Table of Contents
Cannabis Use in Pregnancy: 10-Year Study Findings
Cannabis use during pregnancy is a topic that often invokes strong opinions, fierce emotions and societal biases on both sides of the discussion. Some in the “pro-cannabis” camp either have an impression that cannabis can do no harm at all, or that the potential benefits far outweigh the potential benefits. On the other side of the debate, the “anti-cannabis” camp often paints a doomsday perspective that cannabis is harmful in any amounts, and in all circumstances.
| Pro-Cannabis Camp | Anti-Cannabis Camp |
|---|---|
| Perceived Benefits | Health Risks |
| – Symptom Relief: Many women report significant relief from pregnancy-related symptoms such as nausea, anxiety, and pain. | – Potential Harm to Fetus: Studies have linked cannabis use during pregnancy to adverse outcomes such as preterm birth, low birth weight, and developmental issues. |
| – Natural Remedy: Cannabis is viewed as a natural alternative to pharmaceuticals, potentially with fewer side effects. | – Neurological Impact: Concerns about the potential impact on fetal brain development and long-term neurodevelopmental outcomes. |
| – Historical Use: Cannabis has been used for medicinal purposes for centuries, suggesting a long history of perceived safety and efficacy. | Insufficient Safety Data |
| Mistrust in Conventional Medicine | – Lack of Robust Research: Critics argue that there is insufficient high-quality research to guarantee the safety of cannabis use during pregnancy. |
| – Negative Experiences: Some women have had adverse reactions to prescribed medications or feel that their concerns were dismissed by healthcare providers. | – Precautionary Principle: Given the potential risks, it is argued that cannabis should be avoided during pregnancy until more conclusive evidence is available. |
| – Autonomy and Choice: Advocates argue that women should have the right to choose their form of treatment based on their personal experiences and beliefs. | Public Health Messaging |
| Lack of Conclusive Evidence | – Consistency with Guidelines: Most health organizations, including the American College of Obstetricians and Gynecologists, advise against cannabis use during pregnancy. |
| – Inconclusive Studies: Some studies on cannabis use during pregnancy have limitations and do not conclusively prove harm. | – Avoidance of Mixed Messages: Consistent messaging is crucial to prevent misunderstandings about the safety and risks of cannabis use. |
| – Potential Bias: There is a belief that some research is biased against cannabis due to historical stigmatization and legal issues. | Potential for Dependence |
| Mental Health | – Substance Use Disorders: There is a risk of developing a dependence on cannabis, which could complicate pregnancy and postpartum recovery. |
| – Self-Medication: Some women use cannabis to manage mental health conditions like anxiety and depression, which could otherwise worsen during pregnancy. | – Gateway Theory: Some believe that cannabis use can lead to the use of other, more harmful substances, although this theory is debated. |
| Legal and Ethical Considerations | |
| – Child Protection Concerns: Continued use of cannabis during pregnancy may trigger involvement from child protection services. | |
| – Ethical Duty of Care: Healthcare providers have an ethical obligation to recommend treatments that are evidence-based and proven safe for both mother and child. |
The study presented here, “Predictors for Cannabis Cesssation During Pregnanc y: A Ten-Year Cohort Study,” published in the Journal of Psychosomatic Obstetrics & Gynecology, takes a tour through this intensely complex issue by exploring the factors that influence cannabis discontinuation during pregnancy and its impact on neonatal outcomes.
What is the Study All About
This study took place over ten years at a hospital in Barcelona, Spain. It involved 142 pregnant women who either reported using cannabis or tested positive for THC. The researchers aimed to find out what factors helped women quit cannabis during pregnancy and how stopping cannabis use impacted their newborns. They looked at things like the women’s backgrounds, pregnancy details, and mental health support.
Key Findings
-
- Cannabis Discontinuation Rates:
- About 24.6% of the women stopped using cannabis during pregnancy.
- Women who were identified as cannabis users during their pregnancy were much more likely to quit than those identified at the time of birth.
- Predictive Factors for Discontinuation:
- First-Time Mothers: Women who were pregnant for the first time were more likely to stop using cannabis.
- Early Detection and Mental Health Support: Women who were identified as cannabis users early in their pregnancy and received mental health support were much more likely to quit.
- Mental Health Interventions: Counseling and support from mental health professionals played a significant role in helping women stop using cannabis.
