The American College of Obstetricians & Gynecologists (ACOG) has released new recommendations urging people to avoid marijuana during pregnancy and breastfeeding. The group also recommends that doctors regularly ask patients about marijuana throughout their pregnancy journey so they can better address possible risks.
Marijuana use has grown significantly among pregnant women in the U.S., a trend linked to changing laws and greater social acceptance. In response, ACOG developed the new guidelines to provide healthcare professionals with research-based strategies for counseling and reducing use.
According to a 2019 National Institute on Drug Abuse study of more than 450,000 women between 2002 and 2017, cannabis use during pregnancy more than doubled in that time.
Dr. Amy Valent, an obstetrician-gynecologist at Oregon Health and Science University and contributor to the new guidelines, said that normalization often leads people to underestimate risks. She noted that while cannabis hasn’t been definitively tied to birth defects, that alone does not make it safe for pregnancy.
Recent studies show that cannabinoid receptors form in a fetus within the first trimester and that THC, the primary psychoactive element in marijuana, can cross the placenta and enter breast milk. This exposure has been linked with poor outcomes such as NICU admissions, low birth weight, and, in some cases, higher risks of perinatal death. Long-term effects may also include developmental challenges such as attention problems, memory issues, or learning difficulties.
Although it is difficult to measure exactly how much cannabis leads to these outcomes, experts stress that the safest approach is to avoid use altogether.
The updated guidance also stresses how providers should approach screening. Biological testing, such as urine or hair samples, has historically led to biased treatment of ethnic and racial minority groups, and ACOG strongly advises against using those methods. Instead, open conversations and patient self-reporting are encouraged.
Doctors are encouraged to ask permission before bringing up the subject, keeping the tone nonjudgmental and focused on health rather than punishment.
The recommendations also acknowledge the complexity of state laws on drug testing during pregnancy, which can involve child protection services. ACOG urges providers to understand local regulations while still fostering a safe and honest space for patients.
According to ACOG, many individuals turn to cannabis to manage pregnancy-related nausea, anxiety, or stress. However, doctors suggest discussing other options that may ease symptoms, such as small dietary changes, light exercise, or safe medications. Valent noted that personalized care is key, since every patient’s situation is different.
Medical marijuana companies, such as Cresco Labs Inc. (CSE: CL) (OTCQX: CRLBF), could also increase their consumer education programs so that individuals make informed decisions when choosing to use marijuana products while pregnant.
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