Racial Differences in Prenatal Cannabis Screening Among Women at Elevated Risk for Substance Use and Sexually Transmitted Infections.

The sample was limited to 176 pregnant cisgender women at increased risk for sexually transmitted infections and substance use, recruited from clinics in one midwestern state where recreational cannabis is legal, so it may not apply to other pregnant people. Follow-up numbers varied, and not all women completed every assessment, so comparisons over time may be unstable. The study only asked whether a clinician had talked or asked about cannabis. It did not know who started the conversation or whether women experienced it as supportive or stigmatizing. Race was examined without adjusting for socioeconomic variables, and Black women in the sample had lower education, lower income, and more public assistance, so some differences may be tied to those factors rather than race alone. Cannabis frequency and reasons were only assessed at baseline, while clinician communication was asked at every follow-up, so changes in communication over time cannot be compared with changes in cannabis use.

Do not read the higher reporting of clinician discussion among Black women as proof that Black women use cannabis more or that clinicians acted with intentional bias. The study adjusted for prior cannabis use, but it did not know who started the conversation or whether women experienced it as helpful or stigmatizing.