We #Need to #Talk About #Pot Use and #Pregnancy

A new study says that the number of pregnant women using marijuana and marijuana-derived products appears to have risen significantly in California over the past decade.

Publishing in the journal “JAMA” this month, the researchers found that among a representative sample of 279,457 expecting mothers in California, marijuana use rose from 4.2 percent to 7.1 percent in the period 2009 through to 2016.

CNN reports on the findings that the under 24s appeared to be using marijuana far more than their older counterparts:

“We were concerned to find that the prevalence of marijuana use in pregnancy is increasing more quickly among younger females, aged 24 and younger, and to see the high prevalence of use in this age group,” the study’s lead author, Kelly Young-Wolff, licensed clinical psychologist and research scientist at the Kaiser Permanente Northern California Division of Research, wrote in an email.

For other age groups, the researchers found that marijuana use rose from 3.4% to 5.1% among women 25 to 34 and from 2.1% to 3.3% among women older than 34.

Behaviors like recreational marijuana use, smoking and drinking tend to appear alongside young teen pregnancy, so this pattern isn’t as surprising as it might first seem. Obviously, we can’t safely say that this trend is representative of the entire United States, or even those states where marijuana is now legal. Nor do the researchers claim a direct correlation between loosening marijuana restrictions and a growth in maternal marijuana use. However, other studies have also spotted an upward trend in mothers using marijuana, so it is at least safe to say this is an issue that needs our attention.

To be clear, because marijuana is a Schedule 1 class drug, we have only a limited body of research because getting permission to research cannabis products is very difficult. However, there are a few things we do know.

The CDC notes that there are many chemicals in marijuana that can potentially cross from a mother to her unborn child, for example the main psychoactive ingredient of marijuana known as THC. Some studies suggest infant THC exposure may lead to low birth weight, which can lead to slower growth and development. There is also some research to suggest that marijuana use during pregnancy may contribute to a child’s risk of developmental problems and may potentially set the stage for lower IQ. It is critical, however, to say that some research does not find these problems. In addition, and differing from research on heavy alcohol use for example, we don’t have evidence that marijuana use in pregnancy leads to physical birth defects. That said, more research is sorely needed to ascertain the risks.

As with the CDC’s unhelpful guidelines surrounding alcohol and pregnancy, these bare facts and calls to shun marijuana don’t give us the context and wider information we may need and they leave many women unprepared to truly manage their health.

In case any one wanted to use this study as a tool to rally against legalization of marijuana, it’s important to say that the study could not differentiate between women who used marijuana prior to finding out they were pregnant but then discontinued use, and women who kept using marijuana throughout their pregnancies. In terms of (often male) officials tendency to pontificate and lecture women to “behave responsibly” during pregnancy, many women in the study and throughout the U.S. may choose to stop using marijuana during their pregnancies. This study should not be used to obscure that fact.

But, we do need to highlight one important fact: we don’t know how long chemicals like THC stick around in our bodies and the precise cut-off point for ensuring the health of children. That’s because THC has the ability to be stored in our fat reserves. That means that even after cessation of use, we may have THC in our bodies for days or even weeks. This needs to be highlighted and factored into a family planning routine for mothers who have used marijuana but intend on stopping during their pregnancy.

Furthermore, we are seeing a significant lack of research on expecting mothers who have been using marijuana as part of their pain relief or symptom management strategies. Lecturing women on their marijuana use without taking into account this fact is a significant problem because it ignores the fact that marijuana use often overlaps with other areas of health and wellness.

Another important thing to consider is that we likely don’t know the scale of marijuana use among this demographic. That’s because even in states where marijuana possession is legal, people often fail to self-report or will under-report their use. Societal stigma around expecting mothers and taboos over their behavior may further drive down reporting.

So yes, we do need to be concerned about these figures because there are potential health issues to consider, but our ire should not be directed at mothers-to-be but rather the federal and state governments who have systematically failed to legalize and then properly regulate and policy make for marijuana use.

We need clear and well researched guidelines built on evidence like this to show where interventions may be necessary–for example, among younger women who may not realize the potential risks–so that we can concentrate not on moral policing but actually safeguarding everyone’s health.

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