Buying ganja Vestfall
Buying ganja VestfallBuying ganja Vestfall
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Buying ganja Vestfall
Go ahead, be particular. Welcome to North Coast Provisions. Your Premier Cannabis Dispensary. Michigan Born, Michigan Raised. See Today's Specials. Our Specials. Our Products. Featured Strain. Dyno Candy. The plant grows thick, sturdy and uniform branches that develop massive buds that stack with medium node spacing creating the perfect balance between density and yield. The effects carry through heavier characteristics from the Modified Mints side as it brings forward a true medicative and relaxing experience that can help with insomnia and pain relief. View In The Shop. Our inventory rotates, and some strains may not be available at all times. Thank you for your understanding! View All Featured Strains. Upcoming Events. Adrian , E Beecher St. Adrian , MI United States. Sault Ste Marie , W 8th St. Ann Arbor — Arborside , Packard St. Vendor Day, Giveaways, and More! View All Events. Higher Education. New to cannabis? Explore more educational cannabis information. View All. Rewards Program. We appreciate you. Let us show you how much. Earn free products, Loyalty Deals, and more. Learn More. Some Love. Brian Freeman 19 Oct The weed is amazing. The smell and price are amazing. They have the best deals in town. Tops shops and smokes. Deb Van Horn 19 Oct The staff is knowledgeable and friendly. Paul Miles 18 Oct Alicia Vorpagel 17 Oct Tommy is the man! You guys are totally awesome! Great prices and great service! Candice Hunter 17 Oct Adesa is an amazing bud tender. Today's special is lightfarms I asked her what she recommended and she showed me the 5pk infused preroll. I bought and love it! Thanks girl you rock!!!!! Skyler Shank 15 Oct Jordan helped me out and got me a good deal! Jake Casper 15 Oct Skylee was super helpful and very professional. Steve Sunkel 14 Oct Great budtenders, Caitlin took good care of us. The facility is clean and well maintained. Jane wanzeck 14 Oct Great worker I appreciate good service and she gave it. Dylan Smith 14 Oct Penney Russell 14 Oct Very friendly and knowledgeable staff. Great first time experience. Allison Stull 09 Oct Tiffany Berg 09 Oct Jacob Mcclellan 07 Oct Brandon 07 Oct Taylor G. Jessica Turner 06 Oct Amber was attentive, knowledgeable, and funny! Lisa Taylor 06 Oct Ayanna Johnson 06 Oct Michael 03 Oct Bee a great experience every time. David 03 Oct Gabrielle Urrutia 03 Oct James was wonderful , got us the best deals and did it quick fast and in a jiffy but also was pleasant conversationalist as well as doing his job at the same time, thanks bubs for making my first time there a great experience because the whole atmosphere of the place was already groovy when I walked in but James definitely completed the whole scenery. Felicia Smith 02 Oct Everyone is so nice and the place is well set up. Definitely my favorite dispo. Pierre Collins 02 Oct Miguel Avila 02 Oct Excellent service, prices for products are awesome! Brandon Fraley 01 Oct Came here to visit my buddy and he said we had to make the trip. Top tier! Audrey Munther 27 Sep Amazing staff! Great deals! Aaron A 27 Sep Excellent service as always. There's a reason this is where we come despite so many others around!! Steven Casarez 27 Sep Great place to shop love the works they treat you like your one of there family members. Jessica Tabernero 27 Sep Amber King 26 Sep Open communication, very friendly and knowledgeable people. The place to be!! Skylee is simply the best. Trevor Ridgway 25 Sep James was the best! Hooked me up with some sick ass moonrocks! Art Ingmire 25 Sep Teresa Bowers 24 Sep Awesome store and great prices. Kendra Buckingham 21 Sep Best quality only place I go. Mike Thomas 21 Sep Jordon hooked me up good. Gave me ideas on some new brands to try. Gloria Stegg 21 Sep Love this place people are very nice. Tom and Jerry, thank you so much. Brenda Phipps 21 Sep Tj Edwards 20 Sep Great 1st experience with the Jordan the absolute pro, I'll be back. Jacob Kirkpatrick 20 Sep Alec Metta 20 Sep Matt Bailey 20 Sep This is my favorite dispensary, always has the best products and deals! Nicole Winfrey 15 Sep Stephanie Kruger 15 Sep Kellie was very helpful and knowledgeable about products I was getting. What was also great about Kellie is her down to earth, friendly demeanor. She was fun to chat with. Cheyenne Franklin 15 Sep Everyone at Northcoast was amazing and helped us out so much! Connie Sarabia 15 Sep Towndrunk 11 Sep Justin Brooks 11 Sep Friendly and knowledgeable staff great experience. Christina Brode 11 Sep First timer here and this place is amazing friendly staff super chill vibe. Juan Casarez 08 Sep Morgan Atwell 08 Sep This may be the happiest place in the world. Caitlin was a super star! I cant wait to go back! Awesome selection and the all the staff are just amazing. Brandon Wiesman 08 Sep Northcoast is my main go to dispensary everything is always great quality. And if your lucky enough to get Adesa as your bud tender makes your time there even more enjoyable and puts a smile on anyone's face. But really shootout to all the bud tenders yall have a awesome crew won't catch me in any other dispensary. Victor Dom 07 Sep Amber was great and it was a good a smooth time getting what I wanted. Jefferson 07 Sep Great customer service courteous always give free water and coffee. Helen Burman 06 Sep Kellie H gave me awesome service! Thank