Pot Use and Pregnancy

Pot Use and Pregnancy

By Paul Armentano

[Author’s note: This essay originally appeared in article form in the June 2007 issue of Heads Magazine. It has been updated for publication by NORML.]

Few issues concerning cannabis and health evoke more disparate opinions than the question of maternal pot use during pregnancy. It’s easy to see why. Logic presumes that if pre-natal exposure to intoxicants such as alcohol and tobacco poses proven health risks to the fetus, then exposure to pot would likely pose similar risks to a child’s health and development. Nevertheless, much of the science surrounding this issue says otherwise – though a definitive answer remains elusive.

Reasons for this are two-fold. One, it is virtually impossible for investigators to obtain permission to conduct any type of prospective clinical trial that knowingly exposes pregnant mothers – and their future offspring – to cannabis. Two, because women often face severe legal sanctions (such as the loss of child custody or incarceration) for admitting that they have smoked pot while pregnant, most mothers refuse to divulge such information – even to researchers conducting anonymous surveys years after the fact. Moreover, among the handful of surveys that have been conducted, several fail to adequately control for mothers’ use of alcohol, tobacco, or other drugs during the course of their pregnancy.

As a result, much of the published data assessing the extent of maternal pot use and its health implications remains limited to historical texts, studies from non-Western cultures (where the use of cannabis has gained greater social acceptability), and retrospective survey data.

POT FOR MORNING SICKNESS?

Morning Sickness

 

 

 

 

 

 

 

 

 

 

 

Historic references regarding the use of therapeutic cannabis for a variety of female medical conditions, including difficult childbirth, date back to the 7th century BC. According to “Cannabis Treatments in Obstetrics and Gynecology: A Historical Review” by Dr. Ethan Russo, various parts of the plant – including cannabis flowers and seeds – were used by Chinese and Persian societies to induce contractions, prevent miscarriages, and reduce incidences of post-partum hemorrhage. By the mid-19th century, the use of cannabis tinctures became prevalent in Western cultures to hasten pregnancy and reduce pre-partum nausea. The historical use of cannabis use for pregnancy-associated pain and other complications is also referenced in African, Indian, and Southeast Asian cultures.

More recent documentation of the therapeutic use of cannabis by mothers-to-be is less prevalent – no doubt because of pot’s outlaw status in most parts of the world. Nevertheless, some notable references stand out in the modern literature. Writing in the journal Pediatrics in 1994, Dr. Melanie Dreher and colleagues reported that the use of cannabis to treat nausea and increase appetite during pregnancy remains customary among women in southeast Jamaica. Though Dreher acknowledges that such use is discouraged at government-sponsored pre-natal clinics, she found that many women nonetheless consider ganja to hold therapeutic benefits to themselves and their unborn children.

More recently, Dr. Wei-Ni Lin Curry published a first-person account documenting her own use of therapeutic cannabis to alleviate symptoms of hyperemesis gravidarum (HG), a potentially life-threatening condition characterized by severe nausea and vomiting, malnutrition, and weight loss during pregnancy. (While general nausea and vomiting, colloquially known as ‘morning sickness,’ is experienced by an estimate 70 to 80 percent of all expectant mothers, approximately 1 to 2 percent are struck with the persistent vomiting and wasting associated with HG.) Curry recounts:

“Within two weeks of my daughter’s conception, I became desperately nauseated and vomited throughout the day and night. … I vomited bile of every shade, and soon began retching up blood. … I felt so helpless and distraught that I went to the abortion clinic twice, but both times I left without going through the with procedure. … Finally I decide to try medical cannabis. … Just one to two little puffs at night, and if I needed in the morning, resulted in an entire day of wellness. I went from not eating, not drinking, not functioning, and continually vomiting and bleeding from two orifices to being completely cured. … Not only did the cannabis save my [life] during the duration of my hyperemesis, it saved the life of the child within my womb.”

