“Ganja Mamas”: Online discussions about cannabis use in pregnancy

Cannabis is the most frequently used federally illicit substance among pregnant women in the United States (US) (Substance Abuse and Mental Health Services Administration and Mental Health Services Administration, 2019). Increased legalization, decriminalization, easier access, and a pro-cannabis movement have raised questions for the health and safety of women and children (Jarlenski et al., 2017a, Mark et al., 2017). Although the risks of perinatal cannabis use have been the subject of much debate, 4.7 % of pregnant women in the US use cannabis (Substance Abuse and Mental Health Services Administration and Mental Health Services Administration, 2019). Furthermore, 18.1 % of pregnant women who use cannabis met the criteria for abuse or dependence (Ko et al., 2015).

The prevalence of cannabis use during pregnancy is especially notable as the American College of Obstetrics and Gynecologists (ACOG) (American College of Obstetricians and Gynecologists, 2017) advises against the use of marijuana [cannabis] throughout pregnancy and lactation. Similarly, the US Surgeon General recommends that women who are pregnant or contemplating pregnancy avoid cannabis use, citing adverse effects for the developing fetus such as unhealthy fetal brain development and low birth weight (Office of the Surgeon General, 2021). However, the evidence of the impact of cannabis use on perinatal outcomes has been controversial as some studies suggest that the associations are due to confounders; thus, the evidence remains inconclusive (Conner et al., 2016, Gunn et al., 2016).

The dissonance around cannabis use during pregnancy between national health organizations and scientific evidence has left expecting mothers seeking out safety information for themselves. Women have reported the need for better resources as well as improved communication with health care providers around this topic (Jarlenski et al., 2016). Women who disclose cannabis use during pregnancy report either no counseling regarding usage, or dissatisfaction with the quality of information regarding the consequences of cannabis use during pregnancy (Jarlenski et al., 2016, Holland et al., 2016a). When counseling from a medical provider did occur, women reported the discussions being centered around the legal ramifications and child protective services rather than the health implications of cannabis usage (Holland et al., 2016a). A lack of provider counseling regarding cannabis use during pregnancy leaves expecting mothers to seek out safety information for themselves (Jarlenski et al., 2016).

Commonly reported sources of information about perinatal cannabis use include the internet and anecdotal experiences from family and friends (Jarlenski et al., 2016). Consistent with obstetric and pediatric medical society opinions, one study of online media content found that available media items frequently mentioned fetal growth risks and neurobehavioral risks (Jarlenski et al., 2018). However, in a content analysis of Twitter messages, researchers described a general uncertainty about the health effects associated with pre-and post-natal cannabis exposure (Dakkak et al., 2018).

Several studies have emphasized the utilization of online forums and virtual communities across all facets of child-rearing (Appleton et al., 2014, Milne et al., 2017, Pedersen and Lupton, 2018, Ruthven et al., 2018, Aston et al., 2021, Lebron et al., 2020). Beyond traditional sources of information with more didactic descriptions of parenting issues, the experience‐based dialog that online support groups provide can be likened to face‐to‐face support groups in that participants share experiential knowledge and can, in turn, be met with opinions and advice (Doyle, 2013). The objective of this study was to examine the ways in which pregnant women use an online discussion board for information seeking and sharing around perinatal cannabis use.

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