Cannabis and Pregnancy – A Guide for Expectant Mothers

Using cannabis to relieve pain and discomfort has been on the rise, along with the social acceptance of the medicinal value of cannabis. Pregnancy brings with it a host of hopes and expectations, but it is also common to experience pain, discomfort and nausea. When common substances like alcohol, certain creams, and standard medications are advised against during pregnancy it is natural to ask: is cannabis safe and effective to use during pregnancy?

In this guide we will review some of the general properties of cannabis, the prevalence of use by pregnant people, the effects of cannabis on pregnancy, as well as legal and ethical considerations of cannabis use during pregnancy.

Cannabis and General Health

Cannabis, also known as marijuana, has been used for millenia for medicinal, religious, and recreational purposes. With the increasing legalization of cannabis in many parts of the world, it’s important to understand what effects cannabis has on the human body.

Health Benefits of Cannabis

Cannabis contains over 100 different compounds known as cannabinoids. The two most well-known cannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol). Each of these compounds has different effects, contributing to the potential health benefits of cannabis.

  1. Pain Relief: One of the most common uses of cannabis is for pain relief. Studies suggest that cannabinoids can alleviate chronic pain by interacting with the body’s endocannabinoid system (ECS), which plays a role in pain regulation.
  2. Mental Health Support: Some people use cannabis to manage symptoms of mental health conditions like anxiety and post-traumatic stress disorder (PTSD). However, it’s important to note that while some people find cannabis helpful, others may find that it exacerbates their symptoms.
  3. Nausea and Vomiting: Cannabis, particularly the THC component, has been shown to reduce nausea and vomiting. This is why it’s often used by cancer patients who are undergoing chemotherapy.

Lowering Blood Pressure and Reducing Inflammation: A study conducted by JCI Insight in 2017 found that CBD lowered the blood pressure of human participants and reduced inflammation.

Health Risks of Cannabis

While cannabis has potential health benefits, like any substance with bioactive components it’s not without risks. Here are some of the potential health risks associated with cannabis use:

  1. Mental Health Issues: While some people use cannabis for mental health support, for others cannabis use can exacerbate symptoms. It can increase the risk of developing conditions like depression and anxiety and can lead to episodes of psychosis in some individuals.
  2. Dependency and Addiction: Regular, heavy use of cannabis can lead to dependency and addiction. This can result in withdrawal symptoms like irritability, insomnia, and loss of appetite when a person stops using cannabis.
  3. Respiratory Problems: Smoking cannabis can lead to respiratory problems, similar to those caused by smoking tobacco. This includes chronic bronchitis and lung inflammation.

Impaired Memory and Cognitive Function: Frequent cannabis use, particularly in high doses, can impair memory and cognitive function. This can affect a person’s ability to learn, concentrate, and make decisions.

How Cannabis Interacts with Other Medications or Substances

Cannabis can interact with other medications or substances, which can either increase or decrease the effects of those substances. Here are a few examples:

  1. Alcohol: Combining cannabis and alcohol can amplify the effects of both, leading to increased impairment. This can increase the risk of accidents and injuries.
  2. Prescription Medications: Cannabis can interact with certain prescription medications, including blood thinners, seizure medications, and certain types of antidepressants. This can either increase or decrease the effectiveness of these medications.
  3. Over-the-Counter Medications: Cannabis can also interact with over-the-counter medications like aspirin and ibuprofen, potentially increasing the risk of bleeding.
  4. Illicit Drugs: Combining cannabis with other illicit drugs can lead to unpredictable effects and increase the risk of adverse reactions.

Cannabis Use During Pregnancy

Prevalence of Cannabis Use Among Pregnant Women

Cannabis is the most commonly used dependent substance during pregnancy, with up to half of users continuing their use while pregnant [3]. Between 2016 and 2017 in the United States, 7% of pregnant persons reported using marijuana in the past month [4]. Cannabis use disorder (CUD) is a substance use disorder which entails that beyond the occasional use of cannabis, someone has developed a form of dependence. From 2002 to 2012 researchers found a sharp increase in the number of babies delivered whose mother had CUD, noting a rise from 2.8 to 6.9 per 1000 live births.

