When Kayla, who lives in Asheville, North Carolina, became pregnant a few years ago, she decided to continue consuming cannabis after weighing the benefits and risks with her doctor. Not only did it relieve her anxiety and improve her ability to focus, she also found that cannabis improved her morning sickness.

Despite these benefits, Kayla, whose name we’re withholding to protect her privacy, says she recalls several instances of having to deal with stigma. In North Carolina, both medical and recreational cannabis are illegal.

The 31-year-old says that when her mother found out she smoked (she was with Kayla as she disclosed to a nurse during a hospitalization), “her shoulders dropped and disappointment filled the room.”

“She asked me if I had really been that sick the whole pregnancy,” Kayla says. “She asked if I researched and discussed this with my husband. Of course I did. I had many sleepless nights worried about my child. Who doesn’t.”

Later, after her daughter was born, Kayla says she also remembers feeling like she was being criticized for her cannabis use as she recovered from a Cesarean section. Her daughter was barely two days old.

“I remember sitting in the hospital, attempting to feed my baby when a nurse walked in [and] said, ‘Your baby is getting all the THC in your system from breastfeeding her.’ No help with the latch, tips or tricks of the trade. I cried to my husband because it hurt so bad.”

— -

In September, the American Academy of Pediatrics (AAP) published a new report in the journal Pediatrics that included the results of a new study on marijuana use during pregnancy and breastfeeding. Their message to moms and moms-to-be: Avoid it altogether.

As more states vote to legalize cannabis, the health organization noted in a statement, it’s important to understand the effects of its use among women while pregnant and breastfeeding. Currently, recreational marijuana is legal in 10 states and Washington, D.C., while medical marijuana is legal in 33 states and D.C. According to data cited in the report, 4.9 percent of pregnant women ages 15 through 44 in 2016 reported use of marijuana in the past month, compared with 11 percent of nonpregnant women in the same age group.

The study was led by researchers at the University of California, San Diego. They tested the breast milk of 50 nursing mothers between 2014 and 2017. In total, the women provided 54 samples. Lab testing found that THC, the psychoactive chemical in marijuana that makes a person feel high, was detectable in 34 of those samples up to six days after last reported use.

Citing this and other evidence, the AAP recommended “that pediatricians advise adolescents and women of childbearing age to abstain from marijuana use while pregnant or breastfeeding due to potential adverse consequences to the fetus, infant or child.”

Dr. Seth Ammerman, a report co-author and Stanford University pediatrics professor, told CBS News: “We still support women breastfeeding even if using marijuana but would encourage them to cut down and quit.”

The report’s authors also admit that, well, there actually isn’t enough scientific research to really prove that cannabis use is harmful. Or, as they put it, “the evidence for independent, adverse effects of marijuana on human neonatal outcomes and prenatal development is limited.” That’s because of federal regulations that make it difficult to study cannabis use among adults. They argue, however, that what little evidence there is does “indicate reason for concern.”

Their findings aren’t enough to sway most canna-moms though. Talia, for example, is a 23-year-old mother who lives in Maryland, where marijuana for medicinal purposes is legal. Although she is not certified under the state’s medical cannabis commission to obtain it, Talia has been using cannabis to deal with her depression and anxiety for more than two years. Her daughter, whom she’s breastfeeding, is almost one year old now.

“It helps me be a better mom,” says Talia, whose last name we’ve withheld to protect her identity. In addition to her infant, she has two stepdaughters. “I feel more relaxed, even on the days I don’t smoke it. I’m more evened out. It’s really made life a little bit better.”

Talia says she had planned to quit using cannabis after she got pregnant, but found that it helped relieve her pregnancy-related aches and pains, in addition to her morning sickness. When her daughter was born, she researched the association between breastfeeding and cannabis and decided there wasn’t enough evidence of risks to stop smoking.

What she does know, Talia says, is that her daughter is healthy and reaching all of her developmental milestones early or on time. “She’s one of the happiest babies you’ll ever meet — always full of smiles and giggles.”

—

Many women who use cannabis during their pregnancy and afterward reference a 1994 study published in Pediatrics to support their decision. It’s often referred to in online cannabist mom groups as “the Jamaican study.” That’s