Marijuana and Pregnancy

Using cannabis and marijuana preconception may impair fertility

Marijuana use may make conception and getting pregnant more difficult for women who smoke than those who don’t, according to a prospective cohort study from the National Institutes of Health (NIH). The findings, published in Human Reproduction, linked preconception cannabis use with reduced fecundability despite increased frequency of intercourse.

Researchers concluded that women with preconception cannabis use did have reduced fecundability.

Is it safe to use weed/cannabis when you're pregnant?

Cannabis (weed or marijuana) is legal now in over 30 states in the U.S. and more pregnant women are using it. There is no evidence that taking marijuana in pregnancy is safe, and there is scientific evidence that it increases certain adverse pregnancy complications such as premature labor, small babies, and placental abruption. Babies born to mothers who used weed in pregnancy also had lower Apgar scores and were more likely to be admitted to the neonatal intensive care unit. Pregnant women should not use marijuana for those reasons. If the man uses cannabis, a recent study showed a twice increased risk of miscarriage in the woman.

That is why all major medical organizations such as ACOG and the CDC recommend that you do not use marijuana when trying to get pregnant and during pregnancy. All women who are TTC and those who are pregnant should be encouraged to stop smoking marijuana as soon as possible. 

The drug contained in cannabis/marijuana is called 'THC,' and it crosses the placenta. That means every time a pregnant woman smokes marijuana, her fetus also gets this drug. Unfortunately, many pregnant mothers smoke marijuana because it seems that it has not been shown to cause any predictable pattern of abnormal fetal effects. This is not true. Babies born to mothers who smoke marijuana during pregnancy have several problems including lower birth weight and leukemia. Anytime smoke is forced into the alveoli of the lungs, it is competing for oxygen which should be getting to the baby. In addition, because marijuana is not under government quality controls, any number of chemicals could be contaminating it, and this could be potentially harmful to the baby.

Is using medical marijuana during pregnancy safe?

While medical marijuana has become legal in some U.S. states, it is not regulated nor evaluated by the U.S. Food and Drug Administration.  During pregnancy and lactation there are no approved indications, contraindications, safety precautions, or recommendations nor are there any "safe" formulations, dosages, or delivery systems. Doctors should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. There are still no good studies yet on the impact of marijuana on pregnancy or lactation.

The American Academy of Pediatrics says that:

  1. As part of routine anticipatory guidance and in addition to contraception counseling, it is important to advise all adolescents and young women that if they become pregnant, marijuana should not be used during pregnancy." 
  2. Pregnant women who are using marijuana or other cannabinoid-containing products to treat a medical condition or to treat nausea and vomiting during pregnancy should be counseled about the lack of safety data and the possible adverse effects of THC in these products on the developing fetus and referred to their health care provider for alternative treatments that have better pregnancy-specific safety data.

  3. Women of reproductive age who are pregnant or planning to become pregnant and are identified through universal screening as using marijuana should be counseled and, as clinically indicated, receive brief intervention and be referred to treatment.

  4. Although marijuana is legal in some states, pregnant women who use marijuana can be subject to child welfare investigations if they have a positive marijuana screen result. Health care providers should emphasize that the purpose of screening is to allow treatment of the woman’s substance use, not to punish or prosecute her.

Therefore, pregnant women or women contemplating pregnancy should be encouraged to discontinue the use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data.

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