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Budtender and Doctor Perceptions of Perinatal Cannabis Use

Updated: Dec 15, 2022

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A November 2021 study entitled "Healthcare Professionals' and Budtenders' Perceptions of Perinatal Cannabis Use" that was published in The American Journal of Drug and Alcohol Abuse had the goal of determining "healthcare professionals' and budtenders' perceptions of risks and benefits of perinatal cannabis use." Merriam-Webster defines "perinatal" as "occurring in, concerned with, or being in the period around the time of birth."


Study Conclusions

"Healthcare professionals and budtenders reported that the primary reasons perinatal people use cannabis are for relief from nausea, anxiety, pain, and stress. This corresponds with previous research establishing that perinatal people were using cannabis for health management and sought advice regarding the therapeutic effects of cannabis.


"Healthcare professionals and budtenders reported that the primary reasons perinatal people use cannabis are for relief from nausea, anxiety, pain, and stress."

"Comparisons to prescription medications were made by both healthcare professionals and budtenders, with contrasts between cannabis and 'Big Pharma' highlighted by budtenders, in line with research with medical cannabis card holders who noted fewer side effects with cannabis compared to other prescription medications.


"Non-judgmental strategies (asking questions, seeking additional information, etc.) were discussed by healthcare professionals and harm reduction strategies (CBD and low THC products) were noted by budtenders. CBD, having low to zero THC and different psychoactive effects than THC, is being used by pregnant individuals to help with nausea, pain, and anxiety. However, the U.S. Food and Drug Administration advises against the use of CBD products while pregnant or breastfeeding.

"Previous studies with healthcare providers indirectly support our finding that there is a need for nonjudgmental harm reduction approaches; studies report that healthcare providers, including obstetric providers, do not counsel pregnant patients about cannabis use, or if they do, describe cannabis in terms of policy and legal consequences.


"Pregnant women report feeling stigmatized by healthcare professionals due to gaps in healthcare professional education about cannabis use during pregnancy."

"This is unfortunate as research has established that the threat of CPS often deters women from involvement with the healthcare system. Pregnant women have also reported feeling stigmatized by healthcare professionals due to perceived lack of communication, gaps in healthcare professional education about cannabis use during pregnancy, perceived risk-taking behavior, race/ethnicity or class status, and potential legal ramifications regarding cannabis use.


"Perinatal individuals who violate gender norms and expectations of the 'good mother' are often labeled as risky, resulting in additional stigmatization. Perinatal individuals stigmatized due to their substance use also have barriers in accessing and maintaining support to reduce harms associated with their substance use. This stigma is often even more pronounced for women of color, as structural racism disadvantages women of color who report or are suspected of perinatal substance use, contributing to poor reproductive health outcomes.

"Perinatal patients report seeking additional sources of information from budtenders, internet, friends, and family, and describe interactions with healthcare professionals about perinatal cannabis use as generally unhelpful. Although research with budtenders is limited, they have been described by perinatal people as unbiased and having a customer-centered approach. Taken together, this highlights the critical need for healthcare professional education and training regarding perinatal cannabis use. Indeed, healthcare professionals and budtenders in the current study stated the need for more research, education, and training related to perinatal cannabis use and cannabis products.


There is a "critical need for healthcare professional education and training regarding perinatal cannabis use."

"Healthcare professionals and budtenders reported seeing more perinatal cannabis use yet it was unclear whether the prevalence of perinatal cannabis use was higher, as noted by national trends, or if women were more likely to report cannabis use post-legalization due to more general acceptance and lack of legal consequences. Healthcare professionals noted the need to change their clinical practices to address the increase in perinatal cannabis use, while budtenders observed more postpartum customers.


"Healthcare professionals focused on the possible negative impacts of perinatal cannabis use whereas budtenders presented a wide spectrum of attitudes regarding perinatal cannabis use. Previous research found that many healthcare professionals have reported not being familiar with risks of cannabis use during pregnancy, yet discourage perinatal substance use. Budtenders in this study had a wider range of responses regarding perceived impacts of perinatal cannabis use, yet our results align with those demonstrating that budtenders describe cannabis use as safe for the woman during pregnancy, with few noting concerns about fetal safety.

"Perceived impacts of cannabis use appear to be based on the personal opinion of budtenders, which was the case in the current study. In contrast, healthcare professionals stated that they would follow research and national guidelines regarding perinatal cannabis use, whether or not it aligned with their personal beliefs regarding use. Interestingly, our data do not support perceptions of a spectrum of cannabis use. Instead, our healthcare professionals discussed perceived impacts that they see in infants that were admitted to the NICU and infants that were withdrawing from cannabis, suggesting a binary perspective of no cannabis use versus heavy cannabis use.


"Training is needed for healthcare professionals to assist with patient discussions about cannabis products due to increases in perinatal cannabis use."

"Healthcare professionals and budtenders compared cannabis use to alcohol and tobacco use. Healthcare professionals stated that cannabis (like alcohol and tobacco) is legal yet not recommended or safe to use during pregnancy or while breastfeeding, whereas budtenders stated perinatal cannabis use should not be viewed with the same negative lens as alcohol and tobacco use. Healthcare professionals have described cannabis as less harmful than illicit drugs and our study finds that they view perinatal cannabis use similar to perinatal alcohol and tobacco use, which presents a guiding framework for discussions with perinatal patients.


"Training is needed for healthcare professionals to assist with patient discussions about cannabis products and to manage changes in clinical practices due to increases in perinatal cannabis use. Budtenders also need training on cannabis products and request training on how to best serve perinatal customers. We encourage researchers and healthcare professionals to work with patients and budtenders to better serve perinatal women that use cannabis. Combined efforts are crucial for harm reduction approaches and will help decrease stigmatization perceived by perinatal women who use cannabis."


View the original study.


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