Is It OK to Use Marijuana During Pregnancy?
Using medication during pregnancy remains controversial; using a non-prescribed drug during pregnancy even more so. But there are plenty of pregnant people who swear by marijuana.
Although some states have legalized marijuana for medical use (and some have gone even further and legalized it for recreational use), it remains taboo in some circles — despite the fact that marijuana is considered less damaging than alcohol (according to a 2017 report conducted by the Society for the Study of Addiction). The medicinal properties of cannabis have been well established for many years, and it's often used for pain and nausea relief, according to the National Institute on Drug Abuse. Plus, according to a January 2017 study published in JAMA, marijuana use among pregnant women increased from 4.2 percent in 2009 to 7.1 percent in 2016. But why are pregnant people using the drug?
Some have found that using marijuana during pregnancy improves their morning sickness symptoms significantly. And although morning sickness is bad on its own, some pregnant people are unlucky enough to experience hyperemesis gravidarum, a serious pregnancy complication characterized by severe nausea, vomiting and dehydration. HG can lead to hospitalization so that the parent-to-be can receive intravenous fluids and, in some cases, nutritional support. There are medications available to treat HG, but they’re not always effective and may have adverse effects on the pregnant person or the developing baby, according to the American Pregnancy Association.
"The main reason women choose to use cannabis during pregnancy is for severe nausea and vomiting known as HG," OB/GYN and integrative pain management specialist Dr. Joey Rottman told SheKnows. "They feel, in many cases, it is safer than prescription medications that physicians prescribed and they feel it is certainly safer than having a PICC line."
This is exactly why Sarah,* a mom of two from Iowa, says she would make that choice in the future, if it came down to it. "Honestly," she told SheKnows, "If I were to have another baby, if I again suffered from HG, I would probably seek out edibles," she says. "I was sick the entire time with both of my girls and don't like taking medications when they are only semi-effective. As a last resort, I would smoke, but I would definitely try a pot cookie or a brownie or something similar to see if it worked."
Of course, it can be difficult to get the blessing of a health care provider for cannabis use during pregnancy. But it's not impossible.
"My health care provider believes that there are circumstances in which the benefits outweigh some risks, and I fall under that category," Texas mom-to-be Andrea* told SheKnows. "Recently, we acquired a vaporizer known as a volcano. The marijuana is heated to super-high temperatures, and the vapor then fills a plastic bag. It has a mouthpiece you can attach to it to inhale it. There is absolutely no smoke. Since I gave in and started smoking again, I've had almost no issues with morning sickness, and my appetite has returned. My anxiety level, which is normally extremely high, is about as level as it can be during pregnancy, which I believe has had an enormous benefit. With my son, I spent so much time scared and crying and in a panic. Now the same problems (chronic bleeds, high blood pressure and so on) are either resolving or healing, and I attribute that greatly to not stressing my body out for no need."
Missouri mom Callie,* who is expecting her second child, also got the go-ahead from her provider. "I have the support and encouragement of my midwife," she explained to SheKnows. "[Marijuana] really helps me relax, and it also helps with aches and pains related to pregnancy."
But what are the risks? Well, they're not quite clear.
"A decrease in birth weight, a slight decrease in Apgar scores and an increase of admission to the NICU," Rottman explained. "The study data is fuzzy because they cannot and do not separate cannabis use and alcohol consumption at times. There was one study in Jamaica which showed a benefit of marijuana, but they also showed that those who used cannabis were in a higher socioeconomic class. No known studies compared methods of consumption, but it is commonly felt today that vaporization is safer than smoking and more effective than oral consumption."
One thing Rottman pointed out is that few studies support the use of medical marijuana, but not for the reasons you might think.
"There are so few studies, in general, which support the use of marijuana for medical purposes and any studies or trials very rarely meet standards because the FDA/NIDA makes it very difficult for researchers to conduct large-number randomized controlled trials on humans, unless those studies are designed to show the harm of marijuana," he explained. "FDA-quality trials are very expensive and the funding is not often possible for cannabis research because there are no large pharmaceutical companies paying for the studies as there is no money to be made for them from the results."
The bottom line? "One must sit down with the patient and discuss the risks and benefits of cannabis use," Rottman said. And that means that, sometimes, pregnant people and their care providers can come to an agreement that using cannabis might be a better option than certain medications — and in many cases, better than being hospitalized with a PICC line.
So, if you do catch a whisper that a parent-to-be is using cannabis, maybe think twice before judging them — it may be what's keeping them going toward that 40-week finish line.
*Names have been changed.
A version of this article was originally published in February 2014.