you. Michael Ferguson 05 Sep Alanna Baker 04 Sep Great deals on the pre-rolls. Caitlyn took great care of me with my order!! Bryon Rudd 04 Sep Tessa Taylor 04 Sep Ezra Marks 04 Sep Jennifer Sullivan 31 Aug Kaitlin is the best!! Great friendly and knowledgeable service!! Tara King 31 Aug Maddie Linares 31 Aug I went to North Coast for the first time the other day. Amber was my bud tender she has one of the best most outgoing personality I felt so welcome when walking in Shes so bubbly and Has great customer service. Definitely Makes me want to come back for sure!! Brittney Phillips 31 Aug I love north cost Amber K. Is my favorite bud tender she always knows exactly what I want and helps me get the best deals. Bervia Clark 31 Aug Vibes are vibing, super friendly staff, love the deals!! J James 31 Aug Best deals and hospitality. Quick, quality service. Caitlin was my budtender this afternoon and what a joy it was shopping with her. Adesa did an amazing job, she is very friendly. Jamal 30 Aug Great place. Nice selection. Great people. Bryan Combs 25 Aug Matthew Williams 24 Aug Caitlin was so great I would recommend this place. Paulyboy 24 Aug I was just in the neighborhood visiting. Caitlin was exceptional and super helpful. Ann Clifton 24 Aug Caitlin explained the various products available in market. I was impressed with her knowledge, kindness, and appreciated the time she spent with me. I will be shopping again with her in the near future. Sara Johnston 24 Aug Caitlin was amazing!! Was able to answer all my questions. Hayden Van valkenburg 20 Aug Amelia hooked me up with everything I wanted! Thomas Herrera 19 Aug My budtender was super friendly and knowledgeable. It was a great experience. Can't wait to try this delicious smelling product. Shalle Clark 19 Aug Kelly is so helpful. She always helps me pick out the perfect medication for my pain. She's always smiling and cheerful and I love seeing her! Randy kirkbride 18 Aug Joel Dickerson 18 Aug Excellent selection! Friendly, helpful staff, and good prices! I will be back Jordan was very knowledgeable and enthusiastic! Thanks a bunch! Dan Stevens 17 Aug Kimberly May 14 Aug Love this place. Jordan was the best bud tender. Kelly has best customer service. Nathaniel Hurley 14 Aug Very relaxed atmosphere and friendly staff. My budtender helped me with any and all questions. Koda Plain 13 Aug Awesome place. Great staff. Amelia was nice and took her time to make sure I got the best product for the best deal. Most Games 12 Aug Hollywood Collective 12 Aug Best shop in town! Super friendly staff and great deals all over the board. Jasmine Flores 11 Aug Excellent customer service and great products!! Curtis Ryan 11 Aug Carrie Bennett 09 Aug Great dispensary, amazing service will definitely be coming back. Mike Diesel 08 Aug Nice clean and good people! Good product. Curtis Ogles 08 Aug Great place nice staff great product. Deangelo Gunter 07 Aug Best place in Adrian to go with great prices. Evelyn Lambert 07 Aug Nice employees and reasonable prices good quality. Ladonna Guerrero 06 Aug Great place keep prices love it. Dj Esterline 06 Aug You can never go wrong with bud club app! Nice discounts, nice product, although i would like to see them get a bit deeper into the concentrate realm. Robert Beck 05 Aug Best place in MichiganAwesome people. An all around great experience. Lucille Shindler 03 Aug Best, that's the spent 3. I've ever been to friendly courteous. Great atmosphere. Crystal Rosas 01 Aug Very great customer service. Bradley Guild 01 Aug Roxanne Rosas 01 Aug Wonderful Quality dispensary verry awesome especially Skyler! Dean Ross 01 Aug Good prices, great staff, good weed Jason Ross 31 Jul Great experience ordering online and troubleshooting order issues seamlessly. Hayden made it quick and easy. Megan Moore 27 Jul Love north coast they are always so helpful. Braydin Evans 27 Jul Great selection and prices! Mamabear 27 Jul Such a cute small place, staff is super friendly and helpful!!! Will definitely come back!!!! North Coast is the best! Great people and great products at a really good price. Can't beat it! William underwood 26 Jul Paul Martin 26 Jul Love this place bud tenders are amazing! Great Service and Good Product. Jake Kolle 21 Jul Haley Burgos 21 Jul Charles Wilson 21 Jul Greg Meyer 20 Jul Kellie was awesome! Felicia Guedea 20 Jul Kellie is the most amazing bud tender. She's always giving the best recommendations. Cole Gillen 20 Jul Mandee Bagley 20 Jul Eric N 15 Jul Everyone there was very polite, and just so friendly. Amber was very knowledgeable about the products and walked us through every step. Carie Pope 14 Jul Kenneth Roberts II 14 Jul Mary Brown 14 Jul Joseph Bender 14 Jul Amber helped me find some gas. David Davis 09 Jul Customer service is fantastic! Amazing deals. Only shop I will go to. Love this place really friendly people and they always have a good selection. Luke Mcgraw 08 Jul Good place friendly staff highly recommended. SIerra Orner 07 Jul The greatest experience ever because they gave me a wonderful discount and I got super high of their products. Nick Hartford 06 Jul Maria was Friendly, helpful, and courteous. NOT to mention easy on the eyes. Give her a bonus!!!!! Logan Johnston 03 Jul They are always helpful and explain everything. Love it there!!! Maria was awesome friendly kind and helpful and explained and made me make the right choice! Skylee is amazing also! So sweet! Robert 02 Jul They always know what I