mean 27 65% African American 18% Caucasian 17% Other 47% high school graduates 23% some college education 18%grade school 12% associates degree

Participant Characteristics 47% Income level <$4,999/year Gravida mean=3.2 ± 1.9; Range: 1 - 7 Para mean=1.2 ± 1.6); Range: 0 - 5

Themes Marijuana is “natural” Helps with nausea and appetite Decreased use during pregnancy Limited information about risks Primary perceived risk is child protective services Women admitted higher amounts of marijuana use prior to pregnancy & attempted to reduce use once they realized they were pregnant Described marijuana helping with nausea & appetite changes during pregnancy Identified the primary risk with perinatal marijuana use was the threat of child protective service involvement in their care Noted limited information regarding risks of perinatal marijuana use on pregnancies & babies

Marijuana is “natural” I consider crack cocaine, you shouldn’t do that. But marijuana, you can actually grow that…. It is just like, it is from the earth. I don’t want to sound like a hippie, but it is from the earth.

Helps with nausea and appetite …I don’t want to smoke marijuana but it helps me not being sick ….

Decreased use during pregnancy I was a heavy smoker then, but when I found out I was pregnant, now, it is just like…I might take two puffs, and then I give it up…I used to smoke sssshhh like 5-6 blunts a day….

Limited information I never once, I could not tell you one thing that happens to you when you smoke marijuana while your pregnant….I mean I know what cigarettes and alcohol does…. There’s so much conflicting research. Like you’ll go on different sites and they say, pros and the cons. So it pretty much evens out so nobody really knows. But if there was more research….

Concerns for potential consequences reported/CYF She didn’t leave no punches. She said you’re going have to quit smoking because when…you have your baby and they test you and your baby, if you come back positive CYF [Child Youth and Families services] will be right there.

Conclusions Although our study participants viewed marijuana as natural and helpful with pregnancy symptoms, they did describe reducing use and wanting more information about risks. The primary negative consequence of perinatal marijuana use perceived by the women was the involvement of child protective services.

Limitations Majority subjects African American Pennsylvania is a non-legal state Perspectives only from pregnant women who use marijuana

Practice Implications Counseling discussions regarding perinatal marijuana use need to include medical & health information and resources, rather than relying on legal threats or child custody concerns.

Need more research [I told my friends] “I’m doing a research study.” They were like, ‘You are so stupid. You are going to get in trouble.” I’m like, “No I’m not… I’m helping. I’m helping them learn.” It is just like everyone tries to say, it is just bad. It is going to hurt the baby. So, I want to see what happens. I want to know….