Marijuana Use During Pregnancy

If you are expecting, or even just considering starting a family, chances are that you’ve received extensive counseling from family, friends, and doctors on what you should and should not do to keep you and your future baby healthy. Where does marijuana play into this list of pregnancy do’s and don’ts?

Most people know that alcohol should be avoided during pregnancy. In contrast, using marijuana while pregnant represents more of a gray area–studies have shown that women rarely receive counseling on marijuana use from their healthcare providers (Bayrampour et al, Prev Med, 2019). Although marijuana may seem less dangerous to use while pregnant compared to a substance such as alcohol, we know several things for certain. First, marijuana is capable of crossing the placenta during pregnancy, which means it can enter your unborn child’s circulation and impact fetal development. Second, marijuana can be found in breast milk, meaning it can have effects on the health of your child even after they’ve been born.

Whether you are pregnant and contemplating marijuana use, or actively using marijuana and contemplating pregnancy, it’s wise to be aware of the possible consequences.

Studies have shown that marijuana is one of the most commonly used substances during pregnancy, with anywhere between 2-5% of all pregnant women reporting some degree of marijuana use while pregnant (Committee on Obstetric Practice, Obstet Gynecol, 2017).

Furthermore, rates of marijuana use have been increasing with time–3.85% of women reported marijuana use in pregnancy in 2014, which was a 60% increase since 2002. One particular study found that of those pregnant women who use marijuana, 18.1% met the criteria for Cannabis Use Disorder, indicating that their babies were likely getting exposed to significant levels of the drug (Ko et al, Am J Obstet Gynecol, 2015).

Marijuana’s prevalence amongst pregnant women is especially remarkable when you consider trends in use of other drugs: while rates of alcohol and tobacco use in pregnant women dropped significantly between 2002 and 2017, the prevalence of marijuana use increased from 3% to 7% (Volkow et al, JAMA, 2019; Agrawal et al, JAMA Pediatr, 2019). Clearly, pregnant women are using marijuana, which begs the question–what impact does marijuana have on the health of developing babies? We’ll get into the science and statistics of that next.

The potential effects of marijuana use on the health of your child are numerous and wide-ranging. In order to keep everything straight, we’ll separate these effects by time period: during pregnancy and after birth.

During Pregnancy

The placenta is the vital organ in your womb that is responsible for exchanging oxygen, nutrients, and waste products with your baby. Marijuana can cross the placenta, meaning that it is capable of reaching your baby’s bloodstream while you are still pregnant.

Several studies have shown that women who use marijuana during pregnancy give birth to babies with altered developmental patterns. For example, infants exposed to marijuana in the womb are more likely to have low birth weight, which is associated with higher chances of future health problems including diabetes, heart disease, and high blood pressure (Gunn et al, BMJ Open, 2016). Additionally, these infants are more likely to require care in the neonatal intensive care following birth versus babies that were not exposed to marijuana during pregnancy, indicating a higher risk of pregnancy complications (Gunn et al, BMJ Open, 2016).

Studies show similar findings outside of humans, as well. In animal models, high doses of marijuana was associated with growth retardation and malformations in offspring, indicating that marijuana may impact key developmental events that allow for normal body shapes and functions (Hall and Degenhardt, Lancet, 2009). Although the mechanism behind this is poorly understood, research is ongoing and it’s safe to say that marijuana has real impacts on babies’ development during pregnancy.

After Birth

The impact that marijuana can have on your child does not end at birth. We know that the breastmilk of women who actively use marijuana contains cannabinoids, meaning marijuana can still enter your baby’s body if you use the drug while breastfeeding. What we know less about, unfortunately, are the actual impacts that may have on your child. Because marijuana is not yet legal throughout the United States, researchers cannot study the impact of the drug on pregnant and breastfeeding mothers in a controlled setting. Therefore, most of what we know is limited to individual cases.

Although we do not understand the full spectrum of mechanisms behind marijuana’s impact on development, we do know that it can potentially interfere with your ability to produce breastmilk at all. Long-term marijuana users have been shown to have approximately 20% lower levels of a hormone called “prolactin” in their bloodstream. Prolactin normally functions to induce breastfeeding in women who have just given birth (Ranganathan, Psychopharmacology, 2008) which may reduce their ability to produce milk (Barnett, Addict Behav, 2012).

As far as reproductive health goes, the impact of marijuana does not fall exclusively on women–men seeking to start families should also be cautious of marijuana use, which can disrupt the signaling pathways in the male reproductive process. Studies suggest that marijuana disrupts the hormonal pathways, production of sperm, and function of sperm necessary for men to be fertile (du Plessis, J Assist Reprod Genet, 2015).

Warning Signs

If you are pregnant, or interested, and find yourself struggling to resist the urge to use marijuana despite knowing the potential harms, it may be time to seek help. Browse our website to learn more about addiction to weed.

Consider ask a healthcare provider if you are pregnant or thinking about getting pregnant and need help decreasing your marijuana use. On this website, we discuss treatment options for marijuana addiction and cannabis use disorder. To summarize though, ensuring that you find a plan to kick your habit will require careful planning, multiple strategies, and lifestyle changes.

Medications

Short answer—no medication has yet met the criteria of efficacy and safety needed for FDA approval (Gates, Cochrane Database Syst Rev, 2016). Drugs require even further vetting before the FDA can label them as safe for use during pregnancy, as many medications that are safe in non-pregnant individuals can be “teratogenic”, or disturbing to the development of a growing baby, in pregnant individuals. Unfortunately, this all means that it won’t be as simple as taking a pill to kick your marijuana habit.

Therapy

Psychosocial interventions like therapy have been proven to work, not just for quitting marijuana (Gates, Cochrane Database Syst Rev, 2016), but in helping with other substance addictions as well. In fact, studies have demonstrated that while medication-based interventions for drug withdrawal syndromes might help in managing withdrawal symptoms in the short-term, long-term abstinence is unlikely without some component of psychosocial intervention (Allsop, Clin Pharmacol Ther, 2015).

Existing psychosocial treatment options for marijuana cessation include cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET), which are both typically conducted via appointments with a licensed therapist in the outpatient setting. CBT is meant to help people identify problematic thoughts and behaviors surrounding their use of marijuana, as well as teach coping strategies that promote more healthy behaviors (Budney, Addict Sci Clin Pract, 2007). Meanwhile, MET is a supportive, patient-centered psychotherapy approach that emphasizes the development of self-efficacy and motivation for change. Studies have shown that starting CBT, MET, or both has consistently allowed patients to reduce their frequency of marijuana use and severity of their dependency on the drug (Gates, Cochrane Database Syst Rev, 2016; Hoch, Drug Alcohol Depend, 2014).

Exercise

Although lifestyle-based interventions may not seem like an obvious way to combat marijuana addiction, numerous studies have found that it’s actually quite effective. Exercise is known to improve overall health, feelings of depression and anxiety, and has been shown to decrease the symptoms of drug withdrawal (Linke, Am J Drug Abuse, 2015; Brellenthin, Am J Drug Alcohol Abuse, 2016).

When it comes to marijuana specifically, exercise reduces marijuana consumption and cravings, increases abstinence, and helps with depression (Flemmen, Biomed Res Int, 2014; Roessler, Scan J Public Health, 2010; Brown, Ment Health Phys Act, 2010; Buchowski, PLoS One, 2011).

Before jumping into an exercise program, however, make sure to talk to your doctor–some rigorous forms of exercise are not safe in pregnancy and should be avoided!