Prevalence and Perceptions of Cannabis Use Among Pregnant and Breastfeeding Women in Illinois

Background and Purpose: Previous research has indicated that pregnant and breastfeeding women use cannabis for fun, stress management, chronic conditions, and pregnancy-related symptom management. However, cannabis use while pregnant or breastfeeding has been linked to other substance use, cannabis-related pregnancy hospitalizations, fetal growth restriction, increased risk of stillbirth, pre-term birth, low birth weight, birth abnormalities, and long-term brain developmental issues. The primary objective of this study was to assess pregnant or breastfeeding women’s cannabis use, the extent of their use, reasons for use, modes of use, and whether specific indicators, such as substance use or mental health, are associated with cannabis use. Methods: Women ages 18 and 50 who live in Illinois and were either currently pregnant or had been pregnant within the last 12 months and breastfeeding participated in an online survey. Multinomial logistic regression was used for all categorical variables. Only variables with p<0.01 were retained in the model, and BIC was used for model prediction and selection. Results: Pregnant and breastfeeding women with and without medical cards preferred dried herb (71.4% vs. 54.4%), tended to use cannabis weekly before, during, and after pregnancy, and were more likely to use for headaches/migraines (46.1% vs. 26.5%) and anxiety (53.3% vs. 30.1%). Perinatal cannabis users with and without medical cards were 4.7 (CI=2.3, 9.8) and 2.4 (CI=1.4, 4.2) times more likely to have severe psychological distress, 2.1 (CI=1.6, 2.8) and 1.5 (CI= 1.2, 1.9) times more likely to have experienced any abuse, and 3.0 (CI=1.8, 5.2) and 2.3 (CI=1.5, 3.4) times more likely to have had lifetime alcohol use, respectively. Conclusions: Perinatal cannabis users with and without medical cards are more likely to have mental health conditions, have experienced abuse, and have experience with lifetime alcohol use compared to perinatal women who did not use cannabis. This may provide context as to this population’s reason for use and weekly frequency of use before, during, and after pregnancy. Perinatal women may be experiencing other adverse experiences and conditions that influence use. Social workers must provide pregnant and breastfeeding women with wraparound services to comprehensively address their cannabis use and any other complex challenges and stressors impacting this population.