- Neonatal Outcomes:
- Babies born to mothers who quit cannabis had better outcomes, including lower rates of preterm birth, higher birth weights, and fewer admissions to intensive care units.
- Cannabis Discontinuation Rates:
What Does This All Really Mean? A Discussion:
These findings highlight how important early detection and mental health support are in helping pregnant women stop using cannabis. But they also raise questions about our societal attitudes towards cannabis use, especially during pregnancy.
Reconsidering Implicit Bias
As noted above, many in society view any cannabis consumption negatively, especially during pregnancy. This study encourages those who prefer independent, critical thinking to reconsider and examine these biases by considering WHY pregnant women might use cannabis in the first place:
- Perceived Benefits: Many women use cannabis to manage pregnancy-related symptoms like nausea, anxiety, and pain. They believe it helps and doesn’t harm the fetus, and sometimes see it as safer than traditional medications.
- Mistrust in Traditional Healthcare: Some women prefer cannabis over pharmaceuticals due to negative past experiences with the healthcare system or concerns about the safety of prescribed medications.
| Perceived Benefits | Mistrust in Traditional Healthcare |
|---|---|
| Symptom Relief: Cannabis helps manage nausea, anxiety, and pain related to pregnancy. | Negative Past Experiences: Some women have had adverse reactions or ineffective outcomes from prescribed medications. |
| Appetite Stimulation: Useful for those experiencing severe morning sickness or hyperemesis gravidarum. | Concerns About Medication Safety: Fear of potential side effects or long-term impacts on the fetus. |
| Sleep Aid: Improves sleep quality, especially for those dealing with insomnia or restless sleep. | Perceived Lack of Understanding: Feeling that healthcare providers do not fully understand or acknowledge the benefits of cannabis. |
| Mood Regulation: Helps stabilize mood and reduce feelings of stress and depression. | Cultural or Historical Use: Preference for cannabis due to its historical medicinal use in some cultures. |
| Alternative to Pharmaceuticals: Seen as a more natural remedy with potentially fewer side effects. | Autonomy and Empowerment: Using cannabis as a way to take control of health and make autonomous treatment decisions. |
| Lower Perceived Risk: Belief that cannabis poses less risk to the fetus compared to certain prescription drugs. | Stigma and Judgment: Fear of judgment or stigma from healthcare providers for their choices. |
| Pain Management: Alleviates chronic pain or discomfort related to pregnancy, such as back pain and joint pain. | Lack of Personalized Care: Experiences of receiving generic or impersonal care in the traditional healthcare system. |
| Reduction of Pregnancy-Induced Hypertension: Belief that cannabis can help manage high blood pressure caused by pregnancy. | Skepticism of Pharmaceutical Industry: Distrust in the motives and practices of pharmaceutical companies. |
| Holistic Approach: Fits into a broader lifestyle of using natural and plant-based treatments. | Inadequate Pain Management: Traditional healthcare providers may inadequately address pain management needs. |
| Control Over Dosage and Consumption: More control over dosage and form of consumption compared to standardized pharmaceuticals. | Community and Peer Influence: Recommendations and positive experiences from friends or community members. |
What If …. Cannabis Use Was Banned? (Thought experiment)
If cannabis use were forcibly prohibited, what would happen to these women? Let’s consider what the “alternative might be, and suggest a few potential outcomes:
- Increased Suffering: These women have chosen cannabis of their own free will. With the available information, seeing and hearing from the doctors that they see, and learning from the media and friend groups that they have. So… without cannabis, women who rely on it for symptom relief might experience more discomfort and distress, no?
- Forced Medication: If they are “really” ill, should these women be forced (either directly or indirectly) to take medications they don’t want to? Does this not raise ethical concerns about their right to choose their own treatment?
- Risk of Stigma and Judgment: Pregnant women using cannabis face significant stigma and shaming already – wouldn’t we expect this to turn them away from cannabis? If they are shamed for consuming cannabis, as they are today – are we not worried that they will be discouraged from seeking prenatal care or disclosing their substance use? Do we not want everyone to be open and honest with their healthcare providers?!
The Role of Healthcare Providers
Healthcare providers have a crucial role in addressing cannabis use during pregnancy. Instead of imposing blanket bans or judgments, they should:
- Provide Non-Judgmental Support: Have open, empathetic conversations with pregnant women about their cannabis use, understand their reasons, and provide evidence-based information about the risks.