Age is another factor determining whether a pregnant person uses cannabis with younger mothers under 25 much more likely to use it in some form.

These increases are significant and possible reasons for them include cannabis’ perceived safety in pregnancy, the recent legalization trend, and its appeal in potentially providing relief from certain pregnancy-related symptoms.

Why Some Pregnant Women Choose to Use Cannabis

Pregnant women report using marijuana predominantly to self-treat depression, anxiety, stress, pain, nausea, and vomiting. It is most commonly used during the first trimester and by women with severe nausea. One survey of pregnant Cannabis users at a clinic in Vancouver, Canada found that 68% of respondents said they used cannabis specifically to treat nausea and of that group, 92% said cannabis was “effective” or “extremely effective”.

A systematic review of studies of pregnant people who self-reported using cannabis also found that some people might be using cannabis to treat a condition they experienced prior to getting pregnant, such as depression, or they might use it to help in quitting substances they perceive as more harmful. The same review also found that wider social normalization and perceptions of therapeutic benefit influence the decision to use cannabis during pregnancy. This can result in a diminished sense of the health risks associated with cannabis use.

Potential Risks and Benefits of Using Cannabis During Pregnancy

While pregnancy comes with well-known discomfort and many women are simply looking for relief when they turn to cannabis, it’s important to note that there are potential risks associated with its use during pregnancy.

Studies have found that up to 30% of the THC a mother consumes can have contact with the fetus [4].

Potential Risks
  1. Developmental and Mental Disorders: Prenatal exposure to cannabis has been associated with developmental and mental disorders [1].
  2. Lower Birth Weight: Cannabis use during pregnancy is associated with lower birth weight [7].
  3. Impaired Cognitive Development: There is concern that cannabis use during pregnancy may affect the baby's cognitive development and put them at risk of developmental issues later in life [4].
Potential Benefits

While some pregnant women report using cannabis to self-treat symptoms such as nausea and vomiting, it's important to note that the perceived benefits are largely based on self-reporting, and more research is needed to fully understand the potential benefits and if they outweigh the risks. Currently, the American College of Obstetricians and Gynecologists and other health organizations advise against the use of cannabis during pregnancy due to potential risks.

Expert Interview

Dr. Kay Chandler, MD

Dr. Chandler is dedicated to promoting health and wellness through true lifestyle change and has served as Medical Director of Ideal Health NOW! since 2011. She is passionate about helping women of all ages feel and function at their best by helping them navigate health care with an integrative approach and even more importantly, by educating and encouraging them in self-care.
Dr. Kay Chandler interviewed in 2021 on KTHV, a television station in Little Rock, Arkansas.

Dr. Kay Chandler, MD
What were the key findings of the study regarding marijuana use during pregnancy?

The study presented at a medical meeting and published in the Journal of the American Medical Association involved an extensive sample of approximately half a million women. It revealed that the use of marijuana during pregnancy is on the rise. While about 7% of pregnant women reported using marijuana, this marks a significant increase compared to the 3% reported a decade or so ago. The study also shed light on the fact that only a fraction of these women received approval from their doctors to use marijuana, indicating a lack of awareness regarding the potential risks involved.

Why are healthcare professionals surprised when pregnant women admit to using CBD oil or medical marijuana?

Healthcare professionals express surprise when pregnant women admit to using CBD oil or medical marijuana because there is limited scientific evidence available regarding their safety during pregnancy. Despite the approval of medical and recreational marijuana in some states, it does not automatically guarantee its safety for pregnant women. This knowledge gap and the increasing use of these substances among pregnant women raise concerns within the medical community.

What are the potential risks associated with using marijuana during pregnancy?

The study suggests that using marijuana during pregnancy may pose risks to the developing fetus. THC, the psychoactive compound in marijuana, can potentially interfere with the normal development of the baby's brain. Research indicates that this interference may impact the child's IQ and attention span later in life. It is important to note that just because marijuana is used medicinally or recreationally does not imply its safety for pregnant women, as the potential risks are still being investigated.

Is CBD oil considered safe during pregnancy?

