July 6, 2023
Marijuana use is increasing. It is becoming more accepted as more states legalize both medicinal and recreational marijuana use by adults. At the time of this writing, 23 states plus Washington, DC and Guam allow recreational marijuana use, and another 14 states have some form of legal medical marijuana system. And, while marijuana is still illegal on the federal level – it’s classified as a Schedule I substance on the Controlled Substances Act – legislation has been put forth in the House of Representatives to set the stage for federal legalization as well.
While this may be good news for adults who enjoy recreational marijuana use or use it for medicinal purposes, things are a little more complicated when it comes to marijuana use during pregnancy. According to one study, pregnant people in states with legalized recreational cannabis use were more likely to use it at all stages of pregnancy – before conception, prenatal or during pregnancy, and postpartum or after delivery – than pregnant people residing in states where recreational cannabis is not legal.
“It’s a topic of great concern,” says Barbara Schindler, MD, vice dean emerita and professor of psychiatry and pediatrics at Drexel University College of Medicine. “Unfortunately, we don’t have enough research on the effects of cannabis use during pregnancy, but we do have some ideas about consequences to the fetus or unborn baby. We’ll have a lot more data in the coming years, but in the meantime, it’s important to understand that using marijuana during pregnancy may be putting the baby at risk, not only in the short term, but also potentially for a lifetime.” Although someone who is pregnant may have a medical marijuana card, physicians do not recommend marijuana use during pregnancy for any reason, including for nausea relief.
According to the National Institutes for Health (NIH), what we do know is that THC, the main psychoactive component in marijuana, does cross the placenta and enters the fetus’ brain, potentially disrupting its development. Marijuana use during pregnancy is also associated with lower birth weight, behavioral problems, lower academic achievement, and higher levels of self-reported depressive symptoms in children and adolescents, among other problems.
In animal models, THC given during pregnancy shows there may be long-lasting effects on offspring, including an increased preference for other substance use later on.
“Aside from the direct negative effects on the child, which we’re still studying, the use of marijuana can affect the decision-making ability of those who are pregnant,” says Dr. Schindler. “Many marijuana users also use other legal or illegal substances – sometimes without even knowing it, as the cannabis they are using may be laced with other drugs such as fentanyl. Additionally, substance users frequently don’t get prenatal care as they are afraid of being subject to drug screening.”
“It’s all very complex and our best advice for those who are pregnant and nursing is don’t do it,” continues Dr. Schindler. “As physicians, it’s our job to educate patients, try to understand why they are using, and offer them alternatives — whether it’s safer prescribed medications to help control nausea and anxiety, or lifestyle techniques such as meditation and yoga. There are better options out there for both parent and baby.”
If you or someone you know is struggling with marijuana use during pregnancy, please talk to your health care provider.
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