Using weed while in labor? Nearly half of women say they would consider it 

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The list of things pregnant women can’t have is miles long. Deli meat. Wine. Sushi. Rare steak. Canned foods. Even certain types of cookware are to be avoided.

Should cannabis be on that list?

The first instinct is to respond with an emphatic “yes.” But why? Is there science behind that gut reaction? Where is the data?

Those are questions that researchers like Kara Skelton are exploring extensively.

Skelton, a doctor of health education and promotion at Towson University, co-authored a study published last year that explored the attitudes of American women toward using cannabis while in labor. What she found surprised her.

While barely 3 percent of the roughly 160 women polled reported consuming weed while giving birth, nearly half of them — 47 percent — were open to the idea.

The authors concluded that more research was urgently needed to guide clinical practice and advised prenatal care providers to discuss cannabis use during pregnancy with their patients.

“There is no data to support the safety and efficacy of cannabis use during labor or pregnancy,” Skelton said in an interview. “We don’t know the effects on the baby, we don’t fully understand all the drug interactions that are possible with labor medications. There’s so much we don’t know.”

Skelton’s study suggests a sea change is underway, particularly as cannabis becomes more available. More than half of Americans now live in a state where cannabis is legal in some form, and more people are turning to the plant for a variety of reasons.

“This is a conversation that requires a lot of nuances,” said Codi Peterson, a doctor of pharmacy and specialist in cannabis science and therapeutics. “There should be minimal use of any medications during pregnancy, including cannabis because they all have an effect on mom and baby.”

But, he added, there are situations in which the case can be made, even to a medical doctor, for consuming cannabis while pregnant.

ONE MOM’S SUCCESS STORY

That was the scenario for Emily Kyle, a married mother of two who owns Emily Kyle Nutrition, a cannabis communications company in Livingston County.

During her second pregnancy, she suffered from hyperemesis gravidarum, a form of excessive nausea and vomiting. She wasn’t able to eat, began rapidly losing weight, and grew increasingly concerned about her body’s ability to nourish her growing child.
“It was a really hard time,” Kyle said. “I was growing this beautiful gift, but my health was rapidly deteriorating. I truly believe cannabis saved my life and my baby’s life.”
Kyle had a medical marijuana card prior to getting pregnant, which she believes helped her make the case to her midwife for using cannabis.

“For me, cannabis was the first line before pharmaceuticals,” Kyle said. “I felt more confident in my choice to consume cannabis than I would have been taking a pharmaceutical for this.”

Not only did she use cannabis while pregnant, but she turned to the plant during labor to help relieve anxiety. “I had a scheduled induction, and the anxiety of knowing you’re going to give birth is really hard,” Kyle said “Cannabis helped me manage that.”

Kyle used a dry herb vaporizer she bought at her medical marijuana dispensary. With a vaporizer, there’s no combustion, so you’re not inhaling smoke. Vaporizers are also discreet and work quickly.

WHAT’S THE DANGER?

There is not a lot of research on cannabis and pregnancy. Evidence linking marijuana use by pregnant women to adverse outcomes, like premature births or low birth weights, is mixed. Some studies have suggested that children of mothers who used marijuana during their pregnancies have problems with neurological development, but even the National Institute on Drug Abuse has reported that more research is needed to disentangle other environmental and socio-economic factors from marijuana use that could contribute to those outcomes.

Still, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists err on the side of caution and recommend that pregnant women abstain from using weed.

Among the concerns regarding cannabis use by pregnant women are THC’s intoxicating effect and the ability for the drug to stay in their bodies. Cannabinoids are lipophilic molecules — they love fat. That’s why you can test positive for cannabis days after a single consumption; it’s stored in your fat molecules. Even in small doses, THC builds up in your body, and for pregnant women, it may pass to the baby.

Some studies suggest that THC levels in breast milk can be up to eight times higher than THC levels in the rest of mom’s body. Separate studies have shown that THC use by preteens and teens is damaging to brain development, so it’s not a leap to suggest that it’s detrimental to fetuses in utero as well.

This potential build-up of THC is thought to depend on how it is consumed. Using cannabis balms, salves, and bath bombs have not shown to pose the same risk as eating an edible or hitting the bong.
“The exposure concern is mainly with oral and ingestible products,” Peterson explained. “These products get absorbed into the mother's bloodstream, brain, and breastmilk and get passed to baby. But topical products don’t get absorbed into the bloodstream, and so do not present the same exposure risk.”

And of course, childbirth is altogether different from gestation. Delivering a baby is associated with stress, anxiety, and pain.

“During labor, it’s a very different situation,” Peterson said. “There’s minimal exposure to the baby, and we’re less concerned about cannabis impacting the brain or body development at that point.”

For some pregnant women, the risk is worth the reward. Many moms who have consumed cannabis during pregnancy report perfectly healthy children who hit age-appropriate milestones.

“My son is 18 months old now, and he is the happiest, healthiest little boy,” Kyle said. “He has hit every development milestone, and he’s bigger than his brother ever was at his age.”

PREGNANCY IN A POST-PROHIBITION WORLD

For women who choose to consume cannabis during pregnancy, it can be an isolating choice.

Legal weed is still so new that many medical professionals are playing catch up, or refusing to admit what they don’t know. This can lead to antiquated approaches based on shame and judgment, rather than curiosity.

One study published by the Journal of the American Medical Association in 2017 found that one in five pregnant women 24 years old and younger screened positive for marijuana, but also that just one in 10 of them admitted to using the drug.

“We have to remove the judgment and get to the root cause; why are they using cannabis?” Skelton said.

An overwhelming majority of women in her study on attitudes about cannabis consumption during labor reported that a potential benefit to using marijuana while in childbirth was managing pain.

“Having effective clinical guidance and providing a high quality of care is powerful in improving maternal and child health outcomes,” Skelton said. “If providers are focused on shaming women for these choices, rather than taking a harm-reduction approach, we won’t move forward.”

She added that the lingering unknowns are concerning.

“Do the benefits outweigh the risks? We just don’t know,” Skelton said. “Increases in cannabis availability have led to a decreased perception of risk in pregnancy, but there is not enough evidence to support the safety of cannabis use.”

Kyle relied on a strong support system that included her midwife, husband, and parents.

“I was so scared – the stigma is really strong, even though I knew I was making the right choice for me and my baby,” Kyle said. “I was shaking when I told my midwife.”
For Peterson, the historical context has to be considered.

“Women have been using cannabis while pregnant for decades,” he said. “But we do know that there are some adverse effects, particularly when it comes to continued exposure to cannabis.”

Is using cannabis while pregnant the right thing to do? That’s a deeply personal question that can only be answered by a mother and her doctor.

Peterson paused when pressed as to what advice he would give a pregnant woman consuming cannabis.

“While I don’t support the use of cannabis during pregnancy, I would say to be mindful,” Peterson said. “We know that adverse effects are dose-related, so if you need to, find a way to consume consciously.”

Jessica Reilly is a freelance writer for CITY. Feedback on this article can be directed to [email protected].