Smoking Marijuana While Pregnant

Although marijuana is one of the most widely used illicit drugs, there is limited data on the prevalence among pregnant women. One report estimated marijuana use during pregnancy to be anywhere from 2-5% ¹. It is likely that these numbers are lower than actual figures, since women may underreport the use of drugs during pregnancy for fear of stigma and/or legal consequences.

A woman’s use of marijuana tends to peak when she is in her early 20s. This overlaps with the average age of a woman’s first pregnancy (23 years), making marijuana use during pregnancy a public health concern ². There is even more cause for concern in light of the fact that average potency of the drug has gone up, and, due to legalization of the drug in many areas, more people are using it than ever ².

When a woman smokes marijuana or consumes cannabis edibles during pregnancy, its active psychoactive components are able to cross the placental barrier. The primary intoxicating substances in marijuana are fat-soluble and able to traverse the fetal blood brain barrier and bind to cannabinoid receptors in the baby’s brain ².

Although many women of reproductive age use marijuana, there is limited and conflicting evidence on how it affects birth outcomes. According to information from the World Health Organization (WHO) and several studies, marijuana use during pregnancy may cause ^3,4.

• Impaired fetal development.
• Preterm birth.
• Small size according to gestational age.
• Low birth weight.
• Rare forms of cancer.

One study found that children born to mothers who smoked marijuana during pregnancy were more likely to require neonatal intensive care unit (NICU) admission and had higher rates of hospitalization after birth ⁵.

Research evidence indicates that repeat exposure to marijuana can disrupt portions of fetal brain development by altering signaling pathways that involve receptors for naturally occurring endocannabinoid molecules. The developmental course of very high-level brain connections (in the fetal cortex) may also be irreparably altered. In other words, marijuana use can adversely affect behavioral, neuropsychiatric, and executive functioning—and these effects could last forever ⁶.

Marijuana’s Effects on the Baby After Birth

Our understanding of the effects of marijuana on a developing brain would benefit from continued research. Though animal studies suggest that marijuana use during pregnancy can alter the course of normal brain development ⁹, the long-term effects of human intrauterine exposure to marijuana is poorly understood ¹⁰.

The active ingredient in marijuana, delta-9-tetrahydrocannabinol or THC, may put a baby at risk for developing long-term problems. Studies have found that prenatal marijuana exposure is associated with ¹¹:

• Attention problems.
• Hyperactivity.
• Impulsivity.
• Increased delinquent behavior.

Children who are exposed to marijuana as a fetus are more likely to use marijuana and cigarettes in young adulthood ².

It is difficult to draw conclusions from studies on women who smoke marijuana during pregnancy for a number of reasons. In addition to not feeling comfortable disclosing their smoking status due to fear or stigma, women who use marijuana during pregnancy may also be using other substances (either illicit or legal), as well as smoking tobacco cigarettes ¹². The potential influence of other drugs and/or toxic combustibles (from cigarette smoke) makes it difficult for researchers to pinpoint causation for marijuana only.

Many expecting mothers wonder whether it is okay to smoke or eat marijuana during pregnancy. There is no clear answer, given the conflicting research on the topic, but many studies do indicate the potential for risk. Naturally, expectant mothers wanting the best for their babies are advised to avoid the use of drugs that are not absolutely necessary for their health.

Is Medical Marijuana Use Okay?

A recent study found that among pregnant women, 3.9% used marijuana in the past month and 7% had used it in the past 2-12 months. Past-month use was highest when women were in their first trimester and lowest in the third trimester ¹³.

Marijuana is not regulated or evaluated by the U.S. Food and Drug Administration. This makes it difficult for doctors to provide recommendations about its use during pregnancy and beyond. There are no standard doses for doctors to prescribe. Due to the harmful effects of smoking on a baby’s oxygen supply, doctors cannot medically condone smoking marijuana during pregnancy and lactation ¹.

According to the American College of Obstetricians and Gynecologists, pregnant women or women thinking about getting pregnant should be encouraged to stop using marijuana for medicinal purposes. Doctors may recommend alternative therapies that are proven to be safe for women who are pregnant. The medical community is still waiting on published, high-quality studies in order to deem marijuana and other cannabis products safe for use during pregnancy and lactation ¹.

Quitting Marijuana While Pregnant

Every woman wants a healthy life for her baby. In order to get started, it is important that you disclose your marijuana use with your provider. Let your doctor know how often you use marijuana, as an honest assessment is required to help them develop a treatment plan that will fit your needs.

Quitting marijuana use while you are pregnant requires a combination of approaches so that you can address the physical, emotional and psychological aspects of your addiction. Currently, there are no FDA-approved medications for marijuana dependence. Treating an addiction to marijuana will often begin with behavioral therapy.

