Cannabis use during pregnancy and postpartum
Weed & Pregnancy: Navigating Relief
Throughout my career as a birth worker, this is a question I've repeatedly gotten from many of my clients—is cannabis use safe during pregnancy and postpartum?
This question often comes newly pregnant and postpartum folks battling exhaustion, nausea, and the big life changes that come with parenthood.
Cannabis, with its well-known cannabinoids THC and CBD, has a rich history as a medical and spiritual ally. In Colorado, where marijuana is legal for those 21 and up, the line becomes blurred for pregnant and birthing individuals. Notably, if an infant tests positive for exposure to a Schedule I or Schedule II substance, such as THC, state law triggers a call to Child Protection Services.
So, where do pregnant and birthing people draw the line?
Policy and practice diverge; discouraging cannabis use during pregnancy doesn't mean that people are just doing to stop doing it. Countless families will continue using cannabis without reliable information on safe use and modulation.
Enter recreational marijuana as a means to manage pregnancy and postpartum discomfort
A quick google search will bring you a lot of polarized perspectives; while major research cautions against it, there are endless anecdotal Reddit forums that lack conclusive facts.
To provide centralized information, I recently polled my community to see everyone’s thoughts on the matter. Dozens reported back; responses from mothers, parents, fellow doulas, and midwives. The overwhelming majority reported routine cannabis use during pregnancy and postpartum, citing positive outcomes for various reasons.
This blog post aims to offer families centralized information to inform their decisions, recognizing the risks, benefits, and the gray areas in between.
At the end of the day, cannabis use during pregnancy & postpartum is a deeply personal choice, and it should come from an informed and empowered place.
I know how comforting it is to have the receipts and hard scientific data so families can make informed decisions on their own, so let’s start there.
THE SCIENCE: THC + pregnancy
In the realm of medical studies, the a recurring concern is that it’s challenging to measure the precise amount of THC or CBD transferred from parent to baby. Consequently, no established US medical authority will approve a general minimum or maximum safe amount of cannabis for pregnancy.
The reason for this is that medical authorities are reluctant to do a full study on a human pregnancy out of concern for the infant, and the potentially adverse effects it could have on their brain development.
The only way to study the effect of cannabinoids on fetal development is retrospectively, and by that point it’s impossible to reverse any side effects.
A quick online search will bring up a study by SAMHSA (Substance Abuse and Mental Health Services Administration), indicating that routine cannabinoid use can lead to fetal growth restriction, preterm birth, and long-term developmental issues. These are the metrics that are easiest to find, and the ones your doctor will likely cite to you at your prenatal visits.
A study I found to be really layered is by American Academy of Pediatrics, which poises the question, “why are there so few studies on the benefits of cannabis during pregnancy?”
This study delves into the demographic and socioeconomic correlation to cannabis use, revealing that it can be an advantageous substitute for individuals with tobacco, alcohol, or narcotic addictions.
Impressively, 78% of women who relied on cannabis and were also receiving substance counseling, abstained from substance abuse altogether by delivery.
I love this study because it shows how cannabis can be used therapeutically and medicinally to manage addiction in expectant parents, which will positively impact the addiction profile of their child.
However, this study highlights that routine cannabis use may increase placental permeability, potentially exposing the baby to other toxins in the parent’s environment.
Additionally, it suggests a link between habitual cannabis use and changes in blood flow in the uterine artery, possibly causing irregularities and increased resistance. Blood flow during pregnancy is essential, and this study suggested that regular use of cannabis could restrict circulation to the uterus and impact fetal development.
The bottom line? This is an evolving field of study, and while not medically recommended, it comes down to how you weigh your own risk factors.
Is the occasional use is better than regular, daily use?
I think so, yes. If you need it, modulate it.
We also have to think about folks who are heavily dependent on cannabis, and why. Underlying anxiety, emotional management, stress management, etc. Going cold turkey can put the body and mind in shock. A slow taper may be a better fit than stopping all at once, which could trigger “yo yo” episodes of heavy use throughout breastfeeding.
Will cannabis use affect the development of your baby?
Hard to conclusively say, as studies are still emerging. It’s possible, and it’s also possible that it may not. But if this is something that keeps you up at night, abstaining may be best for you.
Is using cannabis to manage pregnancy symptoms is ok?
Everything in moderation. It also depends on your unique biology! It depends on your existing relationship with cannabis, your risk profile for addiction, and ensuring that you’re avoiding combustion, and favoring organic cannabinoids vs. edibles or gummies with toxic dyes and additives.
Many of the women I spoke with made a note that when they used cannabis during pregnancy and postpartum, they avoided combustion (smoking) as it has a higher transference rate than a vape or an edible.
They also reported that they relied on cannabis most during their first trimester, to manage nausea, anxiety, and support sleep. Many entries noted that their use tapered throughout their 2nd and 3rd trimester.
I was chatting with my friend and fellow doula Kari Kwinn. She was thoughtful around people who start to use cannabis to manage their pregnancy symptoms, but aren’t able to stop when the time comes.
“I would also be concerned about using in pregnancy and not being able to stop during lactation, where this fat-stored THC ends up in milk and can affect newborn respiration rates.”
This leads us right into….
Concerning cannabis and lactation.
There were a handful of varying studies here, but this is one of the most consistent date points I found.
THC likes to bind to fat, and breastmilk has a fat index of 1-2g per fluid ounce. THC can stay in the body’s fat cells from a few hours to weeks, depending on the amount of THC consumed.
