More California moms-to-be are using cannabis, but is it safe?

It’s been almost one year since both California and Los Angeles legalized recreational marijuana sales.

But new research shows that as California’s stance on cannabis has shifted in recent years, more women are choosing to use it while they’re pregnant or breastfeeding. Similar trends have also been reported nationally. The uptick has doctors and medical researchers worried that more babies than ever are being exposed to marijuana, despite limited research on the drug’s potentially harmful effects.

A growing trend

“There hasn’t been any evidence yet that indicates that using marijuana during pregnancy is safe,” said Kelly Young-Wolff, a clinical psychologist at Kaiser Permanente’s Division of Research in the Bay Area.

Over a seven year period ending in 2016, Young-Wolff and her team looked at data on nearly 300,000 women in California who were pregnant. They found the number of pregnant women who tested positive for cannabis nearly doubled in that time period, from 4 to 7 percent. The rate grew to about 20 percent, or one in five, among women younger than 25 years old.

In another study, Young-Wolf found that women who reported nausea or vomiting in their first trimester were four times more likely to turn to cannabis than those who didn’t report those symptoms.

All of Young-Wolff’s research was conducted before the state legalized recreational sales.

“We do know that perceived approval of marijuana is increasing, that people’s perceptions of the risks associated with marijuana is decreasing, and this is true particularly among young people,” she said.

Young-Wolff said we can’t know for sure whether even more women will choose to use pot while pregnant now that recreational sales are legal. But given how easy it is to get marijuana these days, she says doctors should do more to warn their patients of the potential risks.

This month, the American Academy of Pediatrics reported that research increasingly suggests marijuana can affect how a baby’s brain develops. Using during pregnancy has also been tied to lower birth weights, and could hinder skills that kids develop later in life, like the ability to concentrate and control their impulses.

Dr. Leena Nathan, an OBGYN with UCLA Health in suburban Westlake Village, said she’s seeing more women who say they’re using cannabis to treat their pregnancy symptoms.

“The most common reason I see that women want to use marijuana during pregnancy is for nausea or issues with appetite,” Nathan said, “especially in the first trimester.”

Nathan said patients ask her questions about the safety of edibles, CBD, lotions and all sort of other products Californians can buy now. She said current research hasn’t even taken into account the higher potency levels we’re seeing now or the different ways people can ingest cannabis. In the absence of solid data, she said she tells her patients to abstain from all of it.

“To be honest, most patients will still continue it despite me telling them that,” Nathan said. “But I think they’re so miserable they’re looking for anything that can help them feel a little better.”

Treating her symptoms

“Miserable” is how one new mom described the beginning of her pregnancy.

“I would be driving, and I would just vomit out the window when I hit a stop sign,” said says with a laugh. “Vomit out the window. Keep driving.”

This woman is 33 years old and lives in Boyle Heights. She asked us to withhold her name because there’s a stigma around this issue, and marijuana is still illegal at the federal level. She says initially, she planned to stop using cannabis when she found out she was pregnant.

“I stopped doing everything,” she said. “Everything that I was putting into my body, I was thinking about my kid.”

However, halfway into her first trimester she was throwing up as many as four times a day. She was losing weight, not sleeping and feeling stressed that she was hurting her baby.

After doing some online research, she decided there was some wiggle room in the findings.

In some studies, researchers didn’t control for mothers who were also using alcohol or smoking, or the results were based on a small group of women. This mom felt like she was on her own to figure it out, because she didn’t connect with her doctor.

“I just felt like she didn’t hear me,” she says. “Her concerns were medical. And so her mindset was what can we do to solve this medically. Whereas I am a whole person with a life, and I felt like she had blinders on.”

She said her baby, who’s now three, was born healthy, and hasn’t had any problems.

An online community

Another woman I spoke with lives in West Hollywood and is four months pregnant with her second child. She asked to only use her first initial, S, for this story.

S said she didn’t use cannabis during her first pregnancy because she lived in a state where it wasn’t legal. She also had concerns about how smoking could affect her baby.

But here in California, she said people are more open about their cannabis use, and there are a lot more options in terms of products, so she’s giving it a try.

“It’s just for medicinal purposes now,” S said, “If I have a headache, and I know when you’re pregnant you can’t take aspirin, which really sucks, I’ll reach for a CBD product. If I notice that my mood is really shifty or getting crazy and I’m super hormonal and I feel like a madwoman and not myself, I’ll maybe reach for an indica joint and smoke like half of it.”

S also runs an anonymous Instagram account where she writes about cannabis and being a mom. Her posts usually get hundreds of likes and comments. And she’s not alone: The Facebook group Stoner Moms has more than 23,000 members. A similar Instagram hashtag brings up more than 30,000 posts.

S said rather than having a conversation with their doctors, a lot of women are turning to each other for advice, both in person and on social media.

“There’s so many women who’ve sent me direct messages, and who have emailed me, and who’ve told me that, ‘I smoked weed for both my pregnancies, and my kids are fine, and they’re seven and nine now,’” S said. “And for me, it’s like why would you lie about that? Because I wouldn’t tell anyone that, especially if you’re not in a state where it’s legal.”

A safer way?

While reporting this story, I spoke with several other women who used cannabis during their pregnancies. One told me she opted to use edibles and CBD water for morning sickness because her prescription drugs only worked some of the time. Another woman said smoking helped ease her migraines. One mom said she used a vape pen and edibles during childbirth; she thought it would be better than an epidural.

If more moms-to-be are trying cannabis, researchers need to work on answering the safety question, said U.C. Irvine professor Daniele Piomelli, who also directs the school’s new Center for the Study of Cannabis.

“I think what we need to understand is if there is a level above which cannabis becomes seriously problematic,” Piomelli said, “and if there is a level before which cannabis is still not problematic.”

Piomelli also clarified that he would not recommend that women use any kind of marijuana while pregnant or breastfeeding. He says the risks are too big. But he also said researchers like him have a duty to find out if there are safer ways to do so. Those are questions he hopes to answer

“This is a harm reduction attitude that I think has really lacked in the past, because I think what has prevailed — and still I think a little bit psychologically prevails — is say no.”

Piomelli added that given the ethical limits on researching pregnant women — any definitive answers are still potentially decades away.

This story was produced as a project for the USC Annenberg Center for Health Journalism’s 2018 California Fellowship.