Exploring the Influence of Recreational Cannabis Legalization on Women’s Perceptions and Experiences with Perinatal Cannabis Use: A Qualitative Meta-synthesis

TL;DR

This study explores how legalizing recreational cannabis affects women's views and experiences with using cannabis during pregnancy and childbirth.

Contribution

The study introduces a theoretical model illustrating the complex factors influencing perinatal cannabis use decisions.

Findings

Eight themes were identified, including legalization, stigma, and clinician-patient relationships.

Women's decisions are influenced by social, structural, and contextual factors.

There is a lack of clear messaging and non-stigmatizing healthcare around perinatal cannabis use.

Abstract

We aimed to explore how women living in places with legalized recreational cannabis perceive perinatal cannabis use, and how legalization potentially impacts their experiences.

Between September 2024 and December 2025, we searched databases including PubMed, CINAHL, Scopus, PsycINFO, and Web of Science. All research reports were screened and evaluated based on the inclusion and exclusion criteria. Theory-generating qualitative meta-synthesis methodology was used to extract, analyze, and synthesize the findings from included qualitative research reports. Quality appraisal of each study was also conducted.

Nineteen qualitative research reports were included, and eight themes were identified. Themes included (1) recreational cannabis legalization, (2) clinical policies and practice, (3) stigma and discrimination, (4) access to and desire for information, (5) clinician-patient relationships, (6) most trusted sources: family and friends, (7) perceptions and experiences and (8) self-management.

This qualitative meta-synthesis highlights the complex interplay of public policy, institutional and community, interpersonal, and intrapersonal factors influencing women’s perceptions of and experiences with perinatal cannabis use, as well as provides valuable insight into the decision-making process. These implications can help inform targeted public health and clinical practice interventions to address the complexities of cannabis use during the perinatal period.

Recreational cannabis legalization is rapidly expanding, and cannabis use during the perinatal period could increase even further as a result. Despite known adverse effects on maternal and child health, the growing literature suggests women continue to use cannabis perinatally for its perceived symptom management benefits and safety misconceptions. Social, structural, and contextual factors influence women’s decision-making about perinatal cannabis use. Although this is a multi-faceted issue, the lack of clear cannabis messaging, perinatal health and cannabis education, and non-stigmatizing patient-centered healthcare for the perinatal population are critical gaps. Our theoretical model visually illustrates the intersecting factors driving perinatal cannabis use decisions.

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