Navigating cannabis use during pregnancy: life trajectories, relationships, and contextual influences.

Background: In Canada, between 3 and 7 % of women have reported using cannabis during pregnancy despite public health recommendations. While fetal risks are well researched, the socio-economic, psychological, and environmental factors shaping cannabis use before and during pregnancy remain underexplored.

Method: Drawing on semi-structured interviews with eighteen women who consumed cannabis while being pregnant in Québec (Canada), this interpretive study explores the meanings pregnant women attach to cannabis consumption throughout their lives and pregnancy, the factors conditioning their decisions, and the impact of their choices on their wellbeing.

Results: Women's decisions to reduce, cease, or continue cannabis use during pregnancy are shaped by their life trajectories, gendered experiences, and broader socio-environmental influences. Pregnancy can serve as a motivation to stop or reduce consumption, but for some, especially those with a deep connection to cannabis, pressure for abstinence can generate stress and anxiety. Moreover, decision-making regarding cannabis use is tied to gender norms and inequalities that shape the meanings pregnant persons attribute to their own use during pregnancy.

Conclusion: This research highlights how the interplay of long-term social, relational, and environmental factors shapes cannabis use during pregnancy. It underscores the need for tailored, non-stigmatizing public health interventions that acknowledges this complexity, while also addressing stress, anxiety, and informational gaps. Providing harm reduction strategies and context-sensitive support systems can help ensuring that pregnant women receive compassionate, evidence-based care to navigate cannabis use during pregnancy.