In working with infants and families in the NICU over the last six years, I have seen the cultural changes related to cannabis use in pregnancy since the legalization of medicinal cannabis. In March of 2020, the first medical cannabis facility opened its doors in Utah, and many improvements have been made in Utah’s cannabis program since that time. Bills have since been passed involving employment protection and cannabis use, use with children in the home, and use while pregnant.
According to the American Medical Association (AMA), cannabis use is growing in certain populations, including expecting mothers. Did you know that social media use is also associated with increased cannabis use? Depending on the platform, social media is associated with increased odds of cannabis use between 88% and 129%.
The AMA maintains its stance that cannabis and cannabis-derived products are dangerous drugs and pose a “serious health concern.” They also state that “there is no evidence that cannabis helps with morning sickness,” and stress that “medical marijuana is just as harmful as non-medical cannabis during all stages of pregnancy and while breastfeeding.” Because of the risks and dangers associated with cannabis use, the AMA has proposed a bill that outlines specific labeling requirements including content, size, location, placement, name, potency, identification of testing and a “not safe for kids” icon on any cannabis-derived product.
Tetrahydrocannabinol (THC) is the main psychoactive component in cannabis and passes freely from maternal blood through the placenta to the developing fetus. Maternal cannabis use is associated with certain complications of pregnancy including low birth weight, preterm delivery and stillbirth.
A recent article also highlighted that cannabis use in pregnancy has been associated with adverse cognitive and mental health outcomes in children which may include autism, depression and psychosis.
A major problem currently facing the medical marijuana community is that there is not an abundance of research describing how marijuana can impact pregnancy and babies, and that the majority of existing research was performed prior to legalization of medical cannabis use. It is theorized that as with smoking cigarettes, smoking marijuana decreases the amount of oxygen delivered to the baby, and some studies have tied birth defects to marijuana use. Where research is not abundant, the safest route is to avoid cannabis use during pregnancy and breastfeeding.
In the early days of medical marijuana use in Utah, mothers or infants who tested positive for THC were reported to the Department of Child and Family Services. However, effective July 2023, the Utah State Legislature declared that a parent or guardian’s use of cannabis is not abuse or neglect of their child unless there is evidence showing that the child is harmed from ingestion or inhalation, or that the child is a risk of harm because of chronic ingestion or inhalation of cannabis.
While the reporting requirements have changed, the risks of its use during pregnancy have not. The labeling proposed by the AMA on all cannabis products can help protect mothers who are not aware of the risks associated with ingesting or smoking cannabis during their pregnancies. It is important that voters and state representatives stand with the AMA regarding appropriate labeling of the product that has the potential to harm an already vulnerable population. For those wondering how to help with the change, writing local representatives to support the AMA’s labeling recommendations is a step in the right direction towards protecting unborn infants and their mothers.