Pot and Pregnancy: Is It Okay to Puff When Pregnant?

Marijuana use has become fairly widespread. Pot, hashish, ganja, dope: it’s all over. The legalization of marijuana in many states across the country has made lighting up as acceptable as having a drink; people can routinely be seen puffing in public in places like Colorado and Washington. In fact, to date, 23 states and the District of Columbia have legalized marijuana in some form (medicinal and or recreational use). Many more states have decriminalized the possession of small amounts of marijuana; taken together, pot is now fairly prevalent. It’s no longer something sold surreptitiously on a street corner. Given this, use during pregnancy and the postpartum period (specifically while breastfeeding) has become a more commonly asked question. So we are here to answer the question: can you toke during any trimester?

As you probably predicted (sorry to be a buzzkill for those who are fans), put your lighter down. Marijuana use in pregnancy is not kosher. Legal or not, it’s most definitely not legit in pregnant women. Cannabis sativa (Latin for marijuana) is the most common illegal drug used during pregnancy. About 2–5% of pregnant women report using it during pregnancy. (And if this is the number of patients admitting to it, think about how many more people are not copping to it!) In fact, about 50–60% of marijuana users continue to use during pregnancy. Whether you think of marijuana as the gateway drug to evil or the contrary and celebrate its legalization, you should realize it’s not okay in pregnancy or while breastfeeding (even when being used for medicinal reasons).

Animal models designed to test the impact of marijuana use in pregnancy have shown that the active ingredient in marijuana (tetrahydrocannabional, THC) does cross the placenta. Studies show that use during pregnancy can disrupt normal brain development. Children who were exposed to marijuana in utero had lower cognitive function, impaired visual-motor coordination, and lower scores on tests of visual problem solving. Furthermore, prenatal marijuana exposure was associated with decreased attention span and behavioral problems.

While brain development, behavioral problems, and attention span may be affected, the impact of “smoking up” during pregnancy has not been linked to structural anatomic defects (birth defects and other abnormalities in organ development). Additionally, there does not appear to be an increased risk of infant mortality among mothers who used marijuana during pregnancy. Lastly, the data do not demonstrate a consistently higher risk of preterm delivery or growth-restricted babies (medical term for small babies).

It is also important to remember that, while pot can be ingested (a.k.a. pot brownies), it is most commonly smoked. Smoking, whether it is marijuana or cigarettes, results in the release of really bad toxins. Newsflash: the levels of such toxins in joints is actually several times greater than in tobacco smoke. While this is not meant to be a prescription for eating rather than smoking your marijuana, it is important to remember that you are doing double negative duty to your baby on board when you smoke pot.

The data on breastfeeding and marijuana use are sparse. While THC has been observed in breast milk, the effect of its use on breastfeeding babies is limited. Given this, we recommend abstaining until nursing is fully completed. Simply stated, TLC does not equal THC! In addition, while marijuana is prescribed for select medical reasons, it should not be used for such purposes during pregnancy. According to the FDA, there are “no approved indications” for marijuana use during pregnancy and lactation.

If you happened to puff while pregnant but you didn’t know you were pregnant, it is not an indication for termination. Be honest with your OB/GYN about what happened so that the appropriate assessment can be taken. Whether it’s legal in your state or not, we are not here to lecture or lionize you for your personal practices when you’re NOT pregnant. However, when you’re pregnant or breastfeeding, we are here to say you should most certainly lay off the pipe. No matter how chill it makes you, it is not cool in pregnancy!