In recent years, marijuana (also known as cannabis) has become increasingly mainstream. Many states have legalized it for recreational or medical purposes, and products are widely available in dispensaries and, in some places, even delivered to your door. With this shift, more women of reproductive age are using cannabis, including during pregnancy.
At the same time, healthcare providers and researchers are trying to catch up with the science, looking closely at how cannabis affects pregnant women and their babies. Two recent reports shed light on this important issue:
- From the American College of Obstetricians and Gynecologists (ACOG) bulletin: More Pregnant Women Using Cannabis To Ease Symptoms.
- From the OBG Project, reviewing a study in the Annals of Internal Medicine: Are High THC Cannabis Products Associated with Worse Mental Health Outcomes?
Taken together, these articles highlight a complex picture: on one hand, more women are turning to cannabis as a natural-seeming remedy for pregnancy-related discomforts; on the other, growing evidence links certain cannabis products—especially those with high THC (the psychoactive compound in marijuana)—to negative mental health effects.
Let’s break this down.
Why Pregnant Women Are Using Cannabis
Pregnancy can be physically and emotionally challenging. Nausea, vomiting, poor sleep, stress, and anxiety are common. Traditionally, women have turned to remedies like ginger tea for nausea or relaxation techniques for anxiety. But in the modern era, many are reaching for cannabis products.
The ACOG bulletin reports that cannabis use in pregnancy has risen:
- In 2002, 3.5% of pregnant women said they used marijuana.
- By 2019, that number had increased to 5.4%.
- In a 2022 survey of over 3,500 pregnant and recently pregnant women, 17% reported cannabis use during pregnancy, with more than half saying they used it exclusively for medical reasons.
These women often cite relief from:
- Morning sickness
- Stress or anxiety
- Trouble sleeping
For many, cannabis seems like a “natural” alternative to prescription medications, some of which carry their own risks in pregnancy. Social acceptance of marijuana has also grown, making it feel like a safer choice.
What the Science Says About Cannabis and Pregnancy
While some women report benefits, medical organizations—including ACOG—generally advise against cannabis use in pregnancy. Why? Because research suggests potential risks for both mother and baby.
Possible risks to the baby:
- Growth restriction (smaller babies at birth)
- Preterm birth
- Stillbirth (though rare)
- Neurodevelopmental effects (potential impacts on learning, behavior, or attention later in childhood)
Possible risks to the mother:
- Dizziness or fainting (from lowered blood pressure)
- Impaired judgment or reaction time (raising accident risk)
- Mental health effects (see below)
It’s important to note: the science is still evolving. Many studies are limited by confounding factors—like tobacco or alcohol use—that can make it hard to isolate cannabis’s exact effects. Still, most professional bodies urge caution because the potential harms outweigh the unproven benefits.
The Rise of High-THC Products
The cannabis of today is not the cannabis of decades ago. Modern products—especially concentrated forms like vapes, dabs, and edibles—often contain very high levels of THC.
This matters because THC (tetrahydrocannabinol) is the psychoactive component that alters mood and perception. While traditional marijuana might have contained 2–5% THC, many products now boast 15–30% THC, with concentrates going even higher.
The OBG Project review of the Annals of Internal Medicine study found:
- Use of high-potency THC products is linked to worse mental health outcomes.
- These include higher risks of psychosis and schizophrenia, especially in people with a genetic or family predisposition.
- Even outside of psychosis, high-THC use may worsen anxiety, depression, and overall psychological well-being.
This research was not specific to pregnancy, but it is highly relevant because women who use cannabis during pregnancy may also be using these high-THC products.
Juxtaposing the Two Perspectives
When we look at these two articles side by side, an important tension emerges:
- From the patient’s perspective: Cannabis feels like a helpful, natural solution for tough pregnancy symptoms. Surveys confirm that many women are using it for what they believe are medical reasons.
- From the medical and research perspective: Cannabis—particularly high-THC cannabis—is associated with serious risks, including mental health complications and potential harm to babies.
This creates a situation where what feels good in the short term may carry hidden, long-term consequences.
Why Mental Health Risks Matter in Pregnancy
Pregnancy is already a time of significant emotional and psychological stress. Many women experience mood swings, anxiety, or depression during this period. If high-THC cannabis worsens mental health outcomes, the risks may be amplified in pregnancy.
For example:
- Psychosis or hallucinations during pregnancy can endanger both mother and baby.
- Severe anxiety or depression can affect bonding, prenatal care, and even outcomes after birth.
- Sleep disturbance—sometimes the very reason women turn to cannabis—can actually worsen if cannabis use leads to dependence or withdrawal symptoms.
Mental health in pregnancy doesn’t just affect the mother—it can also influence fetal development and family well-being after birth.
Questions Women Commonly Ask
1. Is cannabis safer than prescription medications for nausea or anxiety?
Not necessarily. Some prescription options have been studied more extensively in pregnancy and are considered relatively safe. Cannabis, especially high-THC products, has not been shown to be safe.
2. What about CBD (cannabidiol) products?
CBD is different from THC—it doesn’t cause a “high.” Some women believe CBD is safe, but data on pregnancy use is still limited. Some CBD products are contaminated with THC or other substances, making safety uncertain.
3. If I already used cannabis before knowing I was pregnant, should I be worried?
Many women find themselves in this situation. The best step is to stop using cannabis as soon as you know you’re pregnant and discuss it openly with your healthcare provider. One-time or early exposure does not mean your baby will definitely have problems.
4. What about after pregnancy, during breastfeeding?
THC passes into breastmilk and can be stored in a baby’s fat cells. For this reason, ACOG and the American Academy of Pediatrics advise against cannabis use while breastfeeding.
Practical Advice for Patients
If you are pregnant (or planning pregnancy), here are some practical steps:
- Talk openly with your provider. Doctors are there to support you, not judge. Honest conversations help you get the safest care.
- Seek alternatives. For nausea, options may include vitamin B6, ginger, or prescribed anti-nausea medication. For anxiety and sleep, strategies like cognitive-behavioral therapy, relaxation techniques, or safer medications may help.
- Be cautious with dispensary products. Many contain higher THC than you realize, and labeling is not always reliable.
- Think long term. What feels helpful in the moment may have hidden consequences for you and your baby.
- If you’re struggling to stop, ask for help. Addiction medicine specialists, therapists, and pregnancy support programs can make quitting easier.
The Bottom Line
Cannabis use in pregnancy is becoming more common, often for understandable reasons like nausea, stress, and sleep problems. But evidence suggests potential risks, especially with today’s high-THC products. Research links cannabis use to worse pregnancy outcomes and, in high concentrations, to mental health complications such as psychosis and schizophrenia.
If you’re pregnant and considering cannabis, the safest choice—for you and your baby—is to avoid it. Talk with your healthcare provider about your symptoms and explore safer, better-studied options.
Pregnancy is a time of many decisions, and it’s natural to seek relief from discomfort. But when it comes to cannabis, caution is the best medicine.
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