As an obstetrician, I occasionally cover labour and delivery shifts in small Ontario community hospitals, while in the midst of completing my training as a high-risk pregnancy sub-specialist at the University of Ottawa. Some of the nurses in these community hospitals have remarked to me that more women are presenting to the labour and delivery unit while high, whether they are using cannabis in an effort to control the nausea and vomiting of pregnancy, or for pain control during labour. Considering that women of reproductive age make up a large percentage of the nation’s population, they deserve to know the implications of cannabis use in pregnancy.
The popular news media have covered how marijuana impacts the teenage brain; concerns about addiction, mental illness and lung disease; and worries about workplace use and driving under the influence. They’ve obtained commentary from the Canadian Medical Association, Canadian Paediatric Society and Canadian Psychiatric Association. However, few comments have been obtained from the Society of Obstetricians and Gynecologists of Canada (SOGC), the nation’s experts on women’s health. Little information has been provided to the public on marijuana use in pregnancy, and the impact on the developing fetal brain.
This is concerning because 70 per cent of women incorrectly believe that there is either “no” or only “slight” risk of smoking marijuana once or twice a week during pregnancy. Considering this misperception, compounded by the facts that about half of pregnancies are unplanned and marijuana is the most commonly used recreational drug in pregnancy, the public deserves to know about how marijuana impacts this very important aspect of women’s reproductive health, in the context of legalization.
The SOGC has published a very accessible factsheet for the lay public addressing basic things people should know about cannabis use in pregnancy and breastfeeding. It notes that it is safest not to use marijuana during pregnancy because there is an increased risk of low birth weight, pre-term labour and stillbirth, and, after birth, the drug can be passed on to the baby through breastmilk.
Maternal cannabis use has also been associated with abnormal brain development in the baby, affecting memory, ability to pay attention, reasoning and problem-solving skills, as well as increased risk of substance use and mental health problems later in life. Smoking marijuana while pregnant, just like smoking cigarettes, can reduce the amount of oxygen the developing baby will receive.
Concerns about the implications of cannabis legalization on the health of women of reproductive age have been completely left out of the public conversation. The fact that most women are not informed about these significant negative effects of marijuana – effects that can last a lifetime – is significant.
With such an important policy change, there is a responsibility to also educate our nation’s citizens and dispel misconceptions. This is a significant enough public health concern.
Canadian women now have the right to use marijuana, but they also have a right to know what using it means for their own health and for their future children.
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