Is It Safe or Not? Using Evidenced-Based Information to Make Informed Decisions about Cannabis Use During Pregnancy
"Is it safe or not?" A question I'm repeatedly asked from moms, doulas, nurses and dispensary staff as I've made it increasingly known that I support birthing people and women who decide to use cannabis during pregnancy, childbirth, and while breastfeeding.
My answer to that is usually: Well, it depends. Whether cannabis is safe for birthing people largely depends on the quality of the cannabis that they are consuming, their method of consuming, and other factors as well, such as whether they live in a legal state, or a state that at least recognizes cannabis as medicinal, and has decriminalized cannabis to some extent.
Other factors that play an important part in whether cannabis can be considered safe for a mom are her doctor's attitudes toward cannabis, the hospital/birth center's policies and attitudes surrounding testing positive for THC upon giving birth. All of these thing can impact the health and safety of moms who consume cannabis. Moms who choose to consume cannabis risk having their family reported to Child Protective Services, and many women have had their children removed from their homes, in states that have legalized cannabis and states that have not yet legalized.
It is important to know that cannabis has been used to support the uterus, and reproductive health and wellness of birthing people and women since the very earliest known uses of the cannabis plant.
In many countries across the world, many women in communities of color still consume cannabis during pregnancy, childbirth, and postpartum as not only a cultural tradition and norm, but because cannabis has been used for generations to aid in birth,
So much of our ancestral connection to cannabis use during birth was lost in communities across the United States as the prohibition of cannabis AND the outlawing of traditional midwives and Granny Midwives became widespread in the 1920s and 30s. Women and families still secretly consumed cannabis, but without the knowledge and support of the Wise Women who cultivated and crafted cannabis preparations for their community.
Cannabis is the most consumed illicit drug by pregnant women, according to ACOG and WHO. Whether or not you believe cannabis to be safe during pregnancy, we MUST talk about harm reduction, safe access, and cannabis education for families.
Can cannabis be safely used to pregnancy, childbirth, and postpartum?
In order for that to happen, we must come to an agreement to shatter the stigma that is associated the cannabis use by mothers--and really focus on evidence-based information as it pertains to cannabis and reproductive health. More research needs to be done, of course, but there is enough information available to parents and care providers that provides knowledge, data, and insight as to how cannabis can benefit the birthing process, as it always has.
The FDA recently released a warning for women against consuming cannabis during pregnancy, stating the "FDA strongly advises against the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding." This comes as more CBD products are being marketed to support women with pain, anxiety, and morning sickness, and more mothers are opening up about their consumption and success with cannabis.
The FDA further stated that "there may be serious risks to using cannabis products, including those containing CBD, if you are pregnant or breastfeeding."
One risk that they discuss is the amount of THC present in breastmilk ("six days") after consumption. This amount is actually a small fraction of a percentage, and very little compared to other drugs that women are prescribed during pregnancy and reach the baby through breastmilk, or through the placenta.
The FDA went on to say "This THC may affect a newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences." Which is misleading because while THC can affect a newborn's brain development (THC is a neuroprotectant), long term studies of cannabis use showed no long term effects in regard to hyperactivity or cognitive function. The only reliable long term study of cannabis use during pregnancy was the work of Dr. Melanie Dreher and collegues, which notes more benefits to cannabis than long term harm, including higher functioning newborns.
Popular pregnancy websites like What to Expect, also lean toward the FDA's warning due to the possibility of low birth weight or premature babies being born to moms who use cannabis, which is largely a myth.
Most research that drew these conclusions failed to look at confounding variables, such as a mother's tobacco or alcohol consumption, access to education and prenatal support, as well as stress and other factors known to lead to low-birth weight babies and unhealthy pregnancies--like racism.
