American Indian women's perceptions of perinatal cannabis use

Background: Cannabis use during pregnancy continues to rise, yet research examining cannabis use in perinatal American Indian women is lacking. Structural injustices have led to health inequities for American Indian people, including higher prevalence of past-month cannabis use and lower prevalence of receiving mental health treatment, compared to other racial and ethnic groups.Objective: To describe perceptions of risks and benefits of perinatal cannabis use in a sample of American Indian perinatal women who report regularly using cannabis while pregnant.Method: A qualitative descriptive study was conducted with 10 American Indian perinatal women who reported using cannabis at least weekly while pregnant or postpartum. Participants were from three states where cannabis use is legal for adults (Washington, Oregon, and California). Themes were generated from implicit and explicit participant responses and principles of Indigenous research frameworks were utilized.Results: Four themes were derived from the data: 1) Perinatal cannabis use as better than other substances, 2) Medicinal use and perceived therapeutic effects of prenatal cannabis, 3) Unsure if cannabis use while breastfeeding impacts the baby, and 4) Minimal responses from healthcare providers perceived as approval.Conclusions: Cannabis was used for health-related issues and was perceived to be a safer option for than use of methamphetamine, heroin, alcohol, and prescription pharmaceuticals. With a focus on other substance use issues within participants' communities, minimal discussion about cannabis use by healthcare providers was perceived as endorsement of use, highlighting the need for additional training for healthcare providers.