I have to admit… the Warn Pregnant Women about Marijuana Risks bill (HB-1298) really annoys me.
Because it continues to perpetuate the stigma surrounding the use of cannabis by women, pregnant or otherwise, for no good reason.
Why is it that some people demand more from cannabis than they do from other plants, drugs, medicines or supplements? It seems that until they know everything there is to know, until all shred of doubt is eliminated, cannabis continues to be a very bad drug whose consumers deserve to be demonized and shamed at every opportunity. How else are they to convince people not to use it?
When it comes to making a fair comparison between cannabis and other substances, they just can’t seem to do it.
For whatever reason, Rep. Tate, now joined by Rep. Singer and others from the Colorado Legislature, thinks women need to be warned about all the potential dangers and risks if they consume cannabis for any reason while pregnant. They think this is such an important public safety issue that shops selling cannabis need to post warning signs. Is this reasonable?
How do the risks from cannabis compare to other substances?
Caffeine (from the American Pregnancy Association):
“Numerous studies on animals have shown that caffeine can cause birth defects, premature labor, preterm delivery, reduced fertility, and increase the risk of low-birth weight offspring and other reproductive problems. There have not been any conclusive studies done on humans though. It is still better to play it safe when it comes to inconclusive studies.”
Do you see signs warning women about caffeine on the walls of every Starbucks?
Herbal Supplements (from Beth Israel Deaconess Medical Center)
“Some herbs are definitely known to be toxic in pregnancy, such as blue cohosh and pennyroyal . Other herbs that are traditionally regarded with caution during pregnancy include catnip, feverfew, juniper, licorice, nettle, red clover, rosemary, shepherd’s purse, and yarrow, along with many others. Modern research has raised concerns about many other herbs, as well. For example, the herb chasteberry has shown a theoretical potential for inhibiting milk supply. In addition, herbs with estrogen-like properties make scientists worry about possible effects on the fetus; these include soy, red clover, flaxseed, lignans, and hops. There are also theoretical concerns that high intake of green tea could increase risk of birth defects by interfering with folate levels.”
Any signs over the supplement aisles at Whole Foods?
We’re hearing about newborns going through withdrawal due to their mother’s intake of antidepressants. They call it Adaptation Syndrome. I’ve gone through getting off of antidepressants as an adult myself and I can tell you it’s not a pleasant experience. I can only imagine the effect it would have on a newborn. These drugs directly affect brain chemistry; that’s their purpose. And we know nothing about the long term consequences of this for mother or child.
Studies are pretty clear that SSRI antidepressants increase suicidal thoughts in some people, particularly in children and young adults, enough so that the FDA put a black-box warning on these popular antidepressants. Is this the best we can do to help women deal with emotional issues before, during and after pregnancy? And yet, we trust doctors to prescribe these medications to their patients without question.
Pain-killers (from a press release from the CDC)
“Taking opioid medications early in pregnancy can cause birth defects and serious problems for the infant and the mother,” said CDC Director Tom Frieden, M.D., M.P.H. “Many women of reproductive age are taking these medicines and may not know they are pregnant and therefore may be unknowingly exposing their unborn child. That’s why it’s critical for health care professionals to take a thorough health assessment before prescribing these medicines to women of reproductive age.”
Should we mandate signs at every pharmacy while, at the same time, the FDA is considering reducing reporting requirements for direct-to-consumer advertising of pharmaceuticals?
Alcohol (from a study on alcohol during pregnancy and lactation)
“Prenatal exposure of the foetus to alcohol can lead to a broad range of anomalies, including pre- and postnatal growth retardation, preterm delivery, central or craniofacial dysmorphia, neurological and behavioural disorders and disorders of cognitive function, which can persist throughout adulthood. Even though total abstinence of alcohol for pregnant and lactating women is recommended, at least 25% of pregnant women still consumes alcohol. Health care providers have to be aware of the underreporting of alcohol use by pregnant women, especially if they drink heavily since they fear of being stigmatised.”
See any signs at liquor stores warning women about this? How about table tents at every bar and restaurant?
