Cannabis & Pregnancy: Is It Safe?

With cannabis legalization rising across the country, there are many questions we will face concerning proper use and care. One of the many unfortunate consequences of decades of cannabis illegalization and stigma is the lack of research in many areas, including pregnancy and breastfeeding. Cannabis use doubled among pregnant women in California from 2009 to 2016. Some dispensaries even recommend cannabis as treatment for nausea during pregnancy. But is it safe?

As a 30-year-old woman thinking about starting a family in the coming years, this has been a consideration of mine on a personal level. I enjoy smoking to relax at home and with friends in the same way I enjoy a glass of wine. Because I am purely a recreational user and the facts around cannabis during pregnancy are so uncertain, my current assessment is that the risk is likely not worth it. But for others, the choice is not so simple. For a woman who uses cannabis medicinally, is switching to new pharmaceutical drugs while pregnant a better alternative? Is it safe to stop treatment entirely, potentially suffering mental illness that may in turn affect the child?

There is a lot of speculation on the internet surrounding cannabis, pregnancy, and breastfeeding, but the reality is the facts are not yet concrete. Every woman has the right to her own research and should make a medical decision that is best for her. Let’s break down the facts and speculations so that we may do just that.

The Facts of Cannabis, Pregnancy, and Breastfeeding

There are a few things about cannabis and pregnancy that we know for certain. THC (tetrahydrocannabinol) does reach the fetus and its developing brain. THC is found in the breastmilk of women who use cannabis for up to six days after use. Because THC is stored in body fat, it is released over time and stays in the system for at least a month.

We also know that cannabis smoke contains some of the same toxic chemicals found in tobacco smoke, meaning that secondhand smoke can have an impact on pregnant women and children. Beyond this, the facts begin to blur.

The Argument Against Cannabis

Both the American College of Obstetricians & Gynecologists and the FDA counsel against using cannabis while pregnant or trying to get pregnant, citing evidence that moderate levels of THC create a higher risk for miscarriage or stillbirth, with the highest risks occurring early on in pregnancy. There are many studies out there that claim cannabis use (mainly THC) impacts a developing fetus’s neurological development, stress responsivity, attentiveness, and other developmental and behavioral issues. Other studies claim that breastmilk containing THC hinders the brain development of the child. However, most of these studies have been done on animals or lack the proper controls needed to indefinitely prove the relationship between cannabis and brain maturation.

The Argument for Cannabis

A study out of Columbia University and the NYS Psychiatric Institute in 2020 argues that less than 5% of other studies show any statistically significant difference between developing children exposed to cannabinoids and those not. Led by Dr. Ciara Torres, the team pulled 1,604 studies, of which they deemed only 40 as reliable sources, meaning that those select few met the criteria for sufficient data. The study concludes that current evidence does not suggest that prenatal cannabis exposure alone is associated with significant cognitive functioning impairments. In other words, there isn’t enough data to prove that cannabis use is the driving factor of impairment over other health or environmental factors, including the mother's cognitive ability, income level, and home environment.

In all, there are two major concerns with cannabis and pregnancy: the risks associated at birth, such as low weight or miscarriage, and subsequent developmental issues in the child later on. However, with such little information available, it's hard to be sure. More medical professionals will advocate against cannabis use than for, but it seems this counsel is driven more by a lack of information rather than concrete data.

Pregnant women face an overwhelming amount of decisions regarding their own health and that of their baby. Information is ever-changing and rarely absolute. As society remains emboldened to speak for women's health, it’s ultimately within our own power to decide what is best for us and our future children. While one woman might settle for months of abstaining, it might not be the healthiest option for another. As legalization continues and stigmas subside, there’s hope for not only better conversations but also improved research on cannabis and pregnancy. Until then–the choice is yours to make.