New Guidance on Cannabis Use During Pregnancy
Recent recommendations from the American College of Obstetricians and Gynecologists (ACOG) advise individuals to avoid using cannabis during pregnancy and breastfeeding. They suggest that healthcare providers inquire about cannabis use among their patients, both before and after pregnancy, to mitigate potential risks.
The prevalence of cannabis use among pregnant individuals in the U.S. has risen, likely due to increased legalization and societal acceptance. ACOG announced these new guidelines to give healthcare providers reliable strategies for counseling and screening patients regarding cannabis.
A 2019 study analyzed data from over 450,000 pregnant women in the U.S. and concluded that cannabis usage had more than doubled from 2002 to 2017.
Dr. Amy Valent, an ob/gyn from Oregon Health & Science University involved in the guidance’s development, noted that with societal normalization of cannabis, people may overlook its potential risks.
She pointed out that while cannabis use has been prevalent, and no direct links to birth defects have been confirmed, the safety standards for pregnancy should be carefully considered.
The ACOG guidance highlighted the lack of rigorous studies on the safety of cannabis use in pregnant or breastfeeding individuals. Additionally, research has now shown cannabinoid receptors appear in fetuses as early as five weeks into gestation. THC, the active component in cannabis, can also cross the placenta and enter breast milk, raising concerns about adverse effects.
Recent shifts in cannabis legislation and rising usage during pregnancy prompted ACOG to synthesize the latest research into a clear set of recommendations. A team of experts has worked for years compiling findings that relate to cannabis use and pregnancy.
Their findings indicate a potential association between cannabis exposure during pregnancy and issues like low birth weight, neonatal intensive care unit admissions, and even perinatal mortality. Concerns about neurodevelopmental implications, like attention deficits and memory problems, were also raised.
While the exact relationship between the amount of cannabis used and adverse outcomes remains unclear, the guidance aims to reduce risks similarly to other substance use recommendations during pregnancy.
Valent emphasized the importance of understanding the various factors that can affect fetal development, aiming for a supportive approach toward reducing risks during pregnancy.
The guidance makes clear distinctions between validated screening methods and biological testing for cannabis use. It discourages drug tests using hair, urine, or other samples, citing that they can lead to biased treatment of racial and ethnic minorities.
Instead, ACOG advocates for universal screening using interviews or self-reporting to identify opportunities for pre-delivery intervention, fostering equitable health practices.
Dr. Cara Poland from Michigan State University underscores the need for non-judgmental discussions during screenings. Many patients may not understand how cannabis can impact pregnancy, and initiating conversations can be as simple as asking for permission to discuss the subject.
Experts stress it is crucial that screening doesn’t induce feelings of punishment, as state regulations concerning drug testing vary widely and can lead to confusion regarding patient treatment.
Healthcare providers should navigate these complexities carefully. Poland noted that unlike other medical guidelines, where patients aren’t reported for failing to adhere, substance use can lead to severe consequences.
Engaging in dialogue may enhance patients’ understanding of potential risks and impact their behavior regarding cannabis use. Many women may be using cannabis to manage pregnancy-related nausea or anxiety.
Enhanced communication between providers and patients about these issues might help in reducing cannabis usage. Each individual has unique needs, so exploring alternative methods to manage symptoms becomes essential, according to Valent.
“The benefit of screening is that it fosters conversation, which helps tailor treatment to meet patient needs,” she adds. It’s vital for providers to engage comprehensively with patients about their symptoms and support them effectively. This guidance is meant to facilitate such discussions.