What about pharmaceuticals? Don’t we have a lot of data on their safety during pregnancy?
Actually, we don’t.
This from the Centers for Disease Control (CDC):
“The U.S. Food and Drug Administration (FDA) regulates medications to ensure their general safety and effectiveness for the U.S. population. Drug companies have to test all prescription medications to see if they are safe and effective before they can be made available to the public. Pregnant women usually are not included in these tests. This is because of the possible risks to the unborn baby. As a result, we have little information about the safety of most medications during pregnancy when they first become available.”
But we know what drugs cause birth defects, don’t we?
That’s another big no, according to the CDC.
“A 2011 study of medications approved by the Food and Drug Administration (FDA) from 1980 through 2010 found that 91% of the medications approved for use in adults lacked sufficient data to determine the risk of birth defects due to use of medications during pregnancy.”
We tell women to talk to their doctors when it comes to other concerns during pregnancy. And we trust that the doctor will advise them appropriately. Why is that different when it comes to cannabis? Because doctors don’t know? Then maybe more education is in order, education about the risks and benefits. Or is it because we just don’t like the idea of pregnant women smoking pot?
I hear from women on regular basis who report enormous benefit from cannabis during pregnancy. They tell me how much it helps with their nausea, pain and anxiety. Although they’ve been raised in a society that encourages us to “just take something” for relief from most any discomfort, they are reluctant to turn to pharmaceuticals for a variety of very valid reasons, with fear of negative side-effects and addiction chief among them.
Rather than pharmaceuticals, one friend used cannabis alone to help with discomfort during a natural childbirth. She’s delivered two healthy, happy children and now has a third on the way. With a distinct glow, she talks about how much she’s enjoying her pregnancy, how stress-free it has been. She’s incredibly healthy and well-adjusted, as is the rest of her family. They’re actually looking forward to the third childbirth, without fear or worry.
Is that a bad thing? Don’t most women wish for a similar experience?
What about the women who are using cannabis medicinally to control seizures, treat cancer, or help with pain? I’ve spoken with numerous folks in the medical community and they all agree that changing from one medication to another is far more dangerous to the developing fetus, not to mention the mother.
More from the CDC’s advice on medications and pregnancy:
“Some pregnant women must take medications to treat health conditions. For example, if a woman has asthma, epilepsy (seizures), high blood pressure, or depression, she might need to continue to take medication to stay healthy during pregnancy. If these conditions are not treated, a pregnant woman or her unborn baby could be harmed. It is important for a woman to discuss with her doctor which medications are needed during pregnancy. She also should talk to her doctor about which medications are likely to be the safest to take during pregnancy. It is important to balance the possible risks and benefits of any medication being considered. Suddenly stopping the use of a medication may be riskier than continuing to use the medication while under a doctor’s care.”
And what about mothers like Tenille Farr who successfully used cannabis to treat her cancer because all other treatment options would have harmed her baby?
This bill may seem trivial or inconsequential. “It’s just a sign,” they say. It’s not.
Finally, this type of warning has the potential to set a precedent, further stigmatizing women and putting them at risk of losing their children if they make the wrong choice. “We warned you. Didn’t you see the signs?”
Bills like this send a bad message. They reinforce the idea that women who choose to use cannabis during pregnancy are bad mothers who would make other (better) choices if they really cared about their children. Nothing could be further from the truth. Cannabis consuming mothers love and care about their children just as much as any mother.
Women are realizing great benefit from using cannabis while pregnant, nursing and otherwise. We may not have all the info we might like, but we don’t have that about any drug or substance.
We trust pregnant women to make decisions about other substances during pregnancy, even those we know are hazardous. We trust pregnant women and their doctors to determine the best course of treatment for their illness, condition or symptoms. Do we need to suspend that trust now simply because we’re talking about cannabis?
The decision about what to use during pregnancy should remain between the patient and her doctor. Warning signs are unnecessary, where labels will do, just like alcohol, tobacco and other substances.
It’s time to let go of the stigma. It’s a matter of choice.