Marijuana use rising among mothers

By Marybel Gonzalez

Jamie Leon has suffered from depression for most of her life. Her condition worsened after she gave birth to her now 15-month-old son, Rain. The Greeley mother experienced severe postpartum depression and considered suicide.

Her husband suggested she try cannabis edibles to treat her depression. Since using marijuana, Leon says she is more engaged with her son.

“It gives me the energy to want to be around him,” she said while breast-feeding Rain. “For me, using cannabis is a form of self-care.”

Between 2002 and 2014, marijuana use among pregnant women in the United States increased by 62 percent, according to a study published in the December Journal of the American Medical Association. In 2014, nearly 4 percent of the pregnant mothers surveyed reported using marijuana in the past month, compared to 2.4 percent in 2002.

Dr. Erica Wymore, neonatologist at Children’s Hospital Colorado, is researching how long marijuana’s main psychoactive ingredient – tetrahydrocannabinol, or THC – stays in breast milk.

The study is in the early stages of enrollment, but she is experiencing challenges. Participants are asked to discontinue cannabis use for six weeks. About half of them said they couldn’t stop using marijuana.

“It signals to me that we have a public health issue if women are thinking that it’s better to use marijuana, and take that risk and that gamble that it might affect their baby’s brain development and their behavior in the future,” Wymore said.

While there aren’t definitive conclusions on how marijuana use during pregnancy affects babies, some studies point to cognitive and behavioral problems that can develop later in childhood and adolescence.

“We know that marijuana is a fat-loving substance, and so when it is consumed into your body, it stores in your fat stores, and our brain and our nervous system has a lot of fat content, as well as breast milk has high fat content,” Wymore said. “THC marijuana in general is a compound that has a lot of different effects on the body and we know a lot about it, but there’s a lot that we don’t know in regards to how it affects the (baby’s) developing brain.”

In the first statewide survey of its kind, the Pregnancy Risk Assessment Monitoring System, published by the Colorado Department of Public Health and Environment in 2016, assessed maternal use of marijuana in Colorado. Out of the 2,000 mothers surveyed, on average, 5 percent reported using marijuana during the first three months of pregnancy and 2 percent reported using during the last three months of pregnancy. The women in this group tended to be younger mothers, ages 15 to 24, white and living 250 percent below the federal poverty level.

Tri-County Health Department, which serves Adams, Arapahoe and Douglas counties, quantified the number of women in the Women, Infants and Children program who self-reported using marijuana before, during and after pregnancy.

“After legalization of marijuana we realized that there was quite a large data gap in really understanding the prevalence of use of marijuana by pregnant, breast-feeding and postpartum women,” said Jill Bonczynski, director of Nutrition Services at Tri-County Health who oversaw the WIC Client Survey. “Anecdotally, staff were telling us that women were being more forthcoming with their use of marijuana. So we really wanted to understand what was happening and what are the educational needs of this vulnerable population.”

The anonymous in-person survey found that of the 1,749 participants, 95 of them reported using marijuana within the previous 30 days. Of those, almost 36 percent reported regularly consuming cannabis while pregnant. More than 41 percent reported using marijuana after pregnancy and nearly 14 percent while breast-feeding.

Like Leon, many women who responded to the survey reported using marijuana to alleviate medical symptoms or conditions, including depression, pain and nausea.

Numbers in the surveys may not fully reflect the number of mothers using marijuana. Bonczynski says stigma and fear of legal repercussions may play a part in underreporting.

“The mothers that we’ve interviewed have said that they’re a little hesitant to come forward with their doctor or nurse just because they’re scared that their child could be taken away from them,” she said.

Not all babies who test positive for exposure to THC are removed from the custody of the parent. But under the Colorado’s Children’s Code, a mother can be cited for abuse and neglect when, “a child tests positive at birth for ... a schedule I controlled substance,” which cannabis is classified as under federal law.

Public health officials warn mothers to abstain from marijuana while pregnant or breast-feeding to minimize risks to their babies. Colorado Department of Public Health and Environment guidelines urge medical health providers to discuss marijuana use with their patients who could become pregnant. It also has created fact sheets aimed at debunking popular myths surrounding prenatal marijuana. The overarching message: Legal does not mean safe.

Dr. Erica Wymore, a pediatric-neonatology specialist at Children’s Hospital Colorado, echoes that mantra.

“In the 1950s and ‘60s, we all thought alcohol and tobacco were fine,” she said. “It took us several decades to find out that those things were really, really harmful to babies.

“I just hope that people would have more caution. Let us try to find more research or provide more evidence to support what the exact effects are and be a little bit more patient before using something that could harm your child,” she added.