need to help me get the right stuff very helpful They always know what I want what I mean. What will hell very thoughtful friendly the best surround. Lisa Benson 02 Jul Maria is always smiling and very knowledgeable about the products. When we see her we are always happy customer. She is a big asset to your business. Jen Frank 01 Jul Maria was very knowledgeable and helpful made our shopping there much easier. Tim Benson 01 Jul Brad Degner 27 Jun Cody Gower 27 Jun Penny L. Pierce 27 Jun Taylor was so helpful and patient. Love North Coast!! Dave Evans 26 Jun Excellent service, Amber is the best…. Marie Shoemaker 26 Jun Love this place, budtender was patient and kind with my father, as he asked tons of questions. Daniel Scutchfield 25 Jun Jordan really knows what the hell he's doing! William Guthrie 25 Jun Great little dispensary that I'm sure I'll return to on every trip to Adrian. Love the different types of hash and the clones look great! Plus it was nice talking to Thomas, one of my good friend's son in laws, who works at North Coast Provisions. I made another visit to North Coast today, needed more hash, and Jordan was incredible! Very knowledgeable and friendly. Bing Adams 21 Jun Caley Twigg 20 Jun Adesa was very friendly and the best at explaining to me my options and what would work best for me I highly recommend seeing her when you come here. Royce Craft 20 Jun Maria was very personable and very nice to deal with! Casey Holland 20 Jun Some of the best service I've received at any store, anywhere. Solid lineup of products Outstanding Bud!! Jordan the Budtender is very knowledgeable. There are a lot of dispensaries around. William Hampton 20 Jun I love going here. And Adesa is beautiful, and very nice. I'm infatuated with her. Donald Lawson 15 Jun Great experience! We were in and out after arriving an hour before closing on a Friday. Hayden was super helpful! Thanks, man! They have a great selection and a few things I wasn't expecting to find. I'll definitely be a repeat customer. Hollie Beth 14 Jun Anthony Ford 14 Jun Love the people, love the atmosphere! Always Great service, Great deals, and a Great time! Thomas Tanner 14 Jun Jordan's knowledge and energy is unmatched! Frank Stout 14 Jun Great place very friendly and helpful. Very low prices. Quilty is amazing i would recommend them to anyone. Lyndi Philo 13 Jun Caitlin is amazing and made my experience at North Coast incredible so friend so helpful. Just love her and everyone on the team at North Coast. Amazing priece and deals. James Duncan 10 Jun The customer service was excellent my budtender was amber verry knowledgeable it was a great experience. Ben-n- Syder 10 Jun Amber was the best Amazing attitude. Sarah Demlow 10 Jun This place is awesome and has great deals! Adesa has helped me and she is always knowledgeable, super helpful, and friendly. Maximilian Swain 10 Jun Amber is the best! Always helps. Lynn Swain 10 Jun Man Amber is the most thoughtful and attentive bud tender. Daniel Brooks 09 Jun Keep up the great work. Ashley MacHardy 09 Jun Kind and knowledgeable staff. Adesa Seymore was very helpful! Erica Adams 08 Jun Julia Mohr 08 Jun Adesa is the best!! I am so thankful for the awesome workers at NC, from the front desk, bud tenders and managers. Special shout out to Caitlin this time! Lisa Barnett 03 Jun Awesome crew and amazing prices will be back. Uncle Sunkel 03 Jun Crew is courteous and friendly. The inventory could use some improvement. Each time I have visited, the only available flower is mid to lower potency. Damien Moor 03 Jun Service was great but bud was even better thanks ncp. Billy The kid 02 Jun Bry C 02 Jun This place was recommended by a friend, so I decided to stop by, and I'm glad that I did. The staff is really friendly and Caitlin who helped me was highly knowledgeable about the variety in product. She helped me find a strain to help with what I was looking for. They had really good deals at the time. I even got to spin a prize wheel for an extra goodie at the end of my purchase. Would definitely recommend. Kathy Byers Frost 01 Jun She was very nice and helpful and maid my purchase an easy one. Laura Blatnica 28 May Caitlin knows her stuff and I love her vibe. I always have a great experience when I stop in. Michael B 28 May Very helpful and informative. Dawn Quilantan 28 May Kayla Hurley 28 May Wouldn't go anywhere else! Caitlin knows her stuff. Great with customers, super laid back! Highly recommend. Brandon Friedrich 27 May Xavier Hall 27 May Karen Kemp 27 May Maria R was very knowledgeable about products and was very helpful. Amber Hamrick 26 May Awesome experience!! My favorite place to stop!!! Ralph Boozer 26 May Mark Staniszewski 24 May Always get excellent service,recommendations,from Thomas! He suggested a cartridge or 2 of which I am very pleased with purchasing. Thanks Thomas! Richard Warnke 24 May Best deals and budtenders around, point program is top notch. Amber, Maria, and Tommy are always on their game. Ashleigh Nicole 24 May Everyone is so friendly and helpful. Jacob Armstrong 24 May Fast reliable good tasting product best price in town always looking to give you a deal. Brent Staub 23 May My budtender was very helpful in guiding me to a purchase that fit my needs. Brittany Griffith 23 May Best dispensary in town! It really makes for the best experience! Adesa is my favorite budtender! She always has the best recommendations, takes time to answer my every question, and has the