Medical Marijuana Use is Growing Among the Population, But is it Safe for Pregnant and Breastfeeding Women?
Between 2010 and 2018, the number of hospitalized pregnant women with cannabis use disorder rose by 150%, according to a study entitled “Association of Comorbid Behavioral and Medical Conditions with Cannabis,” published in JAMA Psychiatry in November 2021. Columbia University and Weill Cornell Medicine sought to quantify pregnancy cannabis use disorders documented in over 20 million hospital records of patient prenatal matters. The researchers found that pregnant women with cannabis use disorder experienced higher degrees of depression, nausea, and anxiety.
Cannabis use disorder refers to overuse and dependency, similar to any other substance that may cause physical or psychological addiction. A marijuana disorder is quantified by daily marijuana use for more than ten years with six or more attempts to quit. Marijuana substance abuse disorder typically coexists with or induces the early onset of psychiatric disorders, such as schizophrenia.
The Columbia study points to a growing issue with the greater access and acceptance of cannabis after legalization in many states, including New Jersey, which often gives pregnant and breastfeeding mothers a false sense of security in using cannabis over pharmaceuticals. In fact, 2% to 5% of pregnant women use marijuana during pregnancy. One Kaiser Permanente study saw a 3% rise in marijuana use among pregnant women from 2009 to 2016, especially women 24 years and younger. However, leading obstetric and pediatric organizations recommend that pregnant individuals refrain from cannabis use because of the unknown effects on fetuses and the smoking risks to pregnant women.
Accepted Uses of Medical Marijuana in New Jersey
In New Jersey, medical marijuana is available to patients with qualifying conditions, such as opioid addiction, anxiety, cancer, chronic pain, epilepsy, glaucoma, HIV/AIDS, migraines, PTS, and terminal illnesses, among others. Currently, patients may have up to three ounces per month from licensed dispensaries after the 2019 enactment of the Jake Honig Compassionate Use Medical Cannabis Act..
Previously, in 2010, the Compassionate Use Medical Marijuana Act gave rise to the NJ Medical Marijuana Program. The program is recommended for those with approved conditions that have not responded to traditional medicine regimens. Qualified medical staff supervises medical marijuana use, warning patients about mixing marijuana with other medications, alcohol, or other substances that may interact with cannabis.
Those who use recreational marijuana outside of the medical marijuana program cannot remain in the program, and every two years, patients renew their medical marijuana eligibility (medical marijuana card) with their medical records. Each patient must prove that they have tried a wide range of treatments before entering the program, and medical marijuana patients may not grow their own cannabis.
Recreational Cannabis Use Since New Jersey Legalization
Additionally, after 2021, New Jersey adults may have up to six ounces of marijuana for recreational use without a medical marijuana card. However, it is illegal to cultivate or distribute cannabis or cannabis products unless licensed by the state. Governor Murphy signed the New Jersey Cannabis Regulatory, Enforcement Assistance, and Marketplace Modernization Act in 2021, with its new approach to recreational cannabis law set to take effect in 2022. The Act decriminalized marijuana and hashish for those 21 or over.
Potential Effects of Marijuana on a Fetus and Associated Fetal Outcomes
Despite the rising use of cannabis, much is still unknown about the effects of regular use, especially on fetuses. Some evidence exists for low birth weight and neurological development abnormalities in fetuses whose mothers use cannabis during pregnancy. Stillbirths also may run higher in marijuana users, according to some studies. In addition to stillbirth, premature birth and miscarriage have also been connected with using marijuana during pregnancy. Neurological and cognitive delays, learning disabilities, and a serious condition known as anencephaly, which affects the development of the brain and spinal cord, are also potential health risks to babies whose mothers use cannabis.
However, cannabis is not known to cause death, even when a user suffers an overdose. The Centers for Disease and Control Prevention (CDC) does not suspect that cannabis leads to overdose fatalities, despite the side effects of panic, increased heart rate, paranoia, anxiety, hallucination, severe nausea, and increased blood pressure.
However, the CDC points to the health hazards of inhaling smoke to the mother and her baby because of the toxic chemicals known to cause cancer, which are the same as those in tobacco smoke. In addition, the CDC states that the psychoactive ingredients in cannabis from THC can also affect babies through secondhand smoke. Further, some studies point to the dangers of marijuana users breastfeeding children in the most vulnerable stage of early brain development, as THC levels can build up in breast milk and enter a breastfeeding baby.
While the effects of THC on fetuses are not fully understood, researchers understand that THC crosses the placenta in animals in amounts corresponding to maternal use. And complete elimination of the substance can take anywhere from hours to nearly a month, depending on how much an individual uses. However, since many users also use tobacco and other substances, the direct effect of marijuana on pregnancy and the long-term effects on children born to cannabis-using mothers is still largely unknown. Nevertheless, since marijuana is not regulated and overseen by the FDA or standardized by formulation or dosage, medical authorities recommend discouraging use during pregnancy and breastfeeding.
Settling the Marijuana Question During Pregnancy by NJ Law
For pregnant women in New Jersey, the question of safety is settled by law, even for nausea alleviation during pregnancy. New Jersey Statutes Annotated, Section 2C:35-8 discourages the sale of marijuana and other controlled dangerous substances to minors and pregnant women. Convictions for selling or giving marijuana to a pregnant woman include prison terms, fines, and parole ineligibility twice as high as distributing to non-pregnant individuals. In fact, the Medical Marijuana Program physicians advise pregnant and breastfeeding women to stop using cannabis unless their treating doctor recommends otherwise.
Recommendations on Cannabis Use Among Pregnant Women
Although a physician may find a reason for a patient to continue marijuana use during pregnancy, most discourage use. The American College of Obstetricians and Gynecologists recommends that gynecologists dissuade patients from using marijuana before and during pregnancy or from prescribing cannabis for pregnancy symptoms or other conditions. As such, a woman planning to become pregnant or who is pregnant should hear their doctor recommend discontinuing marijuana use. Even when a pregnant woman has a medical marijuana card for treating a condition other than pregnancy, her physician should advise her about the risks of using marijuana while pregnant and suggest alternative pregnancy-safe treatments.
Considering the rise in marijuana use that outpaces the confirmed studies on its effects, governing medical bodies instruct gynecologists and obstetricians to help pregnant and breastfeeding women to quit marijuana for their safety and their babies. And physicians who do not advise, encourage, and assist patients with their cannabis use disorder may be liable for the consequences to the parents of a stillborn baby or a baby born underweight and with neurological defects.
Responsibilities of Medical Professionals Caring for Women during Pregnancy
Medical professionals must know and follow the guidelines of their professional boards for best practices, including doctors who care for pregnant and breastfeeding women. Knowing the responsibilities of healthcare providers as is relates to prenatal care, and what may be considered prenatal negligence, is especially valuable if you or your child suffered any type of harm or medical complications during gestation, labor and delivery, or after childbirth. While not every case constitutes grounds for a lawsuit, medical malpractice victims are entitled to seek compensation when physicians and other professionals fail to uphold the appropriate standard of care.
If you suspect malpractice occurred in your or a loved one’s case, contact our legal team to speak with an attorney regarding your unique situation. We are pleased to provide a free case review and to answer your questions as it relates to birth injury and pregnancy malpractice lawsuits, as our attorneys handle these claims on a regular basis in New Jersey and consult on these cases nationwide. Call 866-708-8617 today for a free consultation.