Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study
Objective: To identify perceptions of cannabis use and risk among maternal health providers who provide care for people who use cannabis during pregnancy in safety-net health settings. Methods: Using qualitative, constructivist ground theory methods, we conducted semistructured remote interviews wit...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Mary Ann Liebert
2023-07-01
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| Series: | Women's Health Reports |
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| Online Access: | https://www.liebertpub.com/doi/full/10.1089/WHR.2023.0057 |
| _version_ | 1797345710553694208 |
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| author | Rachel Carmen Ceasar Erin Gould Julia Stal Jen Laughter Michelle Tran Shirlene D. Wang Jordan Granacki Ryan S. Ziltzer Jasmeen Joy Santos |
| author_facet | Rachel Carmen Ceasar Erin Gould Julia Stal Jen Laughter Michelle Tran Shirlene D. Wang Jordan Granacki Ryan S. Ziltzer Jasmeen Joy Santos |
| author_sort | Rachel Carmen Ceasar |
| collection | DOAJ |
| description | Objective: To identify perceptions of cannabis use and risk among maternal health providers who provide care for people who use cannabis during pregnancy in safety-net health settings.
Methods: Using qualitative, constructivist ground theory methods, we conducted semistructured remote interviews with 10 providers (2 midwives, 6 OB/GYN physicians, and 2 OB/GYN residents) in Southern California, United States, between March 15, 2022, and April 6, 2022. We selected participants through selective sampling using a convenience sample and snowball approach. Providers were eligible for the study if they self-reported via survey to being a maternal health provider (e.g., physician, doula, midwife, and so on) providing care in a safety-net health setting and had cared for people who used cannabis during pregnancy in the last year. Analysis drew upon grounded theory methods to document the socio-structural contexts that contribute to provider perceptions about cannabis. This study was approved by the University of Southern California Institutional Review Board (UP-21-00282-AM009).
Results: We identified three categories of provider perceptions of cannabis use and risk during pregnancy: (1) Relying on self-education, (2) Taking a case-by-case approach, and (3) Avoiding cannabis discussions to maintain an alliance with patients. Findings indicate that provider reluctance to counsel patients about cannabis in favor of preserving a therapeutic relationship can overlook the lack of resources and access to health care alternatives available to low-income patients that can shape self-medicating.
Conclusions: Nonpunitive policies and training on cannabis use are critical steps for supporting providers to counsel patients who use cannabis during pregnancy, alongside a harm reduction approach that acknowledges the broader socio-structural contexts and barriers facing patients who disclose use. |
| first_indexed | 2024-03-08T11:22:28Z |
| format | Article |
| id | doaj.art-68862714ed884939bc27c89fd7e99480 |
| institution | Directory Open Access Journal |
| issn | 2688-4844 |
| language | English |
| last_indexed | 2024-03-08T11:22:28Z |
| publishDate | 2023-07-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Women's Health Reports |
| spelling | doaj.art-68862714ed884939bc27c89fd7e994802024-01-26T06:03:57ZengMary Ann LiebertWomen's Health Reports2688-48442023-07-014140040810.1089/WHR.2023.0057Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot StudyRachel Carmen CeasarErin GouldJulia StalJen LaughterMichelle TranShirlene D. WangJordan GranackiRyan S. ZiltzerJasmeen Joy SantosObjective: To identify perceptions of cannabis use and risk among maternal health providers who provide care for people who use cannabis during pregnancy in safety-net health settings. Methods: Using qualitative, constructivist ground theory methods, we conducted semistructured remote interviews with 10 providers (2 midwives, 6 OB/GYN physicians, and 2 OB/GYN residents) in Southern California, United States, between March 15, 2022, and April 6, 2022. We selected participants through selective sampling using a convenience sample and snowball approach. Providers were eligible for the study if they self-reported via survey to being a maternal health provider (e.g., physician, doula, midwife, and so on) providing care in a safety-net health setting and had cared for people who used cannabis during pregnancy in the last year. Analysis drew upon grounded theory methods to document the socio-structural contexts that contribute to provider perceptions about cannabis. This study was approved by the University of Southern California Institutional Review Board (UP-21-00282-AM009). Results: We identified three categories of provider perceptions of cannabis use and risk during pregnancy: (1) Relying on self-education, (2) Taking a case-by-case approach, and (3) Avoiding cannabis discussions to maintain an alliance with patients. Findings indicate that provider reluctance to counsel patients about cannabis in favor of preserving a therapeutic relationship can overlook the lack of resources and access to health care alternatives available to low-income patients that can shape self-medicating. Conclusions: Nonpunitive policies and training on cannabis use are critical steps for supporting providers to counsel patients who use cannabis during pregnancy, alongside a harm reduction approach that acknowledges the broader socio-structural contexts and barriers facing patients who disclose use.https://www.liebertpub.com/doi/full/10.1089/WHR.2023.0057cannabispregnancyprenatal cannabis usehealth care provider knowledgematernal healthsubstance use |
| spellingShingle | Rachel Carmen Ceasar Erin Gould Julia Stal Jen Laughter Michelle Tran Shirlene D. Wang Jordan Granacki Ryan S. Ziltzer Jasmeen Joy Santos Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study Women's Health Reports cannabis pregnancy prenatal cannabis use health care provider knowledge maternal health substance use |
| title | Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study |
| title_full | Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study |
| title_fullStr | Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study |
| title_full_unstemmed | Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study |
| title_short | Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study |
| title_sort | legislation has changed but issues remain provider perceptions of caring for people who use cannabis during pregnancy in safety net health settings a qualitative pilot study |
| topic | cannabis pregnancy prenatal cannabis use health care provider knowledge maternal health substance use |
| url | https://www.liebertpub.com/doi/full/10.1089/WHR.2023.0057 |
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