brightest personality! Ryan Joseph 23 May Jay T 23 May I will never give you guys service again. Endo will be getting all my business from now on. Step your game up guys and learn how to treat people with respect. Big Jon 23 May Steven Simon 20 May Hayden was awesome definitely be back. Shelly McCullough 19 May Hayden was awesome. Friendly, quick, and very efficient. Anica Hallaman 19 May I love this place, all of the employees are always very helpful, knowledgeable, and enjoyable to do business with. The store always seems to have deals and specials going which is awesome, and also a great selection, highly recommend! Fernando was super helpful and professional! Im glad that the rep amber knew about the products and def sold myself stuff that would help my pain. We will be back again thxs. Shannon Miller 19 May She was awesome! Gave options and knew the product. Nicholas Thomas 11 May Jon Adamus 10 May Found North Coast and now this is the only place I go! Visit Adrian location great people great prices! Ann Arbor also! Richard Kanneman 09 May Emmalyn Kukura 07 May Great experience, good vibes. Ryan Whittymore 06 May Erik Schilling 05 May Great weed, great prices. My preferred dispo. Hannah Tunis 04 May Chris Ritchie 04 May Always friendly experience and the house flower is top notch. Alex Shareef 04 May Erica 29 Apr Great atmosphere and good prices. William McIntosh 27 Apr Best dispo in Adrian for sure! Boutique feel with great products and prices. Traci Cardwell 27 Apr This is the absolute worst dispensary that I have ever done business with. Never have delivery drivers. Would not shop here! This dispensary is awful! Amazing buds always comes through!!!! Bobby Shindler 26 Apr Joseph Wince 25 Apr Chill, friendly atmosphere with knowledgeable tenders. Great product selection for med and rec. Competitive prices, awesome deals and a rewards program. Only spot I go to. Vishal Reddy 22 Apr Very modern looking dispensary Ashlyn 21 Apr Google said you guys were open until 12, I drove from Toledo to come shop and was closed was very disappointed. Keeli Crutchfield 21 Apr Love it here!! Dj Butler 16 Apr Great deals all week, deli style flower selection is a plus! Bud tenders are always friendly, Kellie was helpful last trip as alwaysmust try store.. Kevin Wrobleski 14 Apr Kerry Coon 12 Apr Best dispensary in Adrian!! Staff is knowledgeable and patient. Great prices too!! Alyezaih Goncalves 12 Apr This is a great place to go to get some real mellow trees at a decent price, the place is inviting and staff are very friendly. Jon Smith 11 Apr Great place everyone is very helpful. Vayda Hahn 11 Apr I'm unsure who handles their ATM or if it differs from credit purchases in store but I will never use my card here again. Matthew Sharp 06 Apr Kelly Davis 06 Apr Northcoast rocks!! Best prices and friendly peeps around. Alex Davis 06 Apr Nothing but rude and inexperienced budtenders. Other than free cheap grab bags once a month this place is not worth your time. Manager with the curly hair and gray bear sweater as even ruder. Theatrical Wardrobe Union 05 Apr Bradley Christina 03 Apr Amazing place. Great product. Queen Mac 01 Apr Best dispensary in lenawee hands down! David Hermansen 01 Apr Shane Thomas 31 Mar Great place to shop great medicine. Bre Bingham 31 Mar Tynell Todd 29 Mar I love the bud nd the people. Nathaniel Curtis 29 Mar Amazing products. Caity 28 Mar Delilah Avila Lale 26 Mar J G 22 Mar
Daily Cannabis Use During Pregnancy and Postpartum in a State With Legalized Recreational Cannabis
Buying ganja Vestfall
Official websites use. Share sensitive information only on official, secure websites. Spokane Falls Blvd. E-mail: celestina wsu. The work cannot be changed in any way or used commercially without permission from the journal. To identify perceptions of risks and benefits of cannabis use during pregnancy and postpartum from the patient perspective. Pregnant and postpartum up to 3 months women residing in a state that legalized the sale of recreational cannabis in were interviewed to determine their perceptions of risks and benefits of cannabis use during pregnancy and postpartum. Qualitative description methodology was used to identify common themes in the data. These themes include 1 continued use for health management, 2 ongoing evaluative process, 3 mixed messages, 4 wanting more information, and 5 legal considerations. All 5 of these themes contributed to the overarching theme of Taking Care of Mom and Baby , which encompasses the mother's need and struggle to care for her own health and wellness, as well as that of her unborn baby. In a state with legalized recreational cannabis, pregnant and postpartum women reported continuing daily cannabis use during pregnancy to take care of themselves and their baby. It is crucial for healthcare providers to follow national guidelines and explain risks of cannabis use during pregnancy and postpartum, while also managing expectations based on patient history. A harm reduction approach to decrease cannabis use is vital to help pregnant women who are using cannabis for health management to continuously evaluate their use during pregnancy and postpartum. Cannabis use during pregnancy has significantly increased in the last 2 decades, growing Past-month use in pregnant women has nearly doubled, increasing from 3. Notably, self-report NSDUH data indicate the majority of cannabis use among pregnant women is recreational Volkow et al. Cannabis use is