Most recently, survey data collected by the directors of the Vancouver Island Compassion Society (The VICS) and the BC Compassion Club and published in the journal Complementary Therapies in Clinical Practice reported that cannabis is therapeutic in the treatment of both morning sickness and HG. Of the 84 women who responded to the anonymous questionnaire, 36 said that they had used cannabis intermittently during their pregnancy to treat symptoms of vomiting, nausea, and appetite loss. Of these, 92 percent said that cannabis was “extremely effective” or “effective” in combating their symptoms. Investigators noted that although most women chose to self-administer cannabis by smoking, many (31 percent) also reported consuming hempen edibles, and eight percent reported using cannabis-based oils or tinctures.

PRE-NATAL POT EXPOSURE AND CHILD DEVELOPMENT

 

Though several retrospective, self-report surveys have been conducted regarding pre-natal exposure to cannabis, not all of these properly control for the use of alcohol or other substances. Among those that do, most report cannabis’ apparent impact on birth-weight and other adverse perinatal outcomes to be minimal. (Though adverse reproductive outcomes have been reported in rodents given synthetic THC, these results are typically only reported after the administration of extremely large doses of the drug at specific times during pregnancy. Therefore, these results likely have little relevance to humans.)

Writing in their 1997 book Marijuana Myths, Marijuana Facts: A Review of the Scientific Evidence (The Lindesmith Center), Drs. John P. Morgan and Lynn Zimmer assert, “Marijuana has no reliable impact on birth size, length of gestation … or the occurrence of physical abnormalities” among infants. Large-scale surveys appear to back up their conclusion.

A 2002 survey of 12,060 British women did not demonstrate significant differences in growth among newborns exposed to cannabis in utero versus those with no exposure, when controlling for co-founding factors such as the mothers’ age, pre-pregnancy weight, and the self-reported use of tobacco, alcohol, caffeine, and other illicit drugs. A 1999 survey of 12,885 Dutch mothers reported similar findings after controlling for maternal tobacco use. “The use of cannabis is not a major prognostic factor regarding the outcome of pregnancy,” the authors concluded. A 1997 Australian study of 32,483 mothers also reported, “There is inadequate evidence that cannabis, at the amount typically consumed by pregnant women, causes low birth weight.” Most recently, a large-scale case-control study published in the journal Pediatric and Perinatal Epidemiology determined that mothers who reported using cannabis during pregnancy suffered no increased risk of bearing children with acute myeloid leukemia, a cancer known to strike adolescents under age 15.

Arguably the study most often cited on the subject remains Dr. Dreher’s work from Jamaica, which examined the birth weights and early development of babies exposed to cannabis compared to non-exposed infants. (Mothers in the study reported that they occasionally mixed cannabis with tea as an alternative to smoking.) Her study reported no significant physical or psychological differences in newborns of heavy marijuana-using mothers at three days old, and found that exposed children performed better on a variety of physiological and autonomic tests than non-exposed children at 30 days. (This latter trend was suggested to have been a result of the socio-economic status of the mothers rather than a result of pre-natal pot exposure.)

By contrast, longitudinal data assessing the potential impact of pre-natal cannabis exposure on neurobehavioral and cognitive functioning is ambivalent. Two cohorts have examined this issue, both of which assessed the impact of heavy marijuana exposure on offspring outcome. Both studies remain ongoing.

The first cohort, known as the Maternal Health Practices and Child Development Study, examines the offspring of so-called “high-risk” mothers of low socio-economic status who reported using pot, alcohol, and other intoxicants. Investigators report an association between daily cannabis use in the first and third trimesters and adverse neurobehavioral and cognitive outcomes, such as lower verbal and reading scores and increased depression. However, due to the study’s methodological limitations, researchers cannot conclude whether these outcomes are due to cannabis exposure or other pre-natal or post-natal environmental factors.

The second cohort, known as the Ottawa Prenatal Prospective Study (OPPS) examines the outcomes of prenatal exposure to cannabis and tobacco smoking in a sample of low-risk, white, upper-class families in Ontario, Canada. So far, results of the study have been mixed – showing an association between maternal pot use and higher incidences of adolescent impulsivity, overall poor behavior, and decreased “executive function” (an integration of cognitive processes) at certain ages, but not at others. (By contrast, investigators have not noted any negative association between pre-natal pot exposure and IQ scores.) Recently, a comprehensive review of both studies published in the journal Neuroscience and Behavioral in 2005 concluded that if an association between pre-natal cannabis exposure and certain neurobehavioral and cognitive deficits exists, it is a “subtle” one and appears to be primarily associated with children exposed to heavy amounts of cannabis as well as alcohol and/or tobacco.

