Association for Public Policy Analysis & Management

An estimated 57% of U.S. births occur in states where marijuana is or will soon be legal for recreational or medical use. Marijuana use among pregnant women in the U.S. has increased 62% in the past decade; prenatal marijuana use may lead to fetal growth restriction and other neonatal morbidity. However, scientific opinion differs on whether prenatal marijuana use is causally related to adverse outcomes, or whether associations in observational studies are confounded by other risk factors. It is unknown what messages media may be portraying about the risks or benefits of prenatal marijuana use. Our objective was to analyze the volume and content of recent online media pertaining to prenatal marijuana use.

Methods:

We used the Google Alerts function to simulate Internet search results of online media content from March 2015-January 2017. The Google Alert function uses keywords to produce e-mails containing links to content based on Google’s search function. We saved all online content from the e-mails over our study time period. Our final analytic sample, after excluding duplicate items and those not focused on prenatal marijuana use, included 388 unique media items. We used directed content analysis methods to develop our coding instrument. Two authors independently coded media items, with excellent inter-rater reliability. Descriptive statistics were calculated to assess the volume and content of media items.

Results:

The volume of media items steadily increased over time. There was a sharp increases in the volume of media corresponding to the fall 2016 election cycle, when 9 states considered marijuana-related measures. The majority (59%) of content was non-mainstream news, which largely consisted of online publications focused on marijuana. Sixteen percent of media items were from mainstream online-only media; 15% were online versions of mainstream television or radio content; and 9% were online versions of mainstream print media. Preliminary results indicate that while most media items mentioned scientific studies about marijuana use in pregnancy, mainstream media were more likely to portray that the risks of marijuana use outweighed the benefits of use (73%), relative to non-mainstream media (25%). The most commonly mentioned health risk included low birth weight; the most commonly mentioned health benefit of marijuana use in pregnancy was to combat nausea.

Conclusions:

In our study of online media content, we found that the majority of information about prenatal marijuana use occurred in non-mainstream media outlets that focused on marijuana use. Mainstream and non-mainstream media were similarly likely to mention scientific studies, although mainstream media were more likely to mention risks of prenatal marijuana use, relative to non-mainstream media, which more commonly mentioned benefits. Results suggest competing narratives about prenatal marijuana use that are disseminated to the public via online search results.