Pregnancy Care Providers Suggest Avoiding Marijuana and Suggest Widespread Testing for It
The American College of Obstetricians and Gynecologists (ACOG) has recently released new guidance advising against the use of cannabis during pregnancy and lactation. The new guidelines are based on the assessment of all related research over the past two decades by dozens of experts involved with an ACOG committee for clinical consensus in obstetrics.
Cannabis use among pregnant people in the United States has more than doubled between 2002 and 2017, according to a 2019 analysis by the National Institute on Drug Abuse. However, many people are not aware that cannabis can affect a pregnancy. Doctors can ask permission to discuss the topic, and simply having the discussion may raise a patient's awareness and influence their behavior during pregnancy.
The goal of the new guidance is to risk-reduce pregnancy to help support a healthier version. Exposure to THC, the main psychoactive component of cannabis, is associated with risks of adverse outcomes, including low birth weight, admission to the neonatal intensive care unit, perinatal mortality, attention deficit disorders, memory challenges, and intellectual disabilities.
ACOG recommends that providers ask patients about cannabis use before, during, and after pregnancy. Better communication between patients and their providers about underlying symptoms may help curb cannabis use. The screening conversation should remain nonjudgmental and supportive, as universal screening through various interview methods or self-reporting is recommended, as it supports equitable and nondiscriminatory health practices.
The new guidance strongly discourages the use of drug tests for cannabis use. Drug tests using hair, urine, or other biological materials are strongly discouraged due to potential biases against racial and ethnic minority groups. State laws on drug testing during pregnancy and the involvement of child protection agencies are inconsistent and can lack clarity. Providers should be aware of local implications regarding drug testing during pregnancy.
It's crucial that the screening avoids the risk of punishment. Each patient is unique, and asking about other ways they've tried to manage their symptoms can reinforce a personalized approach to care. The new guidance offers providers "evidence-based guidelines for counseling, screening, and strategies to reduce cannabis use."
The search results do not contain information about the influential experts involved in developing the ACOG's new guidelines. ACOG's last opinion on the issue was in 2017. The new guidance aims to provide up-to-date and comprehensive advice on the subject.
