Marijuana Use Before, During and After Pregnancy in Eight States, 2017

Among women who had recently given birth in eight U.S. states in 2017, 4.2 percent used marijuana while pregnant. The most common reasons they gave were to relieve stress or anxiety, nausea or vomiting, or pain — even though obstetricians and pediatricians advise against using it during pregnancy and breastfeeding, because the evidence on its safety is inconclusive or insufficient.

The survey

CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) surveys, by mail or phone, a sample of women drawn from birth certificates 2 to 6 months after they give birth. In 2017, eight states — Alaska, Illinois, Maine, New Mexico, New York, North Dakota, Pennsylvania and West Virginia — added questions about marijuana. Of 7,688 women, 6,236 answered them.

Marijuana use before, during and after pregnancy, eight states, 2017. Postpartum figures are not available for North Dakota. Credit: CDC, Morbidity and Mortality Weekly Report.

The figure for pregnancy is similar to a national survey's finding that 4.7 percent of pregnant women had used marijuana in the previous 30 days.

Why and how

Reasons for marijuana use during pregnancy among 413 women; more than one could be chosen. Credit: CDC, Morbidity and Mortality Weekly Report.

The most common reasons were to relieve stress or anxiety, nausea or vomiting, and pain. Written-in answers such as depression, post-traumatic stress disorder or bipolar disorder were counted as stress or anxiety, and "to be able to eat" or "to gain weight" as nausea. Smoking was the most common way of using it. In other research, women have said marijuana helped with nausea, appetite and mood, and described it as natural and safe compared with other substances, including prescribed medicines; in a national sample, about 70 percent of pregnant women saw slight or no risk in using it once or twice a week.

Who kept using it

Of the women who used marijuana before pregnancy, 41.2 percent kept using it while pregnant and 58.8 percent stopped. Taking age, race and ethnicity, marital status, education, insurance, previous births, the start of prenatal care, and cigarette and e-cigarette use into account together, the women who continued were more likely to:

Of the women who smoked cigarettes while pregnant, 73.7 percent kept using marijuana; of those who did not smoke, 27.6 percent. Other studies have found that 26 percent of women who kept using marijuana while pregnant saw it as harmful, against 75 percent of those who stopped.

What the guidance says

The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics recommend stopping marijuana during pregnancy and breastfeeding, and replacing medical marijuana with treatments that have better pregnancy-specific safety data. Marijuana is not regulated like a pharmaceutical, so even in states with comprehensive medical laws, plant-derived products may not carry accurate dose or content labels. Doctors and patients should discuss proven drug and non-drug treatments instead.

In 2017, Alaska and Maine allowed both medical and adult nonmedical use; the other six states allowed medical use (in North Dakota and West Virginia, only newly legalized that year).

Limits

The results apply only to these eight states. Use was self-reported, and may be biased by social pressure, rules on reporting substance use in pregnancy, and state law. Written-in reasons were recoded into fixed categories. Dependence was not asked about — though in a national survey, 18.1 percent of pregnant women who had used marijuana in the past year met the criteria for abuse or dependence.

Sources

Based on "Characteristics of Marijuana Use During Pregnancy — Eight States, Pregnancy Risk Assessment Monitoring System, 2017," by Jean Y. Ko and colleagues, Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention; a work of the United States government in the public domain.