Current research also makes a lot of assumptions about cannabis based on the race of the mother, usually African American. Black women and mothers are most often victims of the stigma associated with cannabis use during pregnancy and risk having their children taken or otherwise criminalized for their consumption. After researching the uses of cannabis during pregnancy in communities of Black women all over the world, you may come to find that it is a cultural norm to use cannabis in Black and Indigenous communities. A cultural norm that is not talked about, one that is hidden due to prohibition, the stigma and the racism that keeps Black birthing traditions outlawed,
It is important to note that while making these sweeping claims about the possible negative effects of using cannabis or CBD while pregnant, the FDA also states that "There is no comprehensive research studying the effects of CBD on the developing fetus, pregnant mother, or breastfed baby."
So, while I would like to lean on the recommendations of ACOG, WHO, and the FDA, they've been known to make recommendations that DO NOT have the best interest of women and families of color.
These organizations rely on the financial support of Big Pharma, who also rely on Ob-Gyns to push their medical interventions, all the while taking advantage of the fear of women and birthing people who need support during pregnancy, childbirth, and postpartum.
I will note that some of their concerns about cannabis use during pregnancy is valid. I specifically address the need for cannabis education and harm reduction for cannabis using moms because of the dangers of ingesting toxins/heavy metals, mold, and bugs that may be present in poor quality cannabis, improperly grown cannabis, cannabis grown illegally or stored without proper knowledge and care. This is why cannabis education, like Interpening, can be especially useful for moms in helping to reduce harm and determine the quality of their medicine, and guide them in properly consuming cannabis.
The Healthy Cannabis Consumption: Pregnancy, Childbirth, and Postpartum workshop and training presented by @TheCannabisDoula aims to help moms and doulas improve their knowledge and caregiving with cannabis by providing evidence-based research, resources, and various cannabis remedies to support the birthing person--allowing parents to make informed decisions about their cannabis consumption, without the stigma, fear, and judgement.
As Black women's reproductive health is at risk, I believe that we should take ownership away from these organizations in deciding what is safe for our bodies, and instead make our own decision, for the collective health of ourselves and our communities. In most cases, pharmaceutical drugs (opiods, narcotics, steroids, etc) are not safer for birthing people than cannabis. We have to be bold, knowledgeable, and confident in moving the conversation along with or without the recommendations of these organizations.
My responsibility is to women and birthing people, especially women of color, who have traditionally used cannabis during pregnancy and childbirth, for generations.
The Cannabis Doula | Interpening Cannabis with Trichome Institute + My Experience as a Medical Cannabis Patient on YOUTUBE!
Interpening (In-ter-pen-ing) is the art and science of evaluating cannabis flower to determine quality, variety type designation, and psychotropic effects, through physical and aromatic inspection created by Max Montrose at Trichome Institute ( Instagram @trichome.institute.)
My first week studying Interpening, the art of the Cannabis Sommelier, has been so dope! The Interpening book and tools provides all the necessary skills and information to learn to identify the best quality cannabis. As a patient and caregiver, this is extremely important since most labs don’t test for things like mold, various bugs, and other signs of improperly grown and old cannabis.
It’s one thing to know how cannabis impacts our body and relieves various illnesses by interacting with our Endocannabinoid System—-it requires another level of cannabis expertise to be able to identify (and cultivate!) high quality cannabis products. Shoutout to Trichome Institute for delivering such high quality cannabis education and content!
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I want to take you back to a moment that you may have heard me mention. A moment that was traumatic for me. When I was offered and refused narcotics (opioids) for the severe pain I experienced from having stitches for third degree lacerations, after what was a beautiful and unplanned precipitous homebirth with my first son. I was in labor and gave birth in less than an hour, which is not uncommon for moms who use cannabis throughout pregnancy. Quick & easy, pain-free birth. However, I spent my first two days as a new mother in a maternity suite at the nearest hospital barely able to move, walk, or use the bathroom without pain. My pain was not from giving birth. In fact, my birth was exhilarating. I was in pain largely due to a mean ass OB who violently sutured me up and was even more violent and dismissive toward me for refusing opioids, pitocin, and IVs ( plus vaccinations and all other newborn interventions lol). Truth is, I planned for a natural water birth at the birth center that I was receiving care and when I called them to tell the midwife I was in labor, she told me to call her back because I “was a first time mom and we usually have long labors” smh. So, I had my baby 30mins later, on daddy’s couch and ended up in the maternity suite for aftercare.
