New Criticism Over Pregnant Women Using Cannabis For Nausea

The cannabis and pregnancy conundrum continues. In one corner, the director of NIDA. In another, women barfing their brains out. Who wins?

Feb 20, 2017

Prenatal consumption is one of the most controversial issues in the world of cannabis. The herb is the most popular illicit substance used by pregnant women, and evidence suggests that more expecting moms are turning to the herb to relieve symptoms like nausea and to self-manage other medical ailments during pregnancy. This is concerning for Nora Valkow, an MD and director of the National Institute on Drug Abuse (NIDA), who is telling pregnant women not to use cannabis for nausea.

NIDA director says no cannabis for nausea

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There is no doubt that cannabis consumption during pregnancy can have a share of consequences. For one,  smoking or taking substances of any kind (even coffee) are social faux pas and profoundly frowned upon.

Regardless of any potential health consequences, mother’s caught consuming cannabis during pregnancy in the United States risk having their children taken away by social services.

When it comes to the health risks of prenatal cannabis consumption, things get a little harrier. In a recent opinion editorial for the Journal of the American Medical Association (JAMA), Valkow expressed her concern over the growing rate of women using cannabis during pregnancy. In urgent, bolded text, she writes:

Pregnant women and those considering becoming pregnant should be advised to avoid using marijuana or other cannabinoids either recreationally or to treat their nausea.

Why the concern?

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Valkow cites recent studies that suggest that prenatal cannabis consumption is associated with anemia, low birth weight, and future memory, learning, attention, and behavioral differences.

She argues that consuming cannabis during the first trimester is especially concerning, as the fetus is at the greatest risk of negative consequences.

Valkow isn’t the only medical professional that is concerned. The American College of Obstetricians and Gynecologists issued a statement in 2015 which discourages physicians from prescribing medical cannabis to patients that are trying to conceive, are pregnant, or are breastfeeding.

However, there is one major issue with studies on cannabis and pregnancy. Most of them do not separate cannabis from other confounding factors, like tobacco and alcohol.

Unfortunately, the study Valkow cited which argued that cannabis is associated with anemia and low birth weight failed to control for prenatal tobacco consumption.

Similarly, Valkow cited evidence that cannabis causes brain morphologies in children exposed to cannabis in the womb. Unfortunately, this study also did not control for tobacco use.

So, these morphologies were found in children who had been exposed to both tobacco and cannabis smoke together, which does not paint a quality picture of the effects of cannabis alone.

In 2016, a study not included in Valkow’s sample did check for an association between cannabis and negative birth outcomes after controlling for tobacco. That study found no correlation between cannabis and adverse effects. The authors conclude,

Maternal marijuana use during pregnancy is not an independent risk factor for adverse neonatal outcomes after adjusting for confounding factors.

Thus, the association between maternal marijuana use and adverse outcomes appears attributable to concomitant tobacco use and other confounding factors.

This study suggests that tobacco, not cannabis, is a contributing factor to negative birth outcomes. Unfortunately, this research has its limits as well.

It cannot speak to other potential harms that may present themselves in the long-term, such as learning and attention difficulties. These results also need to be replicated in further research.

Making an informed decision

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There is no doubt that women who consume cannabis during pregnancy are taking a risk. Back in 2015, reporters from Vice interviewed four moms about their decision to consume cannabis during their pregnancies.

While this is hardly scientific evidence of the herb’s safety, these stories may help you see why the plant is seen as so valuable for many expecting mothers.

Valkow was quick to dismiss the plant as an anti-nausea and vomiting aid. Indeed, for minor cases of nausea, remedies like broths, peppermint, ginger, and eating easy to digest foods are far less controversial options.

However, as the mother below describes, some women are picking up the herb as an alternative to pharmaceutical drugs.

I was vomiting so much that I had to go to the emergency room at least once every week (though sometimes as often as three times a week) for IV rehydration.

My doctor prescribed me Zofran, but for most of my pregnancy my insurance company wouldn’t cover it, and it cost about $11 a pill. Cannabis was about $20 a gram and it let me actually eat something.

When asked if she continued to use cannabis during her current pregnancy, she explains,

This time around I’ve already quit because I just don’t want to deal with the hassle. I do think it’s ridiculous.

My daughter was perfectly healthy and though doctors don’t want to hear my anecdotal evidence of “well my kid turned out OK,” I also think that when it comes to marijuana, I should have the power to make the decision on my own. I understand their concern, but it’s not alcohol.

They don’t test me for alcohol at every visit and that would actually do damage, so I think it’s also pretty hypocritical.

Valkow’s criticism comes at a time when some states are attempting to take a more advanced take on the War on Drugs. A bill introduced by legislators in Wyoming would criminalize mothers for fetal deaths related to substance abuses.

House Bill 215 currently has five sponsors. If the mother is found using illicit substances and her newborn does not die, the mother can still face up to five years in prison. Those found providing cannabis to pregnant women may also face penalties.

Of course, there has been no research linking prenatal cannabis use to infant death. However, as the mother above suggests, perhaps there are some instances where women should have the power to choose therapies that they feel confident and comfortable about.

Unfortunately, no one can say with certainty that cannabis is safe for pregnant women to consume. Though, research has been unable to provide concrete evidence of positive or negative effects overall, though negative effects are currently suspected.

For that reason, most medical professionals advocate for the side of caution. There are simply not enough studies to determine whether or not cannabis is safe on a scientific level.

However, some of the hypothesized outcomes seem to contradict the lived experience of many cannabis-consuming moms.

Feb 20, 2017