- Promote Informed Decision-Making: Give women accurate information so they can make informed choices about their health and their baby’s health.
- Offer Alternatives: Suggest alternative treatments that might offer similar benefits without the potential risks associated with cannabis use during pregnancy.
| Healthcare Provider Actions | Description |
|---|---|
| Provide Non-Judgmental Support | Have open, empathetic conversations with pregnant women about their cannabis use. Understand their reasons and provide evidence-based information about the risks. |
| Promote Informed Decision-Making | Give women accurate, comprehensive information so they can make informed choices about their health and their baby’s health. |
| Offer Alternatives | Suggest alternative treatments that might offer similar benefits without the potential risks associated with cannabis use during pregnancy. |
| Create a Safe Environment for Discussion | Ensure women feel comfortable discussing their cannabis use without fear of judgment or repercussions. |
| Continuous Monitoring and Follow-Up | Regularly check in with patients to monitor their health, cannabis use, and overall well-being throughout the pregnancy. |
| Collaborate with Mental Health Professionals | Work closely with mental health specialists to provide comprehensive care and support for women who use cannabis to manage anxiety, depression, or other mental health issues. |
| Educate About Legal and Social Implications | Inform women about the legal and social implications of cannabis use during pregnancy, including potential child protection issues. |
| Provide Personalized Care Plans | Develop individualized care plans that consider each woman’s unique circumstances, preferences, and medical history. |
| Advocate for Research and Education | Support and advocate for more research into the effects of cannabis use during pregnancy and better education for healthcare providers. |
| Integrate Multidisciplinary Approaches | Utilize a team approach, including obstetricians, mental health professionals, social workers, and other specialists to provide holistic care. |
| Respect Patient Autonomy | Respect women’s autonomy and their right to make informed choices about their healthcare, providing support rather than coercion. |
| Stay Updated on Emerging Evidence | Keep abreast of the latest research and guidelines regarding cannabis use in pregnancy to provide the most up-to-date advice. |
| Facilitate Access to Support Groups | Connect women with support groups or peer networks for those who use cannabis or are considering cessation during pregnancy. |
| Utilize Motivational Interviewing Techniques | Employ motivational interviewing techniques to help women explore their cannabis use and consider the benefits of cessation. |
| Provide Resources for Education and Support | Offer educational materials and resources that women can access to learn more about cannabis use and pregnancy. |
My Summary Thoughts
The study “Predictors for Cannabis Cessation During Pregnancy: A 10-Year Cohort Study” provides important insights into the factors influencing cannabis discontinuation and its impact on neonatal outcomes. There may be real concerns with pregnant women consuming cannabis, and very real impact on the growing fetus. Whether these are “meaningful” or truly shaping the fetus in lifelong ways (whether bad, or possibly even beneficial) is not yet clear to science. We know that, in some cases, babies are born early, and in some cases babies are born with lower birthweights. We don’t know whether this is “clinically significant,” that is, whether this makes a difference in the life of the baby, in a way which is permanently harmful. Science does not yet know this.
This paper challenges us to reconsider our perspective and our biases and approach towards pregnant women who do use cannabis. By fostering a more understanding, compassionate, and supportive healthcare environment, we can better address the needs and concerns of these women, ensuring healthier outcomes for both mothers and their babies.
Ultimately, the choice to care about oneself with medicines, especially during such a personal and vulnerable time as pregnancy, is a matter of basic human freedom and personal choices. Society and healthcare systems should respect and support this choice, providing the necessary resources and information to help women make the best decisions for themselves and their children.
Would you want someone to force you to do something against your personal choice? Everyone deserves that same freedom.
Snippet from “The Doctor-Approved Cannabis Handbook“
Page 111:
“Don’t take if pregnant or breastfeeding. Cannabis can cross the placental safety barriers and enter the mother’s milk. Cannabis taken at smaller doses and/or at later stages of a pregnancy appears less likely to impact the fetus, but there are measurable effects in both circumstances that are still insufficiently understood. In time, it seems likely that some forms of can- nabis may be compatible with pregnancy and/or breastfeeding, but until we know that potential benefits clearly outweigh the risks, the purest plan is to avoid cannabis.”
Visuals from the Paper
