WSU study shows need for more education, research about cannabis use in pregnancy

“It helps me feel hungry and it takes away my nausea completely. And it helps with the pain, too. And not so much that it takes away all of my pain, but it helps me mentally manage my pain better.”

That is what participant No. 12 said in a recent study conducted by researchers at Washington State University Health Sciences Spokane, sharing why she used marijuana while either pregnant or nursing. Eighteen other subjects in the study cited similar reasons.

Published in a recent edition of the Journal of Addiction Medicine, the study interviewed 14 pregnant women and five women who had delivered babies within the past three months. All self-reported as being daily users of marijuana while pregnant. Each was questioned extensively on their perceptions of the risk and benefits of using marijuana during pregnancy.

“I think one of the surprising findings was that they were really thankful to be part of this study,” said lead author Celestina Barbosa-Leiker, vice chancellor for research at WSU Health Sciences Spokane and an associate professor for WSU’s College of Nursing.

“One mom drove across the state to tell her story. They (study subjects) were also frustrated by the lack of research. They want to make the best decision for their babies and felt they didn’t have the tools to do so.”

The following themes emerged from study data:

• Participants wanted more information on the impacts of using marijuana while pregnant;

• Participants used cannabis to manage chronic pain and other medical conditions rather than for recreational purposes,

• Most participants conducted their own research to determine the effects of marijuana on unborn or young infants,

• Participants had received mixed messages from health care providers about using marijuana while pregnant or soon after, and

• Participants were hesitant to reveal their cannabis use for fear of consequences from the legal and health care systems.

“There was a concern in the last trimester before having a baby in the hospital. Some mentioned they were going to taper off cannabis use so they didn’t test positive at delivery,” said Barbosa-Leiker.

The few studies that have been done on the effects of cannabis use during pregnancy show that it can be associated with low birth weight, still birth, and cognitive and behavioral issues.

Despite this, data indicates that cannabis use is on the rise overall, including in pregnant and nursing women. Previous studies show that cannabis use during pregnancy has significantly increased in the last two decades, growing 72.5% from 1999 to 2008 and 62% from 2002 to 2014.

Barbosa-Leiker believes some of the reason for that increase can be attributed to there being less perception of harm from marijuana today.

“We could link that to legalization (of recreational marijuana) as more and more states legalize,” she said.

It could also be linked to the opioid epidemic and the large amount of attention it is receiving.

“One thing we were hearing from our moms was that they were using other substances such as opioids to treat issues like pain or anxiety and nausea and decided cannabis is safer. We don’t have any research though comparing cannabis and opioids, so we don’t know if it is healthier.”

Based on these study results, Barbosa-Leiker believes health care providers should take a different tack when working with pregnant women.

“Rather than suggesting expectant mothers go cold turkey, which can cause them to not return to a doctor for further pre- or post-natal care, they should suggest cutting back or limiting marijuana use or finding other ways to deal with health issues.”

Barbosa-Leiker says one result of this study will be to work more closely with health care providers on messaging around cannabis use during pregnancy.

“We have a new grant we’re going to be working on with the College of Communication, creating two different health message campaigns,” she said. “One is for moms with pain and one for more casual recreational users, to help reduce cannabis use.”

Another element of this study included interviewing health care providers and budtenders at cannabis retailers about how they interact with pregnant women or nursing mothers who indicate they use marijuana. Results from those interviews will be published soon.