more prevalent in the first trimester 6. Current evidence indicates cannabis use in pregnancy and postpartum is still growing, and gaps in research eg, concerning breastfeeding as well as methodological limitations require additional study and care in interpreting results Conner et al. Nonetheless, several studies provide evidence for harmful effects of cannabis use during pregnancy, breastfeeding, and postpartum Metz and Borgelt, , and Guidelines from the American College of Obstetrics and Gynecologists ACOG state that women should not use cannabis during preconception, pregnancy, and lactation American College of Obstretricians and Gynocologists Committee on Obstretic Practice, While a link between cannabis use in pregnancy and perinatal mortality has not been established American College of Obstretricians and Gynocologists Committee on Obstretic Practice, , low birth weight has been associated with self-reported cannabis use Hayatbakhsh et al. In the past 40 years, the potency of THC increased 6- to 7-fold Sevigny, , and in the past 12 years the potency in the United States has doubled McLaren et al. Thus, longitudinal studies from the s to 80s may underestimate harmful effects of current cannabis use Warner et al. Legalization of cannabis across the United States has led to a changing legal and social environment with societal challenges that affect families, particularly pregnant and postpartum women who use cannabis Krening and Hanson, The perception that there is no risk to regular cannabis use increased 3-fold among reproductive-age women from to Jarlenski et al. To date, there appear to be few published qualitative studies describing cannabis use experiences, beliefs, and attitudes of women who used cannabis during pregnancy Jarlenski et al. One such study found that women attempted to reduce their cannabis use during pregnancy, used cannabis to help with nausea or to improve mood, perceived cannabis as natural and safe, and were unsure if it was addictive or if there were risks associated with prenatal cannabis use Chang et al. In another study, women reported being unsure if cannabis was addictive or if there were risks associated with prenatal use due to perceived lack of or poor quality of evidence Jarlenski et al. These findings are largely reflected in studies utilizing quantitative methodologies to understand women's perspectives about the health considerations in perinatal cannabis use, including NSDUH data Jarlenski et al. Compared to women who did not use cannabis, women who continued cannabis use while pregnant often perceived no general or pregnancy-specific risk Jarlenski et al. Women reported reasons for continued use during pregnancy related to lack of certainty regarding prenatal and postnatal risks, perceived positive therapeutic effects, and lower cost compared to cigarettes Bayrampour et al. There was a lack of communication from healthcare providers, which women perceived as an indication that adverse outcomes of cannabis use during pregnancy were not significant Mark et al. It was also noted that legal fears have started to fade since legalization Mark et al. Existing qualitative studies Jarlenski et al. The goal of our study was to identify women's perceptions of risks and benefits of cannabis use during pregnancy and postpartum as it relates to breastfeeding and parenting, in a state that has legalized recreational cannabis. This study was conducted in Washington State. In , Washington State legalized the sales of recreational cannabis, subsequently allowing adults in Washington State age 21 or older to purchase and possess cannabis Washington State Liquor and Cannabis, We used Craigslist and community flyers to recruit study participants who called the lab to schedule an appointment for consent and an interview. If a participant missed her appointment, we made 3 attempts to contact her by phone to re-schedule. We sought to recruit pregnant and postpartum up to 3 months women who self-reported as using cannabis daily or occasionally while pregnant or postpartum. We defined occasional use as using cannabis at least once per month but less than daily. Prospective participants were excluded if they self-reported as being under age 18, not pregnant and not recently postpartum ie, within 3 months of giving birth , or using cannabis less than occasionally. The university's Institutional Review Board approved this study. Qualitative content analysis involves combining concept-driven and data-driven analysis approaches to the text. An audit trail was kept throughout the analysis process to document decisions and next steps. Data saturation Fusch and Ness, was reached within our sample as new information was attained with additional interviews and further coding was no longer feasible. Please refer to Table 1 for the interview guide. Interviews lasted 20 to 60 minutes and were conducted in-person by a female researcher authors OB, EB, and CLS on the university campus in a clinical lab. Audio recorded interviews were transcribed and deidentified by a professional transcriptionist who signed an IRB-approved confidentiality agreement. Themes were further revised and reworded as the manuscript was prepared and the authors further engaged with the data. Any revisions that were made after the primary meetings were discussed via email and were made based on a full consensus of the 4 researchers who coded the transcripts. All coding was completed manually. Themes initially