"Anything above marijuana takes priority": Obstetric providers' attitudes and counseling strategies regarding perinatal marijuana use.
To describe obstetric provider attitudes, beliefs, approaches, concerns, and needs about addressing perinatal marijuana use with their pregnant patients.



We conducted individual semi-structured interviews with obstetric providers and asked them to describe their thoughts and experiences about addressing perinatal marijuana use. Interviews were transcribed verbatim, coded and reviewed to identify themes.



Fifty-one providers participated in semi-structured interviews. Providers admitted they were not familiar with identified risks of marijuana use during pregnancy, they perceived marijuana was not as dangerous as other illicit drugs, and they believed patients did not view marijuana as a drug. Most provider counseling strategies focused on marijuana's status as an illegal drug and the risk of child protective services being contacted if patients tested positive at time of delivery.



When counseling about perinatal marijuana use, obstetric providers focus more on legal issues than on health risks. They describe needing more information regarding medical consequences of marijuana use during pregnancy.



Provider training should include information about potential consequences of perinatal marijuana use and address ways to improve obstetric providers' counseling. Future studies should assess changes in providers' attitudes as more states consider the legalization of marijuana.
Magee Womens Research Institute Department of Obstetrics, Gynecology and Reproductive Sciences, 300 Halket Street, Pittsburgh, PA 15213, USA.
Cynthia L
CL
Holland
Magee Womens Research Institute Department of Obstetrics, Gynecology and Reproductive Sciences, 300 Halket Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Dietrich School of Arts and Sciences, 139 University Pl, Pittsburgh PA 15260, USA.
Michelle Abena
MA
Nkumsah
Magee Womens Research Institute Department of Obstetrics, Gynecology and Reproductive Sciences, 300 Halket Street, Pittsburgh, PA 15213, USA.
Penelope
P
Morrison
Magee Womens Research Institute Department of Obstetrics, Gynecology and Reproductive Sciences, 300 Halket Street, Pittsburgh, PA 15213, USA.
Jill A
JA
Tarr
Division of General Internal Medicine, Department of Medicine, UPMC Presbyterian Hospital Suite W933, Pittsburgh PA 15213, USA; Center for Research in Health Care University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh PA 15213, USA; Clinical and Translational Science Institute University of Pittsburgh, 200 Meyran Ave, Pittsburgh PA 15213, USA.
Doris
D
Rubio
Division of General Internal Medicine, Department of Medicine, UPMC Presbyterian Hospital Suite W933, Pittsburgh PA 15213, USA; Center for Health Equity Research & Promotion (CHERP) Veterans Affairs Pittsburgh Healthcare System University Drive 151C, Pittsburgh PA 15240, USA.
Keri L
KL
Rodriguez
Division of General Internal Medicine, Department of Medicine, UPMC Presbyterian Hospital Suite W933, Pittsburgh PA 15213, USA; Center for Research in Health Care University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh PA 15213, USA; Clinical and Translational Science Institute University of Pittsburgh, 200 Meyran Ave, Pittsburgh PA 15213, USA.
Kevin L
KL
Kraemer
Department of Psychiatry, University of Pittsburgh, 3800 O'Hara Street, Pittsburgh PA 15213, USA.
Nancy
N
Day
Division of General Internal Medicine, Department of Medicine, UPMC Presbyterian Hospital Suite W933, Pittsburgh PA 15213, USA; Center for Research in Health Care University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh PA 15213, USA; Section of Palliative Care and Medical Ethics, Institute to Enhance Palliative Care; Institute for Doctor-Patient Communication UPMC Montefiore 932W, 200 Lothrop St. Pittsburgh PA, 15213, USA.
Robert M
RM
Arnold
Magee Womens Research Institute Department of Obstetrics, Gynecology and Reproductive Sciences, 300 Halket Street, Pittsburgh, PA 15213, USA; Division of General Internal Medicine, Department of Medicine, UPMC Presbyterian Hospital Suite W933, Pittsburgh PA 15213, USA; Center for Research in Health Care University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh PA 15213, USA. Electronic address: chanjc@mail.magee.edu.
Judy C
JC
Chang
D000328:Adult; D001291:Attitude of Health Personnel; D002188:Cannabis / Q000009:adverse effects*; D003142:Communication; D003376:Counseling; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009774:Obstetrics / Q000379:methods; D011247:Pregnancy; D036301:Qualitative Research
Marijuana; Patient-provider communication; Pregnancy; Substance use