Studies show that a buildup of THC in infants (through breastmilk) can lead to symptoms of respiratory distress and depression; but waiting a few hours before you breastfeed can help your body metabolize the total amount and mitigate transference to your baby.
A 2018 study by Teresa Baker and Palika Datta, Texas based MDs & OBGYNs studied the transference of inhaled cannabis into human breastmilk. You can read the study here.
The study had 8 women, all in their immediate postpartum period. Each participant was asked to abstain from cannabis use for 24 hours, and then smoke a pre-measured amount. Their milk was tested at 20 minutes, and at 1, 2, and 4 hours. The study found that after 4 hours had passed, there was less than 3% of the maternal THC dose left in the breastmilk.
What do I take this to mean?
If you’re going to use cannabis while you breastfeed, waiting at least 4 hours before feeding is one of the best things you can do to limit THC/ CBD exposure for your baby.
Deciding to use cannabis during your pregnancy and postpartum is a personal decision, and there are safer ways to do it than others.
The only way to ensure zero cannabinoid exposure to your baby is to abstain altogether. And if that’s your goal, waiting until you’re done breastfeeding may be the best thing for you and your family.
While these are the scientific receipts on cannabis use, I think it’s always helpful to hear about other people’s experiences.
PERSONAL EXPERIENCES:
After polling my audience, I must have received over a dozen of personal stories detailing how cannabis was paramount in supporting pregnancy and postpartum adjustment. From things like nausea and sleep aids to helping parents through postpartum depression and adjustment anxiety. Here are a few of their stories.
All names have been changed to protect the privacy of the people involved.
Janine, 31
After a life threatening bacterial infection during her 1st trimester, Janine declined opiates and Tylenol for pain management, and instead opted for short term use of CBD capsules.
Janine had a relationship to cannabis prior to her pregnancy, and towards the middle of her 3rd trimester, would enjoy an occasional toke off of her vape pen, the same way pregnant folks enjoy a small glass of wine here and there. Cannabis helped her manage many of the big emotional and physical shifts of pregnancy, and her use remained occasional and intentional.
During her second pregnancy, Janine experienced more dramatic hormonal shifts, intense headaches, and nausea, on top of care-taking her 3 year old.
“Having a toddler running around and also dealing with weaning, hormonal shifts, and being pregnant again led to intense and prolonged headaches,” Janine explains.
“I began to vape here and there, and that along with magnesium and protein helped my headaches so much. Cannabis, I believe is a potent herbal ally.”
Maritza, 35
Maritza shared that during her second pregnancy, her anxiety, nausea and morning sickness was excruciating. Her doctors prescribed her heavy nausea medicine that just made her sicker. She began to implement light use of cannabis and said that it was the only thing that soothed her through postpartum depression and suicide ideation.
Maritza shared that cannabis use was paramount in adjusting to the intensity of parenthood, ie long nights, long days, little sleep, inconsistent routine, etc. Cannabis use “softened” this stark transition for her.
“I do believe cannabis was made for women,” Maritza says. “I feel that now if I consume cannabis in edible or inhalant form I connect better with my kids and it gives me some grounding and the steadiness I need to be patient and present.”
Maritza has 2 fully developed, well adjusted children.
Jade, age 33
Jade had a completely cannabis free pregnancy, saying that it never even crossed her mind to use it. 3 months into her postpartum, after she had put her son to bed, she took a casual toke and had an immediate, physical reaction.
She describes it as realizing how disembodied she had become during her pregnancy, and how much tension she was holding. She realized that she hadn’t been in her own body just for herself- that she now regarded her body as belonging to her new baby. Food, warmth, comfort, etc. A very small amount of cannabis helped Jade drop back into her body, realize where she was holding spiritual and phsyical tension, and remember herself.
“The cannabis helped me feel more ok in the change. More in touch and free to flow with it rather than trying to control it or push away from it.”
These entries are all good examples of where new parents deserve grace as they navigate the ego death characteristic to parenthood. Loss of individuality, autonomy, and free time are BIG themes here, and more than one entry depicts cannabis as a supportive device for parents to “feel like themselves” and be present with their children.
The trend here indicates that many new parents feel more supported, adjusted, and capable with the recreational support of cannabis.
The common denominator here is that their cannabis use was intentional, occasional, and co-creative with the experience of parenting.
As a birth worker and birth care provider, it’s my obligation to encourage you to check in with your providers before you utilize cannabis.
Simply because you deserve informed support.
I hope this post helped demystify cannabis use during pregnancy, and if you made it this far, I am so grateful to have your eyes and ears here. Make sure to pass this article along to someone you think could use it :)
Sending love and blessings upon your empowered pregnancy, birth, and postpartum.
-Morgan
This think piece aims to offer information to new families curious about recreational cannabis use during pregnancy, breastfeeding, and postpartum. It is important to note that the content provided is not intended to diagnose, treat, or be considered medical advice. Grounding Down is not, and does not claim to be, a licensed medical provider.
In the state of Colorado, marijuana use is legal for those 21 and older. However, it's imperative to understand that there are legal considerations, especially concerning prenatal marijuana use.
This piece strongly encourages readers to contact their medical providers before considering the ingestion of cannabis during pregnancy, breastfeeding, or postpartum. Consulting with healthcare professionals ensures personalized guidance based on individual health considerations and local legal perspectives.