More recently, researchers at the University of Pittsburgh School of Medicine published findings in 2008 from a prospective study assessing the effects of prenatal marijuana exposure in 648 children in a low-income population at a six-year follow up. Researchers reported: “There was a significant nonlinear relationship between marijuana exposure and child intelligence. Heavy marijuana use (one or more cigarettes per day) during the first trimester was associated with lower verbal reasoning. … Heavy use during the second trimester predicted deficits in the composite, short-term memory, and quantitative scores. Third-trimester heavy use was negatively associated with the quantitatives core. … These findings are of concern, but they do not by themselves demonstrate causality.” Most recently in 2009 investigators at the University of Bristol in Great Britain assessed whether maternal use of tobacco, alcohol, or cannabis during pregnancy increased the risk of psychotic symptoms in their offspring. Researchers examined the drug use habits of the mothers of over 6,300 adolescents – approximately 12 percent of which exhibited some symptoms of psychosis.

Authors concluded: ʺFrequency of maternal tobacco use during pregnancy was associated with increased risk of suspect or definite psychotic symptoms (in offspring.) Maternal alcohol use shows a non-linear association with psychotic symptoms, with this effect almost exclusively in the offspring of women drinking >21 units (approximately a half-pint of beer or a glass of wine) weekly. Maternal cannabis was not associated with psychotic symptoms.ʺ

THE OCCASIONAL TOKE: SAFE FOR MOMS OR NOT?

Unfortunately, there is not a definitive answer to this question available at this time. Nevertheless, with a reported three percent of US women of reproductive age reporting that they occasionally use marijuana, it may be arguable that potential pre-natal and post-natal dangers posed by maternal pot use – particularly moderate use – are rather minimal, especially when compared to the in utero exposure of alcohol and tobacco. Ultimately however, any decision by the parent regarding the maternal use of cannabis should be made in consultation with a physician. In addition, any decision to potentially use cannabis carries with it serious potential legal ramifications, including temporary loss of child custody.

Finally, it should be noted that scientists today are just now beginning to understand the role of endocannabinoids and the endocannabinoid system in reproduction, including their role in pre-natal and post-natal development. Whether the future understanding of this system will shed additional light on the health implications of maternal pot smoking remains to be seen. Regardless, let’s hope that it is science — not rhetoric — that ultimately is the final arbiter in this decades-long debate.

REFERENCES

Ethan Russo. 2002. Cannabis Treatments in Obstetrics and Gynecology: A Historical Review. Journal of Cannabis Therapeutics 2: 5-35.

http://www.cannabis-med.org/membersonly/mo.php?aid=2002-03-04&fid=2002-03-04-1&mode=a&sid= Dreher et al. 1994. Prenatal marijuana exposure and neonatal outcomes in Jamaica: An ethnographic study. Pediatrics 93: 254-260.

http://www.druglibrary.org/schaffer/hemp/medical/can-babies.htm Wei-Ni Lin Curry. 2002. Hyperemesis Gravidarum and clinical cannabis: To eat or not to eat? Journal of Cannabis Therapeutics 2: 63-83.

http://www.informaworld.com/smpp/content~db=all?content=10.1300/J175v02n03_05 Westfall et al. 2006. Survey of medicinal cannabis use among childbearing women: Patterns of its use in pregnancy and retroactive self-assessment of its efficacy against ‘morning sickness.’ Complementary Therapies in Clinical Practice 12: 27-33.

http://www.ncbi.nlm.nih.gov/pubmed/16401527 John P. Morgan and Lynn Zimmer. Marijuana Myths, Marijuana Facts: A Review of the Scientific Evidence. New York: The Lindesmith Center. 1997. Fergusson et al. 2002. Maternal use of cannabis and pregnancy outcome. BLOG: An International Journal of Obstetrics and Gynaecology 109: 21-27.

http://www.ncbi.nlm.nih.gov/pubmed/11843371 Balle et al. 1999. Cannabis and pregnancy. Ugeskr Laeger 161: 5024-5028.

