Not too long ago, I was blessed to be on the cover of this incredible “bright idea for patients by patients” cannabis publication – 1000 Watts Magazine. My article was the featured article of Issue 58. I was twenty weeks along with my second baby, and my article centered on the hot topic of cannabis and pregnancy. To round out all of the special surrounding this wonderful opportunity, my dear husband took the photos that comprised the cover and accompanied the featured article within. He captured the joy and excitement that I have felt throughout this pregnancy as I carry our second child – a little girl.
To be honest, when I saw the cover for the first time, I was all things excited, but then a little doubt crept in. Uh oh, there I am – a practicing cannabis nurse, embracing her pregnant belly, with the big words “Cannabis and Pregnancy” printed next to me. Stigma then followed the doubt and my mind went to some interesting places. I became enveloped in the stigma-driven concern – What would others think of me? But then I found my center and banished that thought as quickly as it came. My article had nothing to do with me. It had everything to do with the challenges faced by women who may benefit from cannabis therapy during pregnancy, how pregnant women typically arrive at informed decisions when they’re in need of any medicine should it be conventional or unconventional. It was about the benefit versus risk analysis that women and health providers implement to arrive at such decisions. My article had everything to do with my passion for women’s health and my continued advocacy for this population – women through the childbearing years.
Since Issue 58 has made it out into the world, I have had quite a few people reach out to me to ask about cannabis use during pregnancy. I provide the most current research literature and data, review known risks, potential risks, and potential benefits. And then the question floats up – “Have you used cannabis during pregnancy?” To this end, I’ve decided this article will be partially about me, because inquiring minds want to know. I also feel this is an important piece in the conversation surrounding cannabis and pregnancy.
My answer is no. I do not use cannabis during pregnancy. I am a medical cannabis patient – I struggle with chronic pain which is the main reason why I use cannabis when I’m not pregnant. I have also used cannabis to manage symptoms of anxiety, depression, and to help me sleep during bouts of insomnia. When I’m pregnant, I choose not to for several reasons. For one thing – the chronic pain I struggle with is cyclical – it accompanies my menstrual cycle. A benefit of being pregnant for me is that I get off the menstrual cycle train for a while. I do still have some pain, but I can manage this pain with other tools I keep in my self-care toolkit. Yoga, meditation, massage therapy, heat, ice all help to relieve tension and pain that I have experienced during this pregnancy. Many of these self-care tools also help reduce anxiety symptoms and prevent depression.
Insomnia has been a different story for me this pregnancy. I struggled with seven weeks of insomnia during the first trimester. It was the only time I really considered using cannabis to relieve symptoms. I came to my decision by weighing the benefits versus the risks of using cannabis. I knew I would likely get some rest, but the great deal of unknown risks related to cannabis use during pregnancy simply outweighed the benefits.
I am biased, I believe cannabis use during pregnancy is (likely, probably) safer than many of the pharmaceutical medications readily prescribed to pregnant women. For me, bias is not a reason to move forward with anything that may put my developing child at risk. Unfortunately, in this current political climate that continues to prevent those of us in the medical and science communities from adequately studying cannabis in general, we really don’t have all of the data we need to make informed decisions regarding cannabis. And the knowledge deficit is even greater when it comes to cannabis use during pregnancy.
Generally speaking in pregnancy, I choose to manage my symptoms without medications. I don’t even take acetaminophen (Tylenol) during this time, and I allowed myself one diphenhydramine (Benadryl) per week when I was struggling with the unrelenting insomnia during my first trimester. I am very fortunate that I am able to manage my symptoms with non-pharmacological methods of pain relief. The insomnia pushed me to my limits, but thankfully it resolved. I certainly considered using a little bit of cannabis while I was in the throes of it though.
This brings me to the most significant reason why I chose to endure insomnia for nearly two months without using cannabis – the risk of Child Protective Services (CPS)/Department of Children & Families (DCF) involvement. Simply put, my medical cannabis use ceased as soon as I found out I was pregnant because I am not willing to compromise the health and well-being of my family.
Pregnant medical cannabis patients are the most vulnerable cannabis users
Every state has its own laws and/or regulations on drug testing pregnant women and newborns for controlled substances, with varying degrees of consequences for positive results. In some states, women who test positive for cannabis may be prosecuted as drug-offending criminals, which may result in loss of parental rights and custody of their children. They may be charged with child abuse if their children test positive for cannabis at birth and beyond. In Massachusetts where I live, there are not any specific laws to criminally prosecute a pregnant woman who uses substances during pregnancy. There are also few protective provisions for parents, pregnant women, and legal guardians who happen to be registered medical cannabis patients. As a result, this demographic remains vulnerable to social system interference related to cannabis use despite the laws explicitly stating that “any qualifying patient who meets the requirements under the law shall not be penalized under Massachusetts law in any manner, or denied any right or privilege, for such actions.” (MA – Ch. 369 of the Acts of 2012 — Medical use permitted by qualifying patients.)
According to the Guidelines for Community Standard for Maternal/Newborn Screening For Alcohol/Substance Use set forth by the Massachusetts Department of Public Health (DPH), all pregnant women undergoing prenatal care should be screened for use of controlled substances and alcohol throughout pregnancy. A pregnant woman who tests positive for controlled substances such as cannabinoids throughout her pregnancy will have to endure having her newborn baby drug tested following birth also, without her consent. If the baby tests positive, DCF intervenes. If the baby tests positive, the mother is denied the ability to breastfeed. If the baby tests positive, the all important first hours of bonding and healing from birth tend to be interrupted.
From my perspective as a mother who understands what it takes to get a breastfeeding relationship underway, and an RN who specializes in women’s health – this intervention may very well put the new family unit at risk of challenges and obstacles from the start. I feel strongly that this interference places families at greater risk than medical/therapeutic cannabis use ever could. That is my biased opinion and I stand by it with good reason. I have been in contact with too many good families, too many women who struggle after DCF has closed their investigation once it was determined that the newborn and other children in the family were not being abused or neglected. I have heard from families who planned to breastfeed and because they weren’t allowed to do so in the hospital, they struggle to afford formula.I have heard from women who endured the trauma that often accompanies DCF involvement – they report symptoms of postpartum anxiety, depression, psychosis as their hormones are spiraling out of control because they don’t have any of the protective benefits that breastfeeding provides to freshly postpartum women. My heart breaks for them. Their decision to use cannabis during pregnancy resulted in DCF interfering with their lives. And now they live with great regret, and in some cases require serious medical help ranging from starting a new cocktail of prescribed psychiatric medications, to hospitalization for their flourishing mental health crisis.
This pregnancy, birth, motherhood game is challenging enough
It is challenging enough to carry a baby for forty weeks, birth a baby, heal from birth, and then learn how to take care of a newborn, or integrate a new baby into an existing family unit. DCF involvement adds a layer of stress that puts many families over the edge. In some cases, such intervention from agencies developed to protect vulnerable people, in this case children and families, is absolutely necessary. Yet when it comes to medical cannabis, I feel the very system that is supposed to protect families causes more harm than good in more cases than not. The risk of DCF involvement directly following labor, delivery, and birth of my second daughter is not something I am willing to endure. I have suffered a bit without medical cannabis, but for me and my family – the benefit of me suffering with some insomnia outweighed the risk of DCF interference in our lives. Again, I’m not willing to compromise the health and wellbeing of my family. It shouldn’t be this way, but for now, it is.
Featured Photo Credit: Mark Fratoni