Cannabis Use Behaviors and Desired Interventions Among Postpartum Individuals With Frequent Cannabis Use in Early Pregnancy: A Qualitative Study.

Background: Cannabis use among perinatal individuals has dramatically increased. Thus, it is crucial to understand postpartum individuals' experiences with cannabis use, particularly during breastfeeding, and desired postpartum interventions to improve the care and well-being of parents and their children. We aimed to understand motivations for postpartum cannabis use and desired interventions for new parents who frequently used cannabis in early pregnancy.

Methods: We conducted semistructured interviews from April to May 2022 with postpartum patients who were first-time parents and endorsed daily or weekly cannabis use during early pregnancy on a universally administered, self-reported screener at prenatal care entry in a large integrated health care system in Northern California. We analyzed the professionally transcribed interviews using thematic analysis.

Results: Our sample included 17 interviews with Black (n=4), Hispanic (n=4), and White (n=9) postpartum patients. Most participants (n=15) reported at least some postpartum cannabis use, two thirds of whom (n=10) reported use during breastfeeding. We identified 4 themes concerning postpartum cannabis use behaviors: (1) cannabis use to cope with mental health and physical pain postpartum, (2) minimal knowledge of cannabis risks with which to make decisions about postpartum use, (3) responsible cannabis use and concern about child's health and safety, and (4) desire for nonjudgmental postpartum supportive services to manage new parenthood.

Conclusions: Findings highlight the need for supportive services for new parents and education on cannabis use while breastfeeding. Health care settings should equip their perinatal care teams with information on how to discuss the current evidence and potential harms and provide appropriate counseling regarding postpartum cannabis use.