Cannabis use among new mothers. A feasibility mixed-method study to investigate motives and perceptions

To assess the feasibility of recruiting new mothers (0-12 months postpartum) who use cannabis through social media and conducting a mixed-methods study to characterize their cannabis use. This pilot study aimed to gather preliminary data on use motives, behaviors, and objective toxicology to inform future large-scale research.

We employed a cross-sectional, mixed-methods design. Participants were recruited via targeted Facebook advertisements in the Greater Lansing area, Michigan (mid-sized metropolitan region). Eligible participants completed a self-administered quantitative survey on cannabis use and beliefs during a clinic visit, where urine and breastmilk samples were also collected for toxicology analysis. Subsequently, a subset of participants completed a virtual, semi-structured qualitative interview. Interview transcripts were analyzed using an inductive thematic approach.

Social media recruitment reached 196 individuals who completed screening; 21 (11 %) were eligible. Of these, 12 mothers (57 % of eligible) completed the clinic visit and provided biospecimens. Participants reported frequent cannabis use (mean of 24 out of the previous 30 days), primarily via smoking. Toxicology analysis confirmed significant concentrations of delta-9 tetrahydrocannabinol (THC) metabolites in urine and breastmilk. Qualitative analysis (n = 9) identified four key themes: 1) Cannabis use as therapy or treatment, 2) Influences on discussion of cannabis, 3) Risk determination of cannabis use, and 4) Individual risk mitigation behaviors. Interviews revealed predominantly negative interactions with healthcare providers regarding cannabis use and a perceived lack of evidence-based guidelines. Mixed methods integration demonstrated agreement between quantitative and qualitative findings.

This study demonstrates the feasibility of recruiting postpartum cannabis users via social media and collecting rich mixed-methods data, including objective biospecimens. The methodology and preliminary results provide a strong foundation for future larger studies on the impact of postpartum cannabis use on maternal and infant health.