identified by each individual were discussed and retained, given agreement by all group members. If the themes lacked commonality amongst the research team, they were discussed with examples cited, and either revised or rejected. The team did not identify any themes that lacked agreement. As themes were discussed, example statements from the narratives were cited and compared, to ensure that the statements were coded consistently. Statements were coded exclusively into one category. Twenty-six women were assessed for eligibility and all 26 met inclusion criteria and were scheduled for a study visit. Seven did not attend their scheduled study visit study visit no-show and did not return phone calls to reschedule. Women reported a range of economic status, from previously being without a home to being in a middle-class household. My husband and I make six figures. We have a reasonable living. We own a home. We both own vehicles. Thirteen of the 14 pregnant participants had other children and therefore were also asked the postpartum interview questions. All postpartum participants were currently parenting their infants or other children. All participants reported using cannabis daily no participant reported only occasional use , and on average, participants reported smoking cannabis 3 times a day, typically around mealtimes or at morning, noon, and at bedtime. The following are comorbid conditions reported by the participants: anxiety, depression, bipolar disorder, substance use disorders, post-traumatic stress disorder, insomnia, anemia, chronic pain, Helicobacter pylori, osteoarthritis, and fibromyalgia. Participants commonly explained that their stories and lives are unique and described in detail that they each had their own individualized reasons for using. Weed smokers come from all different backgrounds and people and places you would never expect people to smoke. Participants described use of cannabis as a method of health management. Accounts described cannabis use as a method of managing physical issues such as morning sickness, nausea, weight gain, pain, and sleep. It helps me feel hungry and it takes away my nausea completely. And it helps with the pain, too. And not so much that it takes away all of my pain, but it helps me mentally manage by pain better. In addition, participants described use of cannabis to manage psychological difficulties such as stress and anxiety, as well as trauma, during pregnancy. He was really abusive, and I ended up in the hospital. So they decided to let me go home and smoke. And my hCG level started rising again. Participants also reporting using cannabis to help with parenting struggles such as stress, the physical toll of parenting, and communicating on a child's level. Participants stated that it helped them function so that they could be better mothers. Um, stress relief for sure. Um, it — it helps for relaxation and things like that. Parenting's tough. Marijuana definitely has a — an easing factor for those things. It gets me up and going with my kids. Since I have four of them \[…\] so it gets me going throughout the whole day. It's easier for me to understand their immediate needs. I felt like it was consistently helping me calm down and be able to function enough — well enough to parent my six-year-old as a single parent and, um, deal with that — that kind of heartbreaking circumstances that I was in. Participants described weighing options such as using cannabis as an alternative to medications they were afraid could potentially be more dangerous for the baby such as opioids, nonsteroidal anti-inflammatory drugs, and anti-nausea medications. And so in order to work and survive, I have to take medicine. Participants described using cannabis in moderation during pregnancy, cutting back use, and making informed decisions about their consumption. They compared cannabis use to caffeine and fast food consumption and contrasted it to cigarette and alcohol use. So in moderation is always key. So it kinda cuts a little bit of the edge off without being something like nicotine or something worse. Caffeine — you know, you have caffeine addictions, and that makes you super stressed out. Some participants were re-evaluating their cannabis use postpartum due to concerns of THC passing to their baby during breastfeeding. Participants also shared their views on cannabis use when children are present. Just because I think it will prevent me from bonding with her as well. Participants commonly reported receiving mixed messages from healthcare providers that often conflicted with their own experiences using cannabis while pregnant. Providers frequently promoted complete abstinence from cannabis during pregnancy. They educated participants that using cannabis while pregnant could harm the baby or told them that there was just not enough research documenting safety. Other providers took a harm reduction approach, encouraging participants to limit their cannabis use for the same reasons. Many spoke about using cannabis while they were pregnant with other children and explained that they felt those children were smart, active, and functioning well. They give you their spiel about why you should quit. You know, why it's not good for you and this and that. Some participants reported that they had never been asked about their cannabis use by healthcare providers. Others explained that when they made their providers aware of their cannabis use during pregnancy