Anyway, I’m particularly critical of hospitals, for reasons unbeknownst to me but I can say is probably due to generational trauma which is why I had no plan to give birth there. I’ve often come to find that the people who work in hospitals are only following orders and protocols that are largely outdated, not evidenced-based, and in complete opposition to what’s best for mama and baby, and often times rooted in racism and classism. How unfortunate for most doctors and nurses who really think they are helping people. (DISCLAIMER: I love good doctors and nurses who advocate for their patients, and who go above and beyond these hospital protocols like the good doctors at Grey-Sloan Memorial Hospital, whose doctors are well-known recipients of the Harper Avery/Catherine Fox award for excellence in medicine...a little Grey’s Anatomy humor to lighten this up a bit? 😊)
So yesterday, I was going through some old paperwork and found my discharge papers from this hospital experience. I often like to look over my discharge papers to see if I’ve missed anything that I didn’t know or see prior. In this packet, I find listed all the medications that the nurses gave me and the medications that they use commonly in maternity suites. And what do you know, oxycodone was listed as being given to me twice, two different dosages. Strange, I thought. I know I declined, repeatedly. I made it clear that I was breastfeeding (and that I was a doula and I knew the effects of narcotics on nursing babies and mamas) so why is this listed? Did they give me oxycodone without my permission? I don’t fucking know. But I do know that moms who are on Medicaid are prescribed opioids more often and I was receiving Medicaid at the time. Did they list it just to get money from Medicaid on my behalf? I don’t fucking know. But I do know that something ain’t right. So I did more digging.
Opioids are commonly prescribed to pregnant and breastfeeding women in spite of the known negative risks, including opioid withdrawals in newborn babies, issues breastfeeding, and the list goes on. According to the FDA, severe and persistent pain that is not effectively treated during pregnancy can result in depression, anxiety, and high blood pressure in the mother. But are opioids the solution to the pain that women experience in pregnancy and postpartum? Hell fucking no, is the answer to that. We have to be real honest, our country is facing an opioid problem. This we know, but we’ve never stopped to think about about how this crisis is impacting pregnant women and babies, the most vulnerable in our communities. And the reason we haven’t done so, is because these drugs are making hospitals lots of money. There is a reason doctors are prescribing opioids. There is a high chance that once a patient fills their opioid prescription, they will continue to refill their prescription. Opioids are highly addictive. Do they work to eliminate the source of the pain? Or do they just numb the symptoms related to the pain temporarily? Big questions, that we already know the answers to.
Black mothers are dying. We need safe alternatives. Like yesterday.
*sounds trumpet* Thankfully, queen cannabis has our back. Cannabis, in its various forms of consumption, is a safer alternative to common pharmaceutical medications found on maternity suites. Yup. I told you Cannabis was used traditionally for women, right? From pain, to blood pressure, hemorrhoids, itching, cracked nipples, infection, digestion, constipation, and the list goes on. I’m supporting mothers who are no longer interested in being misinformed by care providers who have invested interested in pharmaceutical companies. For moms who are interested in natural alternatives that have no negative side effects on their babies or their breastmilk. For moms who choose cannabis, the possibility of healing all of the changes that come with motherhood—physically, spiritually, mentally, and emotionally, cannabis is truly promising.
For more information or to learn about cannabis alternatives to common medications used during pregnancy and postpartum, contact The Cannabis Doula to schedule a consultation. I provide clients with education and research to help inform your doctors and family about the benefits of cannabis, I provide support and tips to avoid negative interactions with Child Protective Services, and importantly, I provide cannabis caregiver services to help families learn to prepare cannabis medication including topicals, tinctures, infused oils, edibles, capsules, and more that can be used to aid moms from pregnancy to postpartum and beyond.