CBD oil, which shares some therapeutic benefits with marijuana, such as reducing inflammation and pain, has not been proven to be safe during pregnancy or breastfeeding. The impact of CBD oil on fetal brain development remains unclear. Furthermore, there are concerns that THC, if present in the CBD oil, can cross into breast milk and affect the nursing baby. As a result, caution is advised regarding the use of CBD oil during pregnancy or breastfeeding.

What caution should be exercised when using CBD oil?

When considering the use of CBD oil during pregnancy, caution is essential. The lack of robust regulation in the CBD industry means that the product's THC content may vary, potentially exceeding what is indicated on the label. This discrepancy becomes particularly significant for individuals who are subject to drug testing, as even trace amounts of THC can have adverse consequences. Additionally, claims made by CBD oil manufacturers may not always be supported by scientific evidence.

What is your main message regarding the use of marijuana and CBD oil during pregnancy?

The main message is to prioritize caution when it comes to using marijuana or CBD oil during pregnancy. Despite the approval of medical and recreational marijuana in some states, there is still a significant knowledge gap regarding their safety for pregnant women. Healthcare professionals and researchers emphasize the need to raise awareness about the potential risks involved. It is crucial for pregnant women to consult their healthcare providers for guidance on safe and evidence-based approaches to manage symptoms during pregnancy.

More Advice From Experts

Are Doctors Worried about their Patients Using Cannabis while Pregnant?

Despite the lack of a scientific consensus on the full extent of the risks, and potential benefits, of using cannabis while pregnant, many doctors remain cautious.

Dr. Albert Hsu is a fertility specialist at University of Missouri Health Care who has expressed his concern regarding the normalization of cannabis usage. “There is this unfortunate public perception that marijuana is safe, when truly what we have is a lack of data. And a lack of data doesn’t mean something is safe — it means there is a lack of data” Dr. Hsu said.

Other doctors have noted a silver lining of cannabis legalization for comprehensive patient care. “Legalization has helped us have a more open discussion. . . Before, patients wouldn’t even want to discuss it with me or bring it up” said Dr. Leena Nathan, an obstetrician with UCLA Health. Now she is more open to enquire about their marijuana use during pregnancy, “Just like we ask whether you drink alcohol – ‘Do you smoke marijuana or use a CBD cream?’ – It’s important to ask specifically.

Dr. Camille Hoffman-Shuler, an OB-GYN at the Anschutz Medical Campus of the University of Colorado who has researched cannabis use during pregnancy, have expressed uncertainty in advising patients pending future research. “If I have a woman who has hyperemesis [a pregnancy complication] and she’s on four different nausea medications, I can’t say that combination is better or worse than if one single agent like marijuana works for you.

Doctors naturally care about making the least risky recommendations for pregnant people and their babies. For now, most doctors advise against using cannabis during pregnancy and worry about increases in usage due to the broader acceptance of cannabis.

Top 8 Resources

Effects on Pregnancy and the Fetus

Effects of Cannabis Use on Pregnancy Outcomes

Some studies suggest that cannabis use during pregnancy may be associated with adverse pregnancy outcomes. These include:

  1. Preterm Birth: There might be a potential association between cannabis use and preterm birth, although more research is needed to confirm this relationship.
  2. Low Birth Weight: Cannabis use during pregnancy has been associated with lower birth weight in some studies [6].
  3. Miscarriage: The relationship between cannabis use and miscarriage is not well understood, and more research is needed to determine whether there is a direct link.

Many studies on cannabis use by pregnant people also look at tobacco and alcohol use as well, so determining the effects of cannabis in isolation from these other two substances is still under way.

Effects of Cannabis on the Developing Fetus

Cannabis use during pregnancy can potentially affect the developing fetus in several ways:

  1. Brain Development: Cannabis use during pregnancy may affect the brain development of the fetus. This is because THC, the psychoactive component of cannabis, can cross the placenta and affect the developing brain [1].
  2. Physical Development: Some studies suggest that cannabis use during pregnancy may be associated with physical developmental issues, although more research is needed to confirm this relationship.
Can Cannabis Use During Pregnancy Lead to Developmental Issues in Children?

Research suggests that prenatal exposure to cannabis may be associated with developmental issues in children. Several longitudinal studies suggest that while there might not be a correlation with lower IQ at various stages of development, the children exposed to cannabis in utero showed poorer scores for sustained attention, visual perceptual functioning, language comprehension, and distractibility [3].

