Is it safe to smoke weed while trying to conceive?

Never has our country been so open about marijuana use. With weed legal medicinally or recreationally in more than half the states, more people are consuming marijuana regularly and not giving it a second thought.

But what does that mean to couples trying to conceive? Are they putting their future baby at risk?

Most women are trying not to, it appears.

“In this cross-sectional study of 73,551 women, cannabis use increased significantly among women before pregnancy and after pregnancy but not during pregnancy in states that had legalized recreational cannabis compared with states that had not legalized cannabis,” the authors concluded.

“These findings suggest the need for interdisciplinary research to better understand how recreational cannabis policies are associated with maternal cannabis use.”

Marijuana use skyrockets where its legal

Several studies have been published showing that marijuana consumption is up. Researchers wondered whether women of childbearing age keep on smoking before, during and after a pregnancy, too.

The study included women from the Pregnancy Risk Assessment Monitoring System. Women came from Alaska and Maine, which have legalized marijuana, or New Hampshire and Vermont, which have not.

Women completed surveys two to six months after delivery, reporting preconception, prenatal, and postpartum cannabis use.

The sample included 23,082 women: 23,859 in the prenatal period, and 26,610 in the post-partum period. Most women were married ages 25 to 34 years and had annual household incomes of less than $50,000.

“In adjusted analyses, preconception and postpartum cannabis use increased significantly in states that had legalized recreational cannabis compared with states that had not legalized it,” the authors concluded. “The risk for prenatal cannabis use was not significant.”

Turns out, most women did not smoke while pregnant even with the availability of cannabis. “In this repeated cross-sectional study, recreational cannabis legalization was associated with changes in maternal cannabis use before and after pregnancy,” the authors concluded. “The findings suggest that future studies should undertake an interdisciplinary approach to maximize benefit and application of findings to future public health, health care, and policy sectors.”

Most aren’t afraid of marijuana dangers

It’s still the wild west when it comes to cannabis and pregnancy. Much is unknown.

Lead author Kara Skelton set out to answer some hard questions about marijuana use and maternity. Skelton is from the Department of Health, Behavior, and Society at Johns Hopkins Bloomberg School of Public Health.

“Levels of safe prenatal cannabis use have not been established to date, and questions regarding the risk of cannabis use have been the subject of debate,” the authors reported. “However, state-level recreational cannabis legalization in the U.S., particularly in states with policies that include provisions for cannabis commercialization, make cannabis products more attainable, affordable, and socially acceptable, which may be contributing to increased use.”

Studies show that cannabis use is up among women of reproductive age and even pregnant women. “This increased use may be associated with an array factors at both individual and ecological levels, including decreased risk perceptions associated with cannabis use and increased social acceptance of use,” the authors explained. “In addition, recent evidence supports hypotheses that increases in cannabis use may be explained by recreational and not medicinal use.”

Fifteen states and the District of Columbia now allow recreational marijuana sales and use.

Political climate favorable to marijuana

“Initially, recreational cannabis legalization was a result of voter support, which has doubled since the early 2000s,” the authors explained. “More recently, however, the political climate in the U.S. has led to increased legislative support for expansive cannabis reform and legalization.

“This support is evidenced by legalization of recreational cannabis through state legislatures, current pending legislation, and numerous states in which legislative bodies have introduced bills in the past 2 years,” the authors continued. “Increases in legislative support, in particular, create an urgent need to examine the public health effects of recreational cannabis legalization, including the association of legalization with maternal and child health.”

What do previous studies already show?

“A recent cross-sectional study revealed that women residing in states in which recreational cannabis use is legal were significantly more likely to use cannabis during these critical periods compared with women residing in states yet to legalize recreational cannabis,” according to the authors. “Another recent case study in Colorado revealed that prenatal use increased after recreational use of cannabis had been legalized.”

Shortcomings in the research

In an accompanying editorial, Kelly C. Young-Wolff of the division of research at Kaiser Permanente of Northern California, comments on the study.

“The authors used a difference-in-difference analysis over time, contrasting changes in intervention and comparison states, an important strength compared with earlier studies on this topic,” Young-Wolff said.

“However, limitations of the study design, most noted by the authors, were that data were available for only 4 states, periods were asynchronous, response rates were low, follow-up periods were short, there was overlapping medical legalization in comparison states, there were differences in the characteristics of women in intervention vs comparison states, and cannabis use was retrospectively self-reported,” Young-Wolff explained.

Marijuana not safe for use during pregnancy

She said that marijuana use is on the rise among women trying to conceive should be cause for concern.

“The U.S. Surgeon General, American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics advise against cannabis use during pregnancy and lactation,” according to the editorial. “However, pregnant women remain uncertain about the harms of prenatal cannabis use and many seek out anecdotal advice from peers and online communities supportive of cannabis when choosing whether to use (or continue to use) cannabis during pregnancy.

“Adding to the confusion, many cannabis retailers tout cannabis as a safe, natural, and effective way to manage pregnancy symptoms.”

These claims are misleading, the authors argued. “In one study, 69 percent of cannabis retailers recommended use for nausea and vomiting during pregnancy in response to a simulated call from a pregnant woman,” according to the editorial.

“Many women using cannabis during pregnancy believe that cannabis carries little risk and perceive it as a natural substitute for prescribed medications used to treat mental health and pregnancy-related symptoms.”

Research demonstrating marijuana’s safety while trying to conceive doesn’t exist, however. Until it does, the safe choice is not to consume marijuana while trying to have a baby.