In the earliest records of human civilizations dating back millennia, cannabis is described as a useful medicine for treating the ill effects of pregnancy. Accounts by physicians across cultures and generations corroborate these stories: A little bit of marijuana allegedly can go a long way in curing severe morning sickness, preventing premature birth and calming uterine pains, among many other conditions.
Today, according to the American College of Obstetrics and Gynecology, 2 to 5 percent of American women use marijuana while pregnant. But despite the legalization of cannabis in California, among other states, there is likely a long way to go before moms-to-be have the support of their doctors in this choice.
“I can’t imagine trying to go to an institutional review board to try to get approval for a clinical study on women of childbearing potential using marijuana,” says Dr. Ethan Russo, medical director of Phytecs. “In this day and age, in our society, it’d be an extraordinarily difficult thing.”
The barriers to modern-day research was one of the reasons Russo decided to look back at how cannabis has been used to treat pregnant women throughout time. It turns out, during the 19th century, various marijuana products, from the indica strain to hemp, were reported as helpful by physicians in Europe, Asia, and Africa.
Cannabis has been used historically to treat everything from menstrual pains to breast soreness. It’s also been used to treat hyperemesis gravidarum, a life-threatening condition often described as intense morning sickness. A study from 2005 reported that 92 percent of women with this condition found cannabis to be an effective treatment, but there’s more research to be done.
“I think these historical studies are instructive on two levels,” Russo says. “They’re instructive on how cannabis can help in obstetrics and gynecology, and they’re also instructive on the lack of problems we’ve seen in using cannabis as a treatment.”
There’s been a number of studies investigating the risks cannabis might pose to unborn children, but many have failed to account for tobacco and alcohol use among mothers. This is what happened in a commonly referenced, large study funded by the National Institute on Drug Abuse, which found that maternal marijuana use negatively affected problem-solving skills and the attention or impulsivity of children starting at around 3 years old. There's been criticism among cannabis researchers, such as dean of Rush University Medical Center Melanie Dreher, that NIDA only funds studies looking into the consequences of cannabis use.
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This catalyzed an overdue review, published late last year in the American Journal of Obstetrics and Gynecology to marijuana use, which determined that risks attributed to marijuana use among pregnant women are often a result of research flaws. Marijuana use on its own does not, the researchers found, create a significant risk of low birth weight or preterm delivery. And it’s difficult to attribute to marijuana use cognitive or behavioral problems among children who are several years old, when there are so many other factors that contribute to development, Dreher says.
Mary Lynn Mathre, co-founder of Patients Out of Time, says she’s worked with “patients and patients and patients” over her career who have used cannabis without problems to aid in pregnancy as well as severe menstrual pain. She says these women often don’t feel comfortable being open about their marijuana use, though, because of legal risks. Women can have their children taken away by social services if they test positive for cannabinoids in their urine upon delivery.
These sorts of punitive policies make little sense when considering American history, Russo says. Marijuana was commonly used as a medicine in the United States until the 1930s, when it began to be regulated federally. In 1930, the editor-in-chief of the American Medical Association recommended cannabis as an aid to childbirth and said he never saw any challenges related to its use.
The majority of researchers now acknowledge that the potential risks of using cannabis while pregnant are inconclusive. This means, Russo says, that marijuana shouldn’t be used recreationally among moms-to-be. But it also means that it’s not scientifically legitimate to unanimously ban it, he says. Russo hopes that a look at the past, and to other parts of the world, will help physicians move beyond present-day stigma to recognize cannabis as a potentially life-changing solution for pregnant women facing serious medical conditions.