Motivations for Cannabis Use During Pregnancy: An Analysis of 2017-2021 Pregnancy Assessment Monitoring System Data

Prenatal cannabis use is becoming increasingly prevalent throughout the United States. Yet little is known about how motivations for cannabis use vary across maternal sociodemographic characteristics or how motivations are related to frequency of use. We aimed to address these evidence gaps via a comprehensive descriptive analysis of existing surveillance system data.

Using data from the 2017-2021 Pregnancy Risk Assessment Monitoring System Marijuana Supplement, we estimated weighted prevalence estimates of self-reported motivations for cannabis use during pregnancy. We examined variations in motivations across sociodemographic characteristics and frequency of use. We also examined write-in responses for motivations for cannabis use.

In our sample representing approximately 802,954 live births from 10 U.S. states, the most common motivations for prenatal cannabis use were for mental health reasons (82.81%; 95% confidence interval [CI]: 77.52, 87.06), to relieve gastrointestinal symptoms (77.10%; 95% CI: 70.51, 82.59), to relieve pain during pregnancy (48.67%; 95% CI: 41.84, 55.56), for fun or relaxation (40.18%; 95% CI: 33.69, 47.04), and to relieve symptoms of a chronic condition (26.31%; 95% CI: 20.55, 33.01). Most women (84.32%) reported two or more reasons for use, which was associated with daily or near-daily use. Qualitative analysis of write-in responses identified alleviation of pregnancy-related symptoms (e.g., nausea/vomiting, appetite, sleeplessness) as the most common motivation for use (54.90%).

Given a growing body of evidence about adverse health outcomes associated with prenatal cannabis use, findings underscore the importance of patient-provider communication and messaging about safe alternatives to cannabis use during pregnancy.