INTRODUCTION: Cannabis use in pregnancy is rising. The objective of this study is to compare attitudes regarding marijuana use among pregnant users and nonusers. METHODS: This was a prospective study (IRB #262700) in which a 35-question, anonymous survey was distributed to pregnant patients at outpatient prenatal visits across gestation. Questions included topics regarding marijuana use in pregnancy, perceived risks, and provider–patient education. RESULTS: 408/460 (88.7%) approached pregnant patients completed the survey. Self-reported rate of marijuana use during pregnancy: 11.8% (48/408). There were no ethnic differences in users and the most common age for use was 18–24 years (24/48). 79% (38/48) reported use two to three times weekly or greater. Average response score (Likert scale) for participants using marijuana compared to those who did not to the following statements were statistically significant and positive towards prenatal use: belief that pregnant patients should refrain from marijuana use: 2.31 versus 3.53 (<.001); acceptability of medical marijuana: 3.68 versus 2.82 (<.001); minimal health risk: 4.15 versus 2.96 (<.001); support for legalization of recreational marijuana: 4.58 versus 3.51 (<.001). Lack of counseling on cessation and risk of cannabis use in pregnancy were reported by 82% and 84% of participants with 74% of current users reporting lack of counseling. 54% of users desired more information regarding cannabis-related pregnancy complications. CONCLUSION: Higher-than-expected self-reported marijuana use during pregnancy. Lack of counseling on risks of marijuana use and importance of cessation highlight an important opportunity for counseling and intervention supporting current ACOG guidelines of SBIRT (screening, brief intervention, and treatment referral).