or postpartum, the providers did not bring up any concerns with use or did not discuss it with them further. One participant reported that she was told that THC does not get passed to the fetus. I currently have a midwife, and she has not talked to me about it. I brought it up to some of the midwives. She \[ primary care provider \] said that she smoked while pregnant and smokes, so that made me feel better. The pediatrician came in and said he had drug tested the baby and that it was negative. Every participant interviewed stated that she wanted more research that could provide information on the safety and effects of using cannabis while pregnant. Participants were frustrated over the lack of research and consistent information available to them. If I was given more information, you know, per scientific research studies, I could maybe make a more informed decision \[…\]. And she's helped me do some of my own research to determine before I was pregnant previously whether or not I felt this was an acceptable time to use cannabis. I came to the conclusion it was. The benefits outweigh the risks. Many reported that they were not getting enough information from medical providers and looked to employees of cannabis retailers for additional scientific and medical information on using cannabis for ailments during pregnancy. Participants were also endorsing patient-centered research. I have a couple of friends that are budtenders and I was actually having a discussion with one of my friends and we were talking about the terpenes. They \[budtenders\] are very helpful people. I would never guess that they would know as much as they know. And they gave me what I — they thought that I needed and would help, and it did. Because a user would know how to explain those kinds of things better. Participants reported that they often did not disclose cannabis use to healthcare providers because of stigma surrounding the issue and feared legal repercussions such as Child Protective Services CPS. Because it helps. I would not do that. This fear of intervention by CPS functioned to both temper their disclosure to providers and to modify their patterns of use, as it was mentioned that they did not want to have their use discovered in the hospital giving birth. Participants vacillated between fear of CPS and insistence that no legal issues would arise because of the legality of recreational cannabis in Washington State. They noted frustration at disrupting cannabis use towards the end of pregnancy due to fears of legal repercussions when cannabis was used to help with their chronic pain, anxiety, etc. She got me kinda really scared, talking about CPS and how I need to stop and how it's not good for the baby, that CPS will come in after I have her to talk to me. And I got really scared, and I talked to my actual doctor. And she said that there were no studies saying it was bad or good. I did refrain from use in my last month of pregnancy and then for two months afterwards. Mostly because of the legal ramifications. Because it's legal, you know? In a state with legalized recreational cannabis, pregnant and postpartum women reported continuing daily cannabis use during pregnancy for personal, individualized reasons to take care of themselves and their baby. The women continued use for health management, continued to evaluate their use during pregnancy and postpartum, often received mixed messages from healthcare providers, expressed frustration over lack of information on health risks, and often changed use due to legal considerations. Participants felt they were making the best decisions for themselves and their baby. Many explained that it helped them manage physical symptoms, such as nausea, so they could eat and provide nourishment for their baby. These perceived positive therapeutic effects are consistent with what other researchers have found Bayrampour et al. Our participants explained that cannabis helped them manage stress so they could be better parents. Women based their decisions on what they believed would help them, translating into benefits and protection for their baby. These decisions often resulted in minimal cannabis use — only as much as participants felt was needed for their health management in order to limit exposure to the baby. In addition, many women decided to use cannabis instead of prescription medications because of concerns that pharmaceutical agents would cause harm to the baby. Similar to a study conducted in Pennsylvania Chang et al. Every mother interviewed wanted to better understand the risks and benefits of cannabis use for their baby. They wanted to feel more confident in the decisions they were making to care for themselves and their baby, but often received mixed messages from providers. Similar to Jarlenski et al. Other participants stated that when they made their providers aware of their cannabis use, the providers did not discuss it with them further. This is in line with findings from a content analysis of audio-recorded patient-health care provider responses, where approximately half of healthcare providers did not respond to cannabis use disclosures or offer counseling to pregnant women Holland et al. Of the healthcare providers that did provide counseling to pregnant women that disclosed cannabis use, specific information on the risks related to cannabis use in pregnancy was not given. Relatedly, our participants felt they were making the best decisions they