Happy Mother’s Day, Women of Weed!

As embodied females, we find ourselves on a wild and never-ending journey of exciting and mystical transitions. From sweet little babies, to having our first moon, entering adulthood, and, probably the most life-altering ka-pow kind of whirlwind game-changer (but also most selfless act of all), transition into parenting!

I’ve spent the last two decades as a birth worker, doula trainer, and labor and delivery and maternal child health nurse. I’ve been able to support families with prenatal education and yoga, through labor and delivery, and watched children and parents grow into making their own families. I’ve also been hearing the same question tossed around the birthing world for years: Is cannabis use in pregnancy ok – and what about during breastfeeding?

Cannabis as medicine for females and the female reproductive tract is recorded as early as 2737 BCE, and was used for migraines, moon/menses cramps, discomforts of childbirth, and even to induce labor. From the 19th century to the early 20th century, cannabis was a common ingredient in pharmaceutical apothecary remedies specifically for women.

Today, about 9.5% of childbearing aged women report cannabis use within the last month. Cannabis use is most prevalent in women aged 18– 25 and has increased in use over the last decade. Pregnant women report decreased use in pregnancy and less cannabis use (4.5% overall) compared with non-pregnant women.

So, what do we know? Unfortunately, not as much as we would think or hope to know. The amount of information available to us in this area is limited as the result of cannabis being classified by the federal government as a Schedule I controlled substance since the 1930s. This means that cannabis has “no currently accepted medical use in treatment in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.” The Drug Enforcement Administration (DEA) regulates cannabis research, making the plant difficult to study.

The data we do have hasn’t identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those with no exposure. We do know the endocannabinoid system is present early in fetal development, and cannabinoids are able to cross the placenta. So, there are questions about exogenous maternal cannabis use during pregnancy, and whether it may interfere with fetal brain growth and neurodevelopment.

So, what do we know? Unfortunately, not as much as we would think or hope to know.

I will say I’ve seen a Vermont doctor verify a MMJ card for pregnancy weight loss due to nausea and vomiting, but this is not a common occurrence.

We know that cannabinoids, such as tetrahydrocannabinol (THC) and cannabinol (CBD), like to stick to fat, which is abundant in human milk, suggesting that those compounds can and may end up in human milk. But without the proper and possibly inadequate research,the health risks to these infants largely remain undetermined, with several old and small studies, and the most recent study by lactation expert Thomas Hale, information is limited.[1]

Also, current technologies have been unable to measure cannabinol or cannabidiol in human milk. However, researchers at the Centers for Disease Control and Prevention recently developed a promising test which appears to be 100 times better at detecting THC (and cannabidiol) in milk than previous techniques, so we are making progress.

I was at the Vermont Lactation Consultants Annual Conference in 2014 and was part of a panel on “Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding.” We were given the opportunity to complete a five-item survey, and 74 of 120 attendees completed the survey. Out of all the responses, 44% reported their recommendations around breastfeeding and marijuana use depended on multiple factors, with severity of maternal use being number one.[2]

Another 41% reported recommending continued breastfeeding with cannabis use because the benefits outweigh the harms. The remaining 15% reported recommending that a woman should stop breastfeeding if she cannot stop using marijuana. Survey participants estimated that 15% of their breastfeeding clients in the past year used cannabis. It was concluded that lactation professionals vary widely in their recommendations to breastfeeding clients who use cannabis.

Regardless of the limited evidence based research, like the majority of Vermont lactation consultants, many health care providers and birth workers still believe that the benefits of breastfeeding outweigh the possible risks of cannabinoids being present in human milk. Of course, we always recommend that one reduce cannabis use as much as possible, and always avoid any infant exposure to second and third hand smoke.

When all is said and done, no one can make the decision for you and your family but you. If you’re contemplating whether or not to use cannabis during pregnancy and breastfeeding, questions you might ask yourself include:

• Do your benefits outweigh the associated known, or hypothesized, risks?
• Do you have a care provider you can be open with and talk to about your cannabis use? Do you feel safe talking with this health care provider?
• Do you choose and use only organic and top-quality cannabis?

Ultimately, the general consensus is that there is not enough evidence based research for medical professionals to make any recommendation or informed decision other than discouraging use in pregnancy and breastfeeding.

There’s also one more consideration that families should be aware of. In some states, a positive urine drug screen in pregnancy could trigger an automatic investigation by Child Protective Services.

Fortunately, in Vermont, the law has recently shifted, and as of November 1, 2017, having a positive THC urine drug screen in pregnancy or infancy is not alone a reason to open an investigation. This is an enormous positive change to the social services and mandated reporting systems – and it went completely unannounced. Thank you Vermont for recognizing that marijuana use in pregnancy no longer automatically warrants a child protection intervention.

Working our way back around to Mother’s Day, I also want to thank my mother and great-grandmother, and all of the wonderful women of weed. A doula is defined as a woman serving a woman. So, from your cannabis doula, Happy Mother’s Day!

Please feel free to reach out to me with any questions or thoughts (or for more detailed information, links and research references). Also come see me at my HomeGrown booth at NECANN. I am happy to support you on your cultivating journey, growing children and cannabis!

Jessilyn Dolan is a RN, specializing in opioid detox and maintenance, research, program development and forensics. She has been an herbalist, massage therapist, doula trainer and yoga instructor for over 20 years. Jessilyn founded Vermont Cannabis Nurses Association and is a cannabis medication and cultivation consultant.  She co-founded H.E.M.P, Horticultural Excellence Medicinal Perfection, and HomeGrown Consulting; hemp farming and marijuana grower consultancy firms. As long time experienced and passionate cannabis growers, H.E.M.P. and HomeGrown’s medical and horticultural teams are dedicated to their craft and work with and teach others how to successfully and organically grow top shelf cannabis. Contact Jessilyn for a wellness consultation today and to start growing cannabis tomorrow!