http://www.biopsychiatry.com/canpreg.htm English et al. 1997. Maternal cannabis use and birth weight: a meta-analysis. Addiction 92: 1553-1560.

http://www.ingentaconnect.com/content/carfax/cadd/1997/00000092/00000011/art00015 Trivers et al. 2006. Parental marijuana use and risk of childhood acute myeloid leukaemia: a report from the Childrenʹs Cancer Group. Pediatric and Perinatal Epidemiology 20: 110-118.

http://www.ncbi.nlm.nih.gov/pubmed/16466429 Richardson et al. 1995. Prenatal alcohol, marijuana and tobacco use: infant mental and motor development. Neurotoxicology and Teratology 17: 479-487.

http://www.ncbi.nlm.nih.gov/pubmed/7565494 Peter Fried. 1995. Prenatal exposure to marihuana and tobacco during infancy, early and middle childhood: effects and an attempt at synthesis. Archives of Toxicology Supplement 17: 233-260.

http://www.ncbi.nlm.nih.gov/pubmed/7786162

Article from: norml.org

Breathe, Push, Puff? Pot Use and Pregnancy: A Review of the Literature



Love The Blog? You'll Love Our Clothing!

SHOP-NOW-BUTTON

You May Also Like:

66 thoughts on “Pot Use and Pregnancy

  1. Sequoia Capital India Shailendra Singh says:

    I needed to compose you this tiny observation to give thanks once
    again with your nice pointers you’ve discussed above.
    It has been simply strangely generous of people like you to present
    freely all that most people would’ve offered for sale as
    an e-book to generate some cash for themselves,
    and in particular since you might well have tried it in case you desired.
    The tips also served as a easy way to understand that many people have the same eagerness similar to my personal own to understand good deal more on the subject of this
    matter. I know there are numerous more fun opportunities in the future
    for many who looked over your blog post.

  2. best chat says:

    Hey there I am so delighted I found your web site, I really found you by
    accident, while I was looking on Askjeeve for something else, Anyways I am here now
    and would just like to say thanks a lot for a remarkable post and a all round thrilling blog (I
    also love the theme/design), I don’t have time to look over it all at the minute
    but I have book-marked it and also added in your RSS feeds,
    so when I have time I will be back to read much more, Please do keep up
    the awesome work.

  3. acceptable passport photos says:

    I do not know whether it’s just me or if everyone else experiencing issues with your
    website. It looks like some of the written text
    on your posts are running off the screen. Can somebody else
    please provide feedback and let me know if this is happening to them too?
    This may be a problem with my web browser because
    I’ve had this happen previously. Appreciate it

  4. pod moving container says:

    Hmm it seems like your site ate my first comment (it was extremely long)
    so I guess I’ll just sum it up what I submitted and say, I’m thoroughly enjoying your blog.

    I too am an aspiring blog blogger but I’m still new to everything.

    Do you have any recommendations for newbie blog writers?
    I’d definitely appreciate it.

  5. winged termites says:

    I’m truly enjoying the design and layout of your site.
    It’s a very easy on the eyes which makes it
    much more pleasant for me to come here and visit more often.
    Did you hire out a designer to create your theme?
    Outstanding work!

  6. Asian mi fece pompini says:

    Great blog right here! Additionbally your webssite quite a bit up fast!

    What web host are you thhe usage of? Can I get your affiliate hyperlink to your host?
    I want my site loaded up as fast as youirs lol

  7. Ina says:

    Howdy just wanted to give you a brief heads up and let you know a few of the images aren’t loading properly.
    I’m not sure why but I think its a linking issue. I’ve tried it
    in two different browsers and both show the same outcome.

  8. diagnostics automobile says:

    Does your site have a contact page? I’m having a
    tough time locating it but, I’d like to shoot you
    an email. I’ve got some ideas for your blog you might be interested in hearing.
    Either way, great blog and I look forward to seeing it expand over time.

  9. KaseyRKelson says:

    whoah this weblog is magnificent i really like studying your articles.

    Keep up the great work! You already know, a lot of individuals are hunting
    around for this information, you can help them greatly.

