Till date, 11 states and the District of Columbia have legalized marijuana for recreational purposes while 33 states and the District of Columbia have legalized marijuana for medical purpose. As laws and attitudes towards marijuana use are shifting, a growing number of people, including pregnant women are using it repeatedly, occasionally or on a regular basis, before and during pregnancy.
According to a recent study published in the journal JAMA Network Open, the frequency of marijuana use in the year before and during pregnancy has gone up among pregnant women in the last couple of years. The study investigated self-reported marijuana use in 276,991 pregnant women during a span of over 9 years in Northern California and it discovered that over the time period, marijuana use increased substantially among this group of the population.
Significant increase in daily use of marijuana before and during pregnancy
The adjusted prevalence of self-reported marijuana use increased from 6.8 percent to 12.5 percent in the year preceding pregnancy from 2009 to 2017, while the adjusted prevalence of self-reported marijuana use increased from 1.9 percent to 3.4 percent during pregnancy. There was a substantial increase in the yearly rates of change in self-reported daily, weekly, and monthly or lesser duration of marijuana use, however, the daily use rose significantly higher.
During the study period, the proportion of women using marijuana on an everyday basis escalated from 17 percent to 25 percent; the weekly users increased from 20 percent to 22 percent; while the proportion of women using it on a monthly or lesser basis decreased from 63 percent to 53 percent. In women who self-reported marijuana uses during pregnancy, the proportion for daily users increased from 15 percent to 21 percent and for weekly users, it increased from 25 percent to 27 percent, while it decreased from 60 percent to 52 percent for monthly users.
Clinicians need to be careful about marijuana use before and during pregnancy
According to the lead study author Kelly Young-Wolf, a research scientist at the Kaiser Permanente Division of Research, this alarmingly high use of marijuana on a daily and weekly basis before and during pregnancy should alert doctors. Young-Wolf further added that it is possible that the actual numbers could be higher than the ones that have been reported as many women would not be willing to disclose their substance use to a medical specialist. In the months following the duration when this study was carried out, it is possible that the daily and weekly prevalence of marijuana use may have increased further, since it was legalized for recreational purposes in California in 2018.
This data was collected from prenatal visits of women at Kaiser Permanente, Northern California. These visits did not reflect if the use of marijuana was continued throughout the pregnancy as these visits take place at around 8 weeks into gestation. Moreover, the investigators couldn’t analyze if the self-reported marijuana use during pregnancy took place after or before these women came to know that they were pregnant. The self-reported cannabis use in pregnant women was substantiated by a research carried out by the Kaiser Permanente in December 2017, which was published in the JAMA Research Letter. This prior research also reflected an increase in prenatal marijuana use via toxicology tests.
Women are lured into using marijuana due to false marketing practices
In a previous (2018) work published by the same author in JAMA Internal Medicine, it was stated that pregnant women struggling with nausea and vomiting were 4 times more likely to use marijuana during their first trimester. The false marijuana product marketing and online media are the strong proponents of marijuana use during pregnancy, claiming it to be safe for use during pregnancy. Many women fall prey to such false claims starting to use marijuana during pregnancy even if they had not used it previously.
However, there is enough evidence establishing that marijuana use during pregnancy is linked with low birth weight of the baby. In addition, the American College of Obstetricians and Gynecologists strongly advocates discontinuing marijuana use for women who are pregnant or planning to get pregnant as the use could lead to an exposure to the adverse effects of smoking and impaired neurodevelopment of the fetus.
Young-Wolf stated that there is a dearth of research on this topic and it is still not known what kind of marijuana products are being used by pregnant women and how the health outcomes differ based on the frequency of prenatal use and mode of administration. Extensive research is required so that clinicians can offer better and specific advice to women.
The way forward
Pregnancy is a beautiful time for any women, however for some, the enjoyment of the phase may be marred by complaints like nausea and tiredness. Nonetheless, these can be managed using alternate medicines and therapies, instead of marijuana. For instance, for morning sickness, instead of using marijuana, one can use a prescribed medicine like Diclegis, a combination of pyridoxine hydrochloride and doxylamine succinate. Other options include ondansetron (Zofran) or metoclopramide (Reglan) but these should be taken strictly under medical supervision.
For those who are not inclined towards taking medicines to curb their morning sickness natural alternatives such as ginger, ginger teas, doxylamine, and vitamin B6 can also help in subsiding nausea and morning sickness. In addition, acupuncture has also proven to be effective in treating morning sickness. Physical exercise can be used to alleviate anxiety and related symptoms.
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