Provider Judgment On Cannabis Use During Pregnancy Causes Patient Mistrust

Many patients believe that a majority of health care providers perceive cannabis treatment as harmful and mainly for recreational purposes. Despite this belief among pregnant and expecting mothers, many have still reported using cannabis to treat pregnancy symptoms and manage their health conditions, according to a study published in Women’s Health Issues.¹

The phenomenon of providers’ sentiments toward cannabis use—as well as patient perspectives on this phenomenon—has created a disconnect that can negatively impact approaches to treating pregnancy symptoms. Overcoming the disconnect, which can be backed by fear of judgment, is crucial for providers to deliver safe and effective pregnancy treatment.

“Recent changes in cannabis policy that have legalized recreational cannabis in many states and increases in cannabis use during pregnancy in the United States have prompted new efforts to inform pregnant people about potential health effects of using cannabis during pregnancy,” wrote the authors of the study.¹ “The literature on health effects of using cannabis during pregnancy is evolving rapidly.”

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According to the CDC, there are a slew of potential health effects that patients can encounter through the use of cannabis during pregnancy. Using it for medical purposes during pregnancy can lead to newborns having low birth weight or irregular neurological development. Among these potential outcomes, the CDC states that more research is needed to better understand the impacts of cannabis use for pregnant mothers and their newborns.²

A previous study from the Canadian Medical Association Journal has reported on the key reasons why pregnant mothers will still explore cannabis use despite the aforementioned health risks. The authors of the study found 3 categories of why cannabis use could be important during pregnancy, including sensation-seeking for fun and enjoyment; symptom management for chronic conditions and those related to pregnancy; and coping with the unpleasant experiences of life.³

Whether or not there is still a lack of knowledge regarding cannabis use and its impacts during pregnancy, researchers of the current study highlighted how mistrust in providers and general patient disconnect caused confusion regarding approaches to using or avoiding cannabis during pregnancy. Providers may be unaware of how to approach conversations of cannabis use with their patients, while patients may not feel comfortable with sharing their thoughts on the drug.

Amid concurrent uncertainties and lack of awareness on cannabis use during pregnancy, researchers wanted to better understand the potential disconnect on the continuously developing issue in the pregnancy space.

“The rapidly changing context could affect how patients and/or providers approach the topic in health care settings,” they continued.¹ “The goal of this study was not to consider the rapidly evolving literature on the potential effects of cannabis use during pregnancy that informs providers' counseling but to examine pregnant people's perspectives on interactions with providers regarding cannabis use during pregnancy.”

For their study design, researchers interviewed pregnant individuals or those who have been pregnant within the past 2 years. Participants also reported cannabis use either before or during pregnancy. The main themes explored in these interviews surrounded patients’ experiences with and perspectives on communication with health care providers about cannabis use during pregnancy.

The final analysis included 34 women (47% aged 26 to 35 years; 67% white) in total.¹

Amid the themes of patient-provider relationships regarding cannabis use during pregnancy, 2 common occurrences were uncovered: most patients did not disclose cannabis use with their providers, and most providers did not initiate discussions around cannabis use during pregnancy.

These reported instances contributed to patients highlighting their distrust in health care providers. The distrust, according to the study results, was also observed in how patients perceived providers’ opinions on cannabis use. Because providers often group cannabis with alcohol and other drugs, participants thought they would be judged or reported to child services if they discussed cannabis use during pregnancy with their pharmacist or primary care provider.

Above all, regardless of the objective outcomes of cannabis use during pregnancy, results of the study highlight a disconnect and common phenomenon in the pregnancy space.

“Pregnant people describe using cannabis as medicine for pregnancy symptoms and other health conditions, yet they experience providers as viewing and treating cannabis like a harmful recreational substance,” concluded the authors of the study.¹ “This phenomenon we identified as clinical dissonance, along with patient fears of provider judgment and of providers reporting them to child welfare, appears to contribute to mistrust that may be limiting effective person-focused discussions regarding risks and benefits of different approaches to treating symptoms and health conditions for which patients are using cannabis.”

READ MORE: Women’s Health Resource Center

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REFERENCES

1. Gould H, Zaugg C, Scott KA, et al. Mistrust limits possibilities for patient-provider discussions regarding cannabis use during pregnancy. WHI. October 10, 2025. https://doi.org/10.1016/j.whi.2025.09.002

2. Cannabis and pregnancy. CDC. January 31, 2025. Accessed October 16, 2025. https://www.cdc.gov/cannabis/health-effects/pregnancy.html

3. Vanstone M, Taneja S, Popoola A, et al. Reasons for cannabis use during pregnancy and lactation: a qualitative study. CMAJ. 2021 Dec 20;193(50):E1906-E1914. doi: 10.1503/cmaj.211236. Erratum in: CMAJ. 2022 Mar 7;194(9):E342. doi: 10.1503/cmaj.220230.