  10. LukeERollf says:

    My coder is intending to persuade me to maneuver to .net
    from PHP. I have got always disliked the theory because of the costs.
    But he’s tryiong none the less. I’ve been utilizing Movable-type on a variety of websites for roughly each year and am nervous about switching to another one platform.
    We have heard good things about blogengine.net. Is there a way I can transfer all of my wordpress content with it?
    Just about any help can be really appreciated!

  11. SignePKnoy says:

    Superb post however , I was wanting to know if you could write a litte
    more on this subject? I’d be very thankful if you could elaborate a little bit more.
    Thanks!

  12. MarionJAsmar says:

    Admiring the time and effort you put into your blog and
    in depth information you present. It’s awesome to come across a blog every once in a
    while that isn’t the same outdated rehashed information. Fantastic read!
    I’ve saved your site and I’m including your RSS feeds to my Google account.

  13. IldaSMamaril says:

    Spot up with this write-up, I truly feel this amazing site needs far more
    attention. I’ll more likely be back again to
    see more, many thanks for the information!

  14. custody laws says:

    I’m impressed, I have to admit. Rarely do I encounter a blog that’s equally educative and engaging, and
    let me tell you, you have hit the nail on the head. The issue is something that too few folks are speaking intelligently about.
    Now i’m very happy I found this during my search for something concerning this.

  15. AshlyLGrande says:

    Excellent pieces. Keep writing such kind of
    information on your site. Im really impressed by it.

    Hi there, You’ve performed an excellent job. I will certainly digg
    it and for my part suggest to my friends. I am confident they will be benefited
    from this web site.

  16. MaeganAMomin says:

    It’s amazing to pay a quick visit this web page and reading the views of all colleagues on the
    topic of this article, while I am also zealous of getting experience.

  17. RussSDuber says:

    Hey There. I discovered your weblog the usage of msn. This can be an incredibly smartly written article.
    I’ll ensure to bookmark it and keep coming back to read more of
    the helpful info. Thank you for your post. I will certainly comeback.

  18. TenaLDainack says:

    Great blog here! Also your web site loads up fast!
    What hosting company are you presently using? Can One get your affiliate hyperlink to your
    host? If only my website loaded up as quickly as yours lol

  19. RoyNLusane says:

    I’m amazed, We have to admit. Seldom will i find your blog that’s both equally educative and engaging, and without
    a doubt, you possess hit the nail about the head. The thing is an element that insufficient people are speaking intelligently about.
    Now i’m happy I found this during my hunt for something relating to this.

  20. SolomonXBars says:

    You happen to be so interesting! I don’t believe We have read through anything like that before.
    So great to find someone else with many original thoughts on this topic.
    Seriously.. many thanks for starting this up. This website is something that is required online, someone
    after some originality!

  21. BuddyEUken says:

    Great blog here! Also your site loads up fast! What host
    have you been using? May I get the affiliate backlink to your host?

    I wish my internet site loaded up as fast as yours lol

  22. CarloZSusi says:

    I don’t know if it’s just me or if everybody else encountering issues with your web site.

    Seems like like a few of the text with your posts are
    running away from the screen. Can other people please provide feedback and tell me if this is happening in their mind
    too? This might become a problem with my browser because I’ve had this happen before.

    Appreciate it

  23. EileenSJeong says:

    I feel this is certainly on the list of most significant info in my opinion. And i’m glad studying your article.
    But wanna remark on some normal things, The site
    taste is wonderful, the articles is in fact nice : D.
    Just right activity, cheers

  24. RoyalSAlekna says:

    Hello just wanted to give you a brief heads up and let you
    know a few of the images aren’t loading properly. I’m not sure
    why but I think its a linking issue. I’ve tried it in two different internet browsers and both show the same results.

  25. DaleCSpinner says:

    Hello! I’ve been following your website for
    a bit of time now lastly got the courage to proceed to offer you
    a shout out from Austin Tx! Just wished to say keep up
    the excellent work!

  26. RicoBBilling says:

    Link exchange is nothing else except it is simply placing the
    other person’s webpage link on the page at suitable place and other person will likely do same in support of
    you.

  27. MarryGBuller says:

    Excellent blog here! Additionally your website quite a bit up fast!

