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Cannabis in Pregnancy, a Closer Look

August 31, 2022

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The use of cannabis as medicine is becoming more and more accepted as common practice in Western culture, after decades of judgment and criminalization. While more research is developing on the pros and cons of medicinal cannabis use, it is still considered a teratogen during pregnancy. A teratogen is any substance or factor that has an effect on the development of a fetus during the embryonic and/or fetal stages. It’s important to note that teratogens, in general, cause 7% of congenital malformations. Less than 2% of all congenital malformations are caused by teratogenic drugs or chemical substances (Green).

Teratogenic exposure can cause the most damage in early pregnancy, sometimes before a woman even knows she is pregnant. Studies show that the crucial development of the central nervous system and heart of the fetus begins only three short weeks after conception (See Figure 1 below). This is important information because many cannabis users may still be consuming without knowledge of their pregnancy, and may need time to create new habits to replace cannabis smoking, if they choose not to consume during pregnancy. It is commonly stated by Western doctors that the main effects of cannabis consumption during pregnancy include low birth weight, intrauterine growth restriction, preterm birth, and increased risk of miscarriage. One study shows that THC, the most active psychoactive compound in cannabis, disrupts the homeostasis of the endocannabinoid system and it’s production of Anandamide, or AEA (Maia). This study concluded that, “In chronic cannabis users, high AEA levels in [the] placenta may disturb the delicate balance of trophoblast cells turnover leading to alterations in normal placental development and fetal growth (Maia).”  Other scientists have labeled cannabis as a ‘conditional teratogen’, after a recent study has shown that negative effects may be dependent “a complementary but insufficient genetic insult (Harkin).” This study looks at the effects of THC on the Hedgehog (HH) signaling pathways. These HH pathways regulate developmental processes, and the slowing of this process can cause birth defects. “In Vitro findings indicated that cannabinoid is in fact a direct inhibitor of the essential HH signal transducer ‘smoothened (Harkin).’”

Healer and plant medicine specialist, Aya Maria, discussed some of these findings from her perspective in her live training that I attended in 2021, Cannabis in Pregnancy, Birth & Postpartum. She talked about the fatty acid amide, Anandamide and it’s role in our bodies. Ananda means ‘bliss’ in Sanskrit.  Anandamide is a regulating, naturally occurring substance in our body that can be released by self love and devotional practices. It plays a role in pain management, fertility, appetite, memory and depression. While studies have shown that an overuse of cannabis and THC may slow down our natural process of creating Anandamide, some may argue that a healthy and ritualistic relationship with this medicine may help us in producing Anandamide. 

Aya Maria also points out the relationship between a plant and patient is important. Cannabis is cultivated in many unique ways now, but our ancestors had a more down-to-earth cultivation practice that affects the properties of the plant. If a woman does choose to consume cannabis during pregnancy, she could consider growing her own organic plants from seed to harvest, or sourcing her medicine from a trusted organic farmer. Aya Maria refers to cannabis as ‘Woman’s medicine’ and a ‘plant ally’, while also acknowledging that pregnancy is already a somewhat psychoactive state. An expecting mother may choose a cannabis strain with a lower THC content, as to not flood the endocannabinoid system. 

A woman may choose to continue to consume cannabis, as the benefits may outweigh the risks in some cases. Smoke is a mixture of the wind and fire elements, and it can be drying from a TCM perspective, which is unhelpful for pregnancy. Smoke may cause toxicity, thicken blood and restrict blood flow and oxygenation. According to Aya Maria, consuming cannabis by smoking during pregnancy is really not recommended unless it is a conscious and intentional routine. She recommends creating a low THC level oil to ingest or apply topically to the body, creating a cannabis ghee infusion to cook with, or even cooking the cannabis leaves from your own organic plants for extra nutrients and benefits with little to no psychoactive properties (Maria). If a pregnant mother would like to discontinue cannabis use during pregnancy altogether, a midwife can provide great support and resources. Helping a woman assess her habits and create alternative routines for stress relief, pain relief, or emotional processing to replace the plant medicine can help set her up for success. Also, supporting a woman with basic nutrition may help if she experiences any sort of withdrawals or detoxification symptoms as her body regulates. Anne Frye suggests advising a woman to drink plenty of water, eat two large servings of veggies a day, and supplement B, C, and Zinc vitamins to help with the detoxification process. “Red clover [infusions] and lemon juice can also be used to detoxify the system (Frye.)” She also suggests adding a warm glass of milk at night to aid in sleep and tension relief in the body as a replacement for an ‘evening smoke ritual.’ 

For me, personally, this was fun to dive into (again) with a little bit more wisdom and knowledge. Cannabis as plant medicine is something that I am passionate about. It has been profound for me on my own healing journey and many of those that I have witnessed. As a midwife, I hope to provide support that is backed by education and intuition for the families I support when it comes to their relationship with cannabis so that they can make the individual decisions that are right for them with informed and respectful consent. 

Figure 1:

Annotated Bibliography 

Frye, Anne. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice. 2010. Pp 266-271, 286

-Discusses smoking and how to support a client in quitting

Green, Maryn. “Teratogens.” Indie Birth Midwifery School. 2022.

-Discusses teratogens affect on fetus, supplied Figure 1

Harkin, Phoebe. “Of Mice, Cannabis, and Hedgehogs- Mount Sinai researchers classify THC as a ‘conditional teratogen’”. 2022.

-discusses the Hedgehog signaling pathways 

Maia, J. “Effects of cannabis tetrahydrocannabinol on endocannabinoid homeostasis in human placenta”. 2019. 

-Discusses ECS and development

Maria, Aya. “Cannabis in Pregnancy, Birth & Postpartum.” 2021. 

-Discusses healthier ways to consume and the benefits

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  1. Emily says:

    This article was wonderful. I did have a more specific question about using cannabis during labor. I’ve been a recreational user but stopped while pregnant. I’m interested in taking it during labor to help me and my body relax. But my worry is if it will relax the uterine muscles too much. Any thoughts/ experience?

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We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 12 children and 18 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth Midwifery School is our space to share it all with you.

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