2 “Ps” That Don’t Belong in the Same Pod: Pot and Pregnancy

COMMENTARY Public Health

2 “Ps” That Don’t Belong in the Same Pod: Pot and Pregnancy

Jan 5, 2023 5 min read

Commentary By

Paul J. Larkin

Rumpel Senior Legal Research Fellow

Meaghen McManus

Fall 2022 Member of the Young Leaders Program at The Heritage Foundation

Marijuana is displayed for sale in a Euflora cannabis dispensary store before the Mile High 420 Festival in Denver, Colorado on April 20, 2022. PATRICK T. FALLON / AFP / Getty Images

Key Takeaways

When it comes to marijuana dispensaries, employees with no medical background are advising women that smoking pot during pregnancy can help with their nausea.

Delta-9-tetrahydrocannibinol, the psychoactive ingredient in cannabis, crosses from a woman’s placenta to her baby.

There is no constitutional right to use cannabis, especially when it poses an unknown risk of harm to others.

Let’s say that you are a pregnant woman and have a choice between receiving a medical opinion about a drug’s effect on your child in utero from either (a) a licensed physician or (b) a high-school graduate with no medical experience. Which one is more likely to offer sound medical advice? Unfortunately, when it comes to marijuana dispensaries, employees with no medical background are advising women that smoking pot during pregnancy can help with their nausea.

To become a doctor, one must complete four years of college (earning “A” grades in courses like physics, biology, and inorganic and organic chemistry). Then, if you are in the 38% of students who are accepted, you must complete four years of medical school, followed by three to seven years in a residency program devoted to a medical specialty, perhaps followed by a fellowship program in a subspecialty. Only then, after spending about 41,760 hours learning your craft, are you legally qualified to prescribe medication.

By contrast, in states like Colorado, there is no required educational or training regimen necessary to work in a pot shop and recommend to pregnant women that they should smoke marijuana

In fact, having a medical license often disqualifies you from jobs in the marijuana industry. The only qualification you might need is a Marijuana Enforcement Division badge, which is an occupational license that requires an online application and a $100 fee.

But dispensary employees are giving women medical advice. They are saying that marijuana helps with nausea during pregnancy. Who can argue with that? 

We can, and you should. A recently published Heritage Foundation Legal Memorandum—titled “Twenty-First Century Illicit Drugs and Their Discontents: The Potential Risks that Cannabis Use by Pregnant and Nursing Women Pose to Their Children”—explains why.

You might think that no one—physician or otherwise—would recommend to a pregnant woman that she use any drug not approved by the U.S. Food and Drug Administration. Sadly, you would be sorely mistaken.

A survey published in 2018 found that employees at 69% of cannabis dispensaries in Colorado recommended treating morning sickness with pot. Only 31% of them recommended first discussing the issue with a health care provider without having to be prompted by the person administering the survey. 

You could hope that no pregnant woman would take this advice, perhaps taking a moment to consider what cannabis could do to her child’s developing brain. But we must disappoint you again. The same survey reported that about 20% of pregnant women 24 years old or younger tested positive for marijuana in a drug screening. That is about double the number of pregnant women who self-reported using marijuana, meaning that pregnant women underreported their cannabis use. 

Is maternal cannabis use harmful to a developing fetus? The medical community doesn’t know everything it would like to, as more research needs to be done, but what it does know gives us significant reason for concern that maternal cannabis use is potentially dangerous to a child in utero. More importantly, there is no conclusive proof that it is not dangerous.

Delta-9-tetrahydrocannibinol, the psychoactive ingredient in cannabis, crosses from a woman’s placenta to her baby. While studies of maternal cannabis use have not proved direct causal relationships with negative outcomes for the child, they certainly have found an association with outcomes like low birth weight and premature birth, which can result in serious health problems for the baby. Cannabis use might also increase the chances of having a stillbirth

If the baby survives, there’s the chance of serious problems down the line because of what cannabis might do to fetal brain development. One study found that there are “significant molecular modifications,” meaning that cannabis interferes with the brain’s development, which results in “neurotypical and behavioral abnormalities.” 

Cannabis also could be associated with higher rates of depression and other emotional regulation problems, like anxiety or delinquent behavior, and executive function deficits in areas such as attention, visual analysis, and hypothesis testing. 

True, other studies challenge the associations noted above. But numerous federal health care organizations—the Office of the U.S. Surgeon General, the FDA, the Centers for Disease Control and Prevention the Substance Abuse and Mental Health Services Administration, and the National Institutes of Health—officially recommend against pregnant women using cannabis.

Several highly respected private medical organizations—the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the American Medical Association—say the same thing.

Why? Because there is no conclusive proof that cannabis will not harm a developing child.

So, what do we do in the face of this uncertainty? Do we throw up our hands and­­ say, “Who am I to judge?”

No. We should not take the unnecessary risk of harming part of an entire generation of innocent, unconsenting children. Why? Because ever since the Federal Food, Drug, and Cosmetic Act became law in 1938, the nation has made the judgment that no drug should be marketed interstate unless and until its proponents prove to the FDA’s satisfaction that it is safe.

That is critical because the FDA has never approved smoking cannabis as a treatment for any disease or even the nausea that women can suffer early in pregnancy.

We should not ignore that proposition. God forbid that the problem turns out to be worse than we now fear. The responsibility for harming the future generations would fall to us for not taking the steps to prevent it.

That is why each state and Congress should make it illegal to knowingly sell cannabis to a pregnant woman. Not only should the criminal law target individual sellers, but a series of unlawful sales should justify seizure of the responsible dispensary.

There is no constitutional right to use cannabis, especially when it poses an unknown risk of harm to others. In fact, even terminally ill patients do not have the legal right to access drugs that have not been approved by the FDA.

And in case you were wondering, the FDA has approved pharmaceutically produced cannabis compounds for treatment of vomiting and cachexia, a wasting disorder that causes extreme weight loss and muscle loss, but the agency has never approved smoking pot for the treatment of any disease or condition.

It is vital that we protect the next generation of children against the ignorance of this drug-proliferating society. We must act now to prevent any more damage, because when we finally have a scientific answer, it might prove too late for millions of already adversely affected children.

This piece originally appeared in The Daily Signal

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