Cannabis and Pregnancy: Everything You Need to Know
Understanding the impact of cannabis on pregnancy, including safety and potential risks.
Short answer
Cannabis use during pregnancy can affect fetal development. Delta-9 THC crosses the placenta and reaches fetal tissue, and cohort studies link prenatal use to lower birth weight, preterm birth, and longer newborn intensive care stays. The CDC, ACOG, and the FDA all advise against cannabis in any form during pregnancy. No safe amount, safe product type, or safe trimester has been established.
How THC reaches the fetus
THC is fat soluble, so it passes the placental barrier and enters fetal circulation. The fetal liver clears THC slowly, which means the compound and its metabolites can stay in fetal tissue longer than in the mother. THC binds to CB1 receptors in the developing brain. Those receptors help direct neuron migration and synapse formation during the second and third trimesters. Interfering with that signaling is the leading explanation for the attention and behavior differences seen in some children exposed before birth.
Marijuana vs CBD in Pregnancy: What's Safer?
Outcomes tied to prenatal cannabis
- Lower birth weight, with reductions reported in the tens to low hundreds of grams across cohorts
- Higher rates of preterm birth before 37 weeks
- More NICU admissions and longer newborn hospital stays
- Modest increase in stillbirth risk in some large population studies
- Childhood differences in attention, impulse control, and problem solving in several long-term cohorts
Study results vary because self-reported use, potency, and concurrent tobacco or alcohol use all differ between groups. The direction of the findings is consistent even when effect sizes are not.
Cannabis Use During the Third Trimester of Pregnancy
What the major health bodies say
ACOG recommends that people who are pregnant or planning pregnancy stop using cannabis and be screened for use at the first prenatal visit. The CDC states that cannabis use during pregnancy is linked to low birth weight and preterm birth and advises against it. The FDA warns against CBD products during pregnancy and breastfeeding. The American Academy of Pediatrics advises against cannabis use while breastfeeding, since THC passes into breast milk.
THC Pregnancy Statistics: What You Need to Know
Steps to lower risk
- Tell your obstetric provider about any cannabis use, including edibles, vapes, tinctures, and CBD topicals.
- Stop THC use as soon as you learn you are pregnant, or before conception if you are trying.
- Do not replace cannabis with alcohol, tobacco, or unregulated herbal sedatives.
- Ask your provider about approved options for nausea, sleep, and anxiety during pregnancy.
- Request a newborn weight and feeding assessment if you used cannabis late in pregnancy.
- Ask about lactation support if you plan to breastfeed and want guidance on timing.
FAQ
Is CBD safer than THC during pregnancy?
No. CBD crosses the placenta as well, and product labels often misstate THC content. The FDA does not consider CBD safe during pregnancy.
Does secondhand cannabis smoke matter?
Yes. Secondhand smoke carries carbon monoxide and particulate matter that reduce oxygen delivery to the fetus, the same way tobacco smoke does.
Can cannabis treat morning sickness?
There is no clinical evidence supporting cannabis for nausea in pregnancy, and some research links heavy use to severe vomiting in pregnancy. Ask your provider for an approved antiemetic instead.