Timeka Thompson

University of Pittsburgh School of Medicine
United States

Abstract Title: Breaking the Silence: Improving Disclosure of Marijuana Use in Pregnancy

Biography:

I was born and raised in Pittsburgh, PA. I am an aspiring OB/GYN and currently a 4th year medical student at the University of Pittsburgh. My pursuit of medicine was influenced by my grandmother’s untimely death from Stage IV lung cancer due to acquired medical mistrust during her upbringing in Tuskegee, Alabama. My goal as a provider is to promote women’s health and bridge the gap of patient-provider trust in the African American community. I maintain my mental health throughout this journey through creativity such as sewing, crocheting, nail art, and painting.

Research Interest:

Background: Marijuana use during pregnancy poses potential health risks to both the mother and fetus. However, many pregnant individuals hesitate to disclose their marijuana use due to stigma, fear of legal consequences, and concerns about healthcare provider judgment. Understanding patient perspectives on disclosure barriers and facilitators can inform strategies to improve open communication in prenatal care settings.

Objective: This study aims to explore the patient experience with obstetric clinicians’ questions or discussions of perinatal marijuana during their first obstetric visit, their suggestions on better methods to ask about perinatal marijuana use, and what influences willingness to discuss marijuana use to their obstetric clinician.

Methods: This study uses semi-structured interviews with pregnant patients who used marijuana during pregnancy from a larger observational study (Talking to Pregnant Patients study, T2P2) investigating patient-provider communication about substance use during obstetric visits conducted from 2011-2015. All interviews were audio recorded and previously transcribed. We coded sections of the transcripts that addressed the topic of prenatal marijuana use and disclosure of this use to healthcare providers.

Results: The primary barriers to disclosure include no intention to quit, concern for legal repercussions, perceived provider judgement, and family members suggesting that substance-use should be confidential. Participants expressed a preference for straightforward, harm-reduction approaches and emphasized the importance of confidential and open-ended discussions initiated by providers. Suggested communication strategies included utilizing direct language such as “marijuana use,” education on perinatal marijuana risks, and shared decision-making.

Conclusion: Enhancing disclosure of marijuana use in pregnancy requires a non-punitive approach that prioritizes trust, nonjudgmental communication, and clear guidance on the implications of use. Training healthcare providers to adopt harm-reduction strategies and ensuring confidentiality in discussions may improve disclosure rates and promote better prenatal care outcomes.