Developmental issues may include:

  1. Cognitive Impairments: Some studies suggest that children exposed to cannabis in utero may experience cognitive impairments, such as issues with memory, which can affect academic achievement [5].
  2. Behavioral Issues: Children exposed to cannabis in utero may be more likely to experience behavioral issues, such as hyperactivity, impulsivity, and increased aggression [5].
  3. Mental Health Issues: Some research suggests that prenatal cannabis exposure may be associated with an increased risk of mental health issues in children, such as depression and anxiety, although more research is needed to confirm this relationship.

As much as it is important to continue to assess the risks, it is equally important not to overstate them. In a systematic review of research conducted on the effects of cannabis on the cognitive performance of children whose parents smoked during pregnancy only minimal differences in cognitive performance were found [8]. Across a variety of cognitive measures, including memory, attention, and visual processing tasks, a discrepancy was found in only 4.3% of the measures. Children whose mothers consumed cannabis performed worse on 3.4% of the measures and better on 0.9% of them [8]. Additionally, their performance only fell below the normal range in 0.3% of the sample.

Legal and Ethical Considerations

The use of cannabis, particularly during pregnancy, is a complex issue that intertwines legal, medical, and ethical considerations. This article aims to explore the legal implications of using cannabis during pregnancy and how healthcare providers approach this topic with their patients.

Legal Implications of Using Cannabis During Pregnancy

The legal landscape surrounding cannabis use is rapidly changing, with many jurisdictions decriminalizing or even legalizing its use. However, these changes do not necessarily translate into a free-for-all when it comes to cannabis use during pregnancy.

  1. Federal Law: Despite changes in state laws, cannabis remains a Schedule I substance under the Controlled Substances Act, meaning it is considered to have a high potential for abuse and no accepted medical use [2].
  2. State Laws: While some states have legalized cannabis for medical or recreational use, others have specific laws regarding its use during pregnancy. Some states require healthcare providers to report suspected prenatal drug use, including cannabis, which could potentially lead to legal consequences for the mother.
  3. Implications for Child Custody: In some cases, cannabis use during pregnancy could potentially impact child custody decisions. If a newborn tests positive for cannabis, it could trigger a child protective services investigation.
Healthcare Providers' Approach to Cannabis Use During Pregnancy

Healthcare providers play a crucial role in discussing cannabis use with pregnant patients. Their approach is typically guided by a commitment to patient safety, informed consent, and non-judgmental care.

  1. Open and Non-Judgmental Communication: Healthcare providers aim to create a safe space for pregnant women to discuss their cannabis use. This involves non-judgmental communication and a focus on understanding the patient’s perspective [4].
  2. Providing Information: Providers strive to give patients accurate and up-to-date information about the potential risks of cannabis use during pregnancy. This includes discussing the potential effects on the fetus and the mother’s health.
  3. Support and Resources: If a pregnant woman is using cannabis and wishes to stop, healthcare providers can offer support and resources to help her do so. This might include referrals to counseling or substance use treatment programs.
  4. Respecting Patient Autonomy: While healthcare providers can provide information and resources, they also respect the autonomy of their patients. This means acknowledging that the final decision about cannabis use during pregnancy is ultimately up to the patient.

In conclusion, the use of cannabis during pregnancy is a complex issue with legal and medical implications. As the legal landscape continues to evolve, it’s important for pregnant women and their healthcare providers to engage in open, informed discussions about cannabis use. This can help ensure that decisions are made in the best interests of both the mother and the baby.

Alternatives to Cannabis

Pregnancy is a beautiful journey, but it can also come with discomforts like nausea and pain. While some women may consider using cannabis to manage these symptoms, it’s important to understand the potential risks and explore safer alternatives. This article will discuss some alternatives to cannabis for managing common pregnancy symptoms and their effectiveness.

