Is Cannabis Safe While Pregnant?

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Legalization of recreational cannabis in many states has led to increased use of the drug across a wide spectrum of the US population.  Currently, eighteen states allow recreational marijuana usage, while 37 states allow medical marijuana usage. According to the CDC, 18% of Americans reported using marijuana at least once in 2019.

Does legalization of cannabis mean that it is safe for all users? Research would indicate otherwise.

“Cannabis and CBD use is not recommended for persons considering pregnancy, or in those who are pregnant or lactating,” said Brooke Cheney, Certified Nurse Midwife with ProMedica Physicians Obstetrics and Gynecology.

“Certified Nurse Midwives and Physicians encourage persons who are pregnant, contemplating pregnancy or who are lactating to discontinue cannabis or CBD use,” Cheney said. “We counsel patients on the potential adverse health consequences of continued use during pregnancy and lactation, including but not limited to brain development and stillbirth.”

Dr. Courtney Townsel, MD, M.Sc, an obstetrician-gynecologist at U-M Health says, “…we recommend against its (marajuana) use in pregnancy for any reason.”

Too Many Unknowns

“Cannabis is not regulated by the US Food and Drug Administration,” Cheney said. “Therefore, there are no approved indications, contraindications, safety precautions or recommendations regarding its use during pregnancy and lactation.”

 According to Dr. Courtney Townsel, MD, M.Sc, an obstetrician-gynecologist at University of Michigan Health Von Voigtlander Women’s Hospital, Michigan Medicine, there are too many unknown variables when it comes to the safety and possible side effects of usage. “There are no standardized formulations, dosages, or delivery systems,” Dr. Townsel added. “There are simply too many uncertainties with cannabis use and pregnancy. Therefore, we recommend against its use in pregnancy for any reason.”

Know the Risks

Cannabis use has often been used by cancer patients to combat nausea associated with chemotherapy. Pregnant women who experience nausea may think this is a suitable remedy, but Dr. Townsel would caution against it.

“There are rare cases that have been reported of clinicians prescribing cannabis for excessive nausea and vomiting in pregnancy (hyperemesis gravidarum). In these scenarios, the physician must fully counsel patients about risks and benefit of use in pregnancy and come to some shared decision about whether the benefits of use outweigh the risks,” Dr. Townsel said.

Those risks can include stillbirth, preterm delivery, lower birth weight, and possible neurodevelopmental impairments in infants and children exposed prenatally as well as during breastfeeding. 

Nursing Mothers and Marijuana

According to the CDC, marijuana use while breastfeeding can allow harmful chemicals to pass on to the infant through breast milk. Tetrahydrocannabinol, or THC, is the main component in cannabis, and it is stored in body fat. Infants have the potential of being exposed to THC as it is slowly released over time through breastfeeding. 

The CDC also cautions against the use of CBD products while pregnant or nursing. These products often contain contaminants such as pesticides, heavy metals, and fungus which could be dangerous to both mother and infant.

Trust the Research

“It’s estimated that 7-10% of pregnant people report cannabis use,” Dr. Townsel said. “Rates based on urine toxicology are even higher at 19% for pregnant people ages 18-25 years of age screening positive for marijuana. This makes cannabis the most commonly used drug in pregnancy. The most common reported reason for use is nausea,” Dr. Townsel added. 

However, Dr. Townsel did note that heavy marijuana users who attempt to wean or discontinue during pregnancy can also experience withdrawal symptoms of severe nausea, vomiting, and abdominal pain.

“Any use of cannabis is experimental and not supported by data or research,” she said. “Currently, these risks along with the unregulated nature of cannabis make it an undesirable choice for use in pregnancy.”