    What hosting company are you using? Can I have your affiliate
    link on your own host? I want my site loaded as quickly as yours
    lol

  28. JanaPDifabio says:

    naturally much like your web-site but you must check
    the spelling on several of your posts. A number
    are rife with spelling issues and I in locating it very troublesome to tell the veracity
    nevertheless I will surely come again again.

  29. RutheNAmelio says:

    I truly do believe all of the concepts you possess presented
    with your post. They may be very convincing and may definitely work.
    Still, the posts are too brief for newbies. May you please prolong
    them a little from next time? Thanks to the post.

  30. TravisDOllis says:

    Hey! This is kind of off topic but I need some help from an established blog.

    Is it tough to set up your own blog? I’m not very techincal
    but I can figure things out pretty fast. I’m thinking about making my own but I’m not sure
    where to start. Do you have any ideas or suggestions?
    Thank you

  31. HangKAlvis says:

    Simply wish to say your article is as surprising. The clarity in your post is just excellent and i could assume
    you’re an expert on this subject. Fine with your permission allow me
    to grab your feed to keep up to date with forthcoming post.

    Thanks a million and please continue the enjoyable work.

  32. DaisyDBigney says:

    Thanks for your personal marvelous posting! I
    genuinely enjoyed reading it, you may be a fantastic author.I am going to make sure to bookmark
    your website and can revisit sometime soon. I would like to encourage you continue your
    great posts, possess a nice afternoon!

  33. RamiroYMaura says:

    Excellent post but I was wondering if you could write a litte more on this subject?
    I’d be very grateful if you could elaborate a little bit
    further. Bless you!

  34. DongWNoble says:

    Hi there! I know this can be kinda off topic however i
    was wondering when you knew where I really could find a captcha plugin for my comment form?
    I’m utilizing the same blog platform as yours and I’m having difficulty finding one?
    Thanks a lot!

  35. AnOSiebeneck says:

    Hi there! This is kind of off topic but I need some guidance
    from an established blog. Is it tough to set up your own blog?

    I’m not very techincal but I can figure things
    out pretty fast. I’m thinking about setting up my own but I’m not sure where to start.
    Do you have any points or suggestions? With thanks

  36. HymanNMutz says:

    Maybe you have considered about adding a bit more than only the articles you write?

    I mean, everything you say is important and everything.
    Nevertheless consider if you added some terrific photos or
    videos to give your site content more, “pop”! Your posts
    is fantastic but with pics and videos, this site could undeniably
    be one of the best in the niche. Amazing blog!

  37. EvieTDepaula says:

    I had been recommended this blog by my cousin. I
    am unclear whether this post is written by him as no one else know such detailed about my problem.
    You might be amazing! Thanks!

  38. SalNSprake says:

    I simply could not leave your website just before suggesting which i
    really loved the standard information an individual
    supply for the visitors? Is planning to be again incessantly to be able to check-up on new posts

  39. SaraiACubr says:

    Greetings! I understand this is kinda off topic nevertheless i was wondering if you knew where I really could locate a captcha plugin for my comment form?
    I’m utilizing the same blog platform as yours and
    I’m having trouble finding one? Thanks a good deal!

  40. IanFSobanski says:

    I am extremely impressed along with your writing skills and also using the layout in your weblog.
    Is this a paid theme or did you modify it yourself? Either way continue the nice quality writing, it’s rare to find out a nice blog similar to this
    one today.

  41. JarvisDJoyce says:

    Just wish to say your article is as astonishing. The clearness in your put up is simply spectacular
    and i can assume you are a professional in this subject.
    Fine with your permission let me to grab your feed to stay up to date with forthcoming post.
    Thanks one million and please carry on the gratifying work.

  42. KacieAAini says:

    Incredible! This blog looks just like my old one!
    It’s on a entirely different topic nevertheless it has pretty much the identical page layout and design. Superb selection of colors!

  43. HankFRehberg says:

    I really love your blog site.. very nice colors & theme.
    Have you make this website yourself or do you employ someone to do it to suit your needs?
    Plz answer back as I’m seeking to create my own, personal blog and
    would like to know where u got this from. cheers

Leave a Reply

Your email address will not be published.

*