The type of behavioral therapy that your doctor will recommend will depend on you and your level of marijuana use. Below are some common methods that may be used during treatment ¹⁴:

• Motivational enhancement therapy: MET helps to produce and increase motivation from within to make healthy changes. Rather than tell you the changes you need to make, the therapist will work with you to find the internal motivation and desire for positive change.
• Cognitive-behavioral therapy (CBT) : This form of psychotherapy addresses the thoughts, feelings, and behaviors that may be contributing to your drug use. The therapist works with you to adjust them so you can overcome damaging thoughts and belief patterns to achieve and maintain sobriety.
• Contingency management : This approach uses a reward system to enforce positive behaviors. You and your therapist may set goals for your treatment. When you reach a goal or when you fail to reach a goal, there is a built-in system of rewards or removal of rewards.

Some programs incorporate  alternative therapies into their treatment model. These could include:

• Meditation.
• Yoga.
• Mindfulness.
• Acupuncture.
• Art therapy.

If your dependence to marijuana is putting your baby at risk, you may want to consider entering a drug addiction treatment program that is skilled at working with pregnant women. There are several options when it comes to marijuana addiction rehab.

Inpatient treatment programs allow you to stay at a facility while you go through treatment. This amount of support and attention can help you properly address any underlying issues related to your marijuana use. Inpatient programs also offer a safe and medically supervised environment. If you are pregnant, this is especially important, as it ensures the safety of you and your baby.

Outpatient programs are a wonderful option if you are unable to leave home and/or work while you go through treatment. Outpatient allows you the flexibility of receiving treatment a couple times a week and allows for periodic check-ins for therapy and medical monitoring.

If you’re struggling with mental health issues like anxiety or depression, you can seek the help of a dual diagnosis program that will work to help you manage your condition while finding recovery from addiction.

If you are pregnant and using marijuana don’t hesitate to seek help. Call us at 1-800-980-3927 to speak with an addiction program support specialist about finding the best program to fit your needs.

References:

1. American College of Obstetricians and Gynecologists. (2015). Committee Opinion: Marijuana Use During Pregnancy and Lactation.
2. Sonon, K. E., Richardson, G. A., Cornelius, J. R., Kim, K. H., & Day, N. L. (2015). Prenatal marijuana exposure predicts marijuana use in young adulthood. Neurotoxicology and teratology, 47, 10-15.
3. Hayatbakhsh, M. R., Flenady, V. J., Gibbons, K. S., Kingsbury, A. M., Hurrion, E., Mamun, A. A., & Najman, J. M. (2011). Birth outcomes associated with cannabis use before and during pregnancy. Pediatric research, 71(2), 215-219.
4. World Health Organization. (2016). Cannabis.
5. Warshak, C. R., Regan, J., Moore, B., Magner, K., Kritzer, S., & Van Hook, J. (2015). Association between marijuana use and adverse obstetrical and neonatal outcomes. Journal of Perinatology, 35(12), 991-995.
6. Jaques, S. C., Kingsbury, A., Henshcke, P., Chomchai, C., Clews, S., Falconer, J., … & Oei, J. L. (2014). Cannabis, the pregnant woman and her child: weeding out the myths. Journal of Perinatology, 34(6), 417-424.
7. Behnke, M., Smith, V. C., Levy, S., Ammerman, S. D., Gonzalez, P. K., Ryan, S. A., … & Cummings, J. J. (2013). Prenatal substance abuse: short-and long-term effects on the exposed fetus. Pediatrics, 131(3), e1009-e1024.
8. Dreher, M. C., Nugent, K., & Hudgins, R. (1994). Prenatal marijuana exposure and neonatal outcomes in Jamaica: an ethnographic study. Pediatrics, 93(2), 254-260.
9. Jutras-Aswad, D., DiNieri, J. A., Harkany, T., & Hurd, Y. L. (2009). Neurobiological consequences of maternal cannabis on human fetal development and its neuropsychiatric outcome. European archives of psychiatry and clinical neuroscience, 259(7), 395-412.
10. Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), 2219-2227.
11. Goldschmidt, L., Day, N. L., & Richardson, G. A. (2000). Effects of prenatal marijuana exposure on child behavior problems at age 10. Neurotoxicology and teratology, 22(3), 325-336.
12. Warshak, C. R., Regan, J., Moore, B., Magner, K., Kritzer, S., & Van Hook, J. (2015). Association between marijuana use and adverse obstetrical and neonatal outcomes. Journal of Perinatology, 35(12), 991-995.
13. Ko, J. Y., Farr, S. L., Tong, V. T., Creanga, A. A., & Callaghan, W. M. (2015). Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. American journal of obstetrics and gynecology,213(2), 201-e1.
14. National Institutes of Health. (2016). Available Treatments for Marijuana Use Disorders.