Alternatives to Cannabis for Managing Nausea

Nausea, often referred to as “morning sickness,” is a common symptom during pregnancy, particularly in the first trimester. Here are some alternatives to cannabis for managing nausea:

  1. Ginger: This natural remedy has been used for centuries to alleviate nausea and vomiting. It can be consumed in various forms, such as ginger tea, ginger ale, or ginger candies.
  2. Vitamin B6 and Doxylamine: This combination is often recommended as a first-line treatment for nausea and vomiting during pregnancy. It’s available over-the-counter in many countries.
  3. Acupressure and Acupuncture: These traditional Chinese medicine techniques can help reduce nausea and vomiting by applying pressure or needles to specific points on the body.
  4. Dietary Changes: Eating small, frequent meals and avoiding foods that trigger nausea can also help manage symptoms.
Alternatives to Cannabis for Managing Pain

Pregnancy can also cause various types of pain, including back pain, pelvic pain, and headaches. Here are some alternatives to cannabis for managing pain:

  1. Physical Therapy: A physical therapist can provide exercises and stretches to help alleviate pregnancy-related pains.
  2. Prenatal Yoga: This form of yoga is specifically designed for pregnant women. It can help alleviate pain, improve flexibility, and reduce stress.
  3. Warm Compresses: Applying a warm compress to the area of pain can provide relief.
  4. Over-the-Counter Pain Relievers: Some over-the-counter pain relievers, such as acetaminophen, are considered safe for use during pregnancy. However, it’s important to consult with a healthcare provider before taking any medication.
Effectiveness of Alternatives Compared to Cannabis

While research on the effectiveness of cannabis for managing pregnancy symptoms is limited and mixed, many of the alternatives mentioned above have been studied extensively and found to be effective and have fewer risks than cannabis. For example, a review of studies found that ginger can be effective in reducing pregnancy-related nausea and vomiting [1]. Similarly, physical therapy and prenatal yoga have been shown to help reduce pregnancy-related pain.

However, it’s important to note that the effectiveness of these alternatives can vary from person to person. What works well for one woman might not work as well for another. Therefore, it’s important to discuss these alternatives with a healthcare provider to find the best approach for managing pregnancy symptoms.

In conclusion, while cannabis might seem like an appealing option for managing pregnancy symptoms, there are safer and potentially more effective alternatives available. By exploring these alternatives and discussing them with a healthcare provider, pregnant women can find ways to manage their symptoms and ensure the health and safety of both themselves and their babies.

Future Research

The use of cannabis during pregnancy is a topic of growing interest and concern in the medical and scientific community. Despite the increasing prevalence of cannabis use among pregnant women, there are still significant gaps in our understanding of its potential effects on both the mother and the developing fetus. Here we will discuss the current gaps in our knowledge and the ongoing research aimed at filling these gaps.

Identifying the Gaps

Before we delve into the specifics, it’s important to understand what we mean by “gaps” in our understanding. In the context of research, a gap refers to an unanswered question or unresolved problem in a field, reflecting a lack of existing research in that area [7]. In the case of cannabis use during pregnancy, these gaps could be related to the effects of cannabis on fetal development, the long-term outcomes for children exposed to cannabis in utero, and the safety and efficacy of cannabis as a treatment for pregnancy-related symptoms.

  1. Effects on Fetal Development: One of the most significant gaps in our understanding is the effect of cannabis use on fetal development. While some studies have suggested potential risks, including preterm birth and low birth weight, the evidence is not conclusive. More research is needed to determine the exact effects of cannabis on the developing fetus.
  2. Long-term Outcomes for Children: Another major gap is the long-term outcomes for children exposed to cannabis in utero. Some studies have suggested potential developmental and behavioral issues in these children, but again, the evidence is not definitive. Longitudinal studies following children exposed to cannabis in utero into adolescence and adulthood are needed to fully understand the potential long-term effects.
  3. Safety and Efficacy for Pregnancy-Related Symptoms: Many women use cannabis to manage pregnancy-related symptoms, such as nausea and pain. However, there is a lack of high-quality research on the safety and efficacy of cannabis for these uses. More rigorous studies are needed to determine whether cannabis is a safe and effective treatment for these symptoms.
Filling the Gaps: Ongoing Research

To fill these gaps in our understanding, several research initiatives are currently underway. These include both observational studies, which observe and collect data on pregnant women who use cannabis, and experimental studies, which involve controlled experiments to determine the effects of cannabis use during pregnancy.

