In 2018, Canada legalized recreational cannabis. This has had significant shifts on the landscape of health and social policy and had implications for health and social care providers. As legalization becomes more entrenched, cannabis related surveillance, stigma and punishment still looms large for marginalized communities. Our project builds on a small body of critical health and social science research that focuses on cannabis use during pregnancy, breastfeeding and the postpartum period.

Cannabis is one of the most widely used substances during pregnancy across Canada

(Corsi et al., 2019a; Corsi et al., 2019b; Krenig & Hanson, 2018; Mets & Stickrath, 2015). Some Canadian studies document up to 5% of pregnant women self-reporting cannabis use (Ryan et al., 2018; Young-Wolff et al., 2019)., Kaarid and colleagues (2021) recent research on the prevalence of cannabis consumption for pregnant women living in urban cities in Canada, found that among the 478 respondents, 54 (11%) reported consuming cannabis at some point during their pregnancy. And yet, studies such as these, that rely on self- reported data are likely to under represent the current reality (Ryan et al., 2018).

Cannabis related stigma and surveillance is shaped and further exacerbated by intersecting identities along axes of Indigeneity, race, socio-economic status, disability, criminalization, child welfare involvement and HIV status.

People who face existing injustice in health and social care settings have concerns about approaching health and social care providers for information, support and education about cannabis consumption during pregnancy, breast/chestfeeding and postpartum.

During the time of cannabis prohibition, Black, Indigenous, and racialized communities have been subjected to greater surveillance and have faced harsher penalties for cannabis consumption and possession (Schlussel, 2017; Vitiello, 2019). Despite legalization, Black and Indigenous mothers continue to experience increased surveillance and unjust consequences because of cannabis use (Boyd, 2019).

The Wading through the Weeds Project seeks to respond to the anti-Black racism that continues to exist in Canadian health and public health policies and practices, and the Truth and Reconciliation Commission: Calls to Action (2015, p. 2-3) to “address gaps in the health, public health policy and healthcare practices between Indigenous and non- Indigenous peoples.”

Research from a gendered and intersectional theoretical lens on cannabis consumption
is limited.

Furthermore, research demonstrating positive health outcomes or perceived improvements in women’s quality of life in relation to cannabis consumption are often not included in the body of “evidence” used to derive guidelines and inform clinical practices

(Kozak, Ion & Greene, 2022).

Currently, multiple public health, obstetric, and pediatric organizations advise against cannabis consumption while pregnant and breastfeeding (Committee on Obstetric Practice, 2017; Health Canada, 2018; Ryan et al., 2018). And yet, there continues to be a lack of conclusive evidence regarding possible adverse effects of cannabis consumption during the perinatal period (Barlett et al., 2020; Jarlenski et al., 2016).

It is acknowledged by researchers that pregnant women who consume cannabis are more likely to be affected by the social determinants known to impact health including racism, colonialism, poverty, mental health challenges, trauma, and other concurrent environmental and social factors (Bartlett et al., 2020; Greene et al., 2016; Ion et al., 2017; Jarlenski et al., 2016).

We echo previous scholars who have noted that cultural, economic, and social factors can shape birth outcomes more broadly and call for an intersectional approach to understanding cannabis consumption during pregnancy, breast/chestfeeding and the postpartum period (Dreher et al., 1994; Nugent, 1994).

There has been a call for increased knowledge at the intersections of gender and cannabis consumption and a need for more research that elucidates how gender roles and relations and identities, intersect with the health and social consequences of cannabis use to “inform more responsible health promotion, effective harm reduction and precise treatment approaches for all genders” (Greaves & Hemsing, 2020, p.11).

The Wading through the Weeds Project offers a critical response to this call by using a participatory arts-based approach to researching with pregnant and breast/chest feeding individuals who consume cannabis across Canada.