could with the information they had. Participants also discussed curtailing use at the end of the pregnancy to avoid the risk of having their baby removed from their care by CPS. Participants in the Chang et al. Participants in both studies reported wanting more information on the effects of prenatal cannabis exposure. In contrast to previous research, additional themes of legal considerations and mixed messages emerged for our sample, most likely due to differences in legality of cannabis across the states wherein data were collected. The latter may also explain the distribution across socioeconomic strata for participants in our study. The rapid changes in the legal landscape surrounding cannabis use, including the growing number of states legalizing recreation cannabis use in the last few years, warrant continued assessment of relevant perceptions of pregnant and parenting women. We were unable to recruit participants who used cannabis less than daily, counter to prevalence data that reports less than daily cannabis use is more common and reports that women decrease use in the second and third trimesters Volkow et al. It may be that only women who use cannabis daily were compelled to be interviewed by researchers, or that the majority of women reporting cannabis use during pregnancy have committed to daily use for various health management strategies. Although some participants noted risks to their baby associated with cannabis use during pregnancy, we found that many were not counseled on decreasing or abstaining from cannabis use during pregnancy and lactation, as recommended by ACOG American College of Obstretricians and Gynocologists Committee on Obstretic Practice, ; Reece-Stremtan and Marinelli, Similar to previous research Mark et al. Of those who were counseled, participants reported feeling stigmatized during these discussions and sought medical and scientific advice elsewhere ie, from friends and cannabis retailers. There are numerous strengths to our study. First, we were able to capture experiences of women using cannabis while pregnant and postpartum in a state where the overall perception of harm resulting from cannabis use has decreased since legalization Jarlenski et al. Participants ranged across the socioeconomic strata and were able to report about postpartum cannabis use. Participants also offered information they received from obstetricians, nurse midwives, and primary care physicians. As the legal landscape of cannabis is changing across the nation, and health messaging is increasing from pro- cannabis sources, participants from Washington State can help researchers and clinicians improve patient education. The primary limitation involves our predominantly Caucasian sample. While representative of Washington State, future research needs to assess perceptions of risks and benefits of cannabis use in other racial and ethnic populations as culturally-driven beliefs may influence use or abstinence during pregnancy. It may be that those who were more ill, had more stressful lives, or were concerned about possible legal ramifications of disclosing cannabis use, chose not to participate in the study. As legalized recreational cannabis becomes more prevalent across the United States, healthcare providers need to more fully assess health-related factors eg, comorbid conditions , engaging in shared decision-making processes with pregnant patients. We found that pregnant and postpartum women were continuing daily cannabis use in an effort to take care of themselves and their baby. Selective intervention programs such as the Nurse Family Partnership Olds, may provide opportunities for healthcare providers to engage with this population and provide education and guidance, without stigma, helping mothers reduce or eliminate cannabis use during pregnancy and postpartum and improving maternal and child health. It is crucial for providers and other staff to follow national guidelines and explain risks of continued cannabis use during pregnancy and postpartum, while also managing expectations based on patient history. A harm reduction approach to decrease cannabis use is vital to help pregnant women who are using cannabis for health management continuously evaluate their use during pregnancy and postpartum. If these discussions with patients are not undertaken, women will seek medical information elsewhere, often from employees in cannabis retail stores. Pregnant women who used cannabis for health management reported feeling that they made the best decisions for themselves and their baby. Therefore, reduced stigma is needed throughout the healthcare system so that women do not choose to stop communicating with their providers in an open and honest manner. Lastly, additional research is needed to determine long-term effects of cannabis use during pregnancy and lactation, disentangling these effects from other substances, on birth outcomes and child development. As a library, NLM provides access to scientific literature. J Addict Med. Find articles by Celestina Barbosa-Leiker. Find articles by Ekaterina Burduli. Find articles by Crystal Lederhos Smith. Find articles by Olivia Brooks. Find articles by Michael Orr. Find articles by Maria Gartstein. Published by Wolters Kluwer Health, Inc. Did your healthcare provider talk to you about your cannabis use? If so, what was said? Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.
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