  1. Observational Studies: These studies are crucial for understanding the real-world effects of cannabis use during pregnancy. They involve tracking pregnant women who use cannabis and collecting data on their pregnancy outcomes and the development of their children. These studies can provide valuable insights into the potential risks and benefits of cannabis use during pregnancy.
  2. Experimental Studies: While observational studies are important, they cannot establish cause-and-effect relationships. This is where experimental studies come in. These studies involve controlled experiments, often using animal models, to determine the effects of cannabis use during pregnancy. These studies can help to establish causal relationships and provide more definitive evidence of the effects of cannabis on fetal development and long-term outcomes for children. For example, current animal studies have shown that normal fetal brain development is affected by endocannabinoids [7].


Consuming cannabis during pregnancy has been referred to as the “last taboo” surrounding the substance as its general acceptance increases. It has yet to be conclusively demonstrated whether this is an empty taboo to be disregarded or one with legitimate, scientific grounding. It is ultimately up to each person if they choose to use cannabis while pregnant or not. In this guide we have attempted to give you a helpful survey of the issues, as well as provide resources, but none of this is a replacement for having an earnest discussion with your medical provider. As with many decisions regarding pregnancy, the consequences of using various substances can be far ranging and affect more than just the person consuming.


  1. Johnson & Wales University. “7 Potential Health Benefits of Cannabis.” Accessed on May 24, 2023.
  2. Medical News Today. “Marijuana (cannabis): Good or bad?” Accessed on May 24, 2023.
  3. National Academies of Science, Engineering, and Medicine. “The medicinal benefits of cannabis are mostly unknown.” Accessed on May 24, 2023.
  4. CDC. “Health Effects of Marijuana.” Accessed on May 24, 2023.
  5. National Library of Medicine. “Marijuana Use in Pregnancy: A Review.” Accessed on May 25, 2023.
  6. CDC. “What are the potential health effects of using marijuana during my pregnancy?” Accessed on May 25, 2023.
  7. NIH. “Is Cannabis (Marijuana) Safe to Use While Pregnant or Breastfeeding?” Accessed on May 25, 2023.
  8. Wiley Online Library. “Pregnant People’s Perspectives On Cannabis Use During Pregnancy: A Systematic Review and Integrative Mixed-Methods Research Synthesis.” Accessed on May 25, 2023.
  9. BioMedCentral. “Cannabis use during pregnancy and its relationship with fetal developmental outcomes and psychiatric disorders. A systematic review.” Accessed on May 25, 2023.
  10. New York Times. “Cannabis Use in Pregnancy May Lead to a More Anxious, Aggressive Child.” Accessed on May 25, 2023.
  11. CDC. “Cannabis and Work: Implications, Impairment, and the Need for Further Research.” Accessed on May 25, 2023.
  12. British Medical Journal. “Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline.” Accessed on May 25, 2023.
  13. National Library of Medicine. “Consumer health-related needs of pregnant women and their caregivers.” Accessed on May 25, 2023.
  14. BioMedCentral. “Mothers’ accounts of the impact on emotional wellbeing of organised peer support in pregnancy and early parenthood: a qualitative study.” Accessed on May 25, 2023.
  15. Grad Coach. “The Research Gap (Literature Gap).” Accessed on May 25, 2023.
  16. American College of Obstetricians and Gynecologists. “Marijuana Use During Pregnancy and Lactation.” Accessed on May 25, 2023.
  17. UC San Diego Health. “Cannabis Use Disorder Rate Rose among Pregnant Women between 2001-2012.” Accessed on May 26, 2023.
  18. National Library of Medicine. “It’s Not Your Mother’s Marijuana: Effects on Maternal-Fetal Health and the Developing Child.” Accessed on May 26, 2023.
  19. National Library of Medicine. “Reprint of: survey of medicinal cannabis use among childbearing women: patterns of its use in pregnancy and retroactive self-assessment of its efficacy against ‘morning sickness’.” Accessed on May 27, 2023.
  20. Frontiers in Psychology, “Totality of the Evidence Suggests Prenatal Cannabis Exposure Does Not Lead to Cognitive Impairments: A Systematic and Critical Review.” Accessed on May 27, 2023.
  21. STAT News “As more states legalize marijuana, pregnant women and their doctors grapple with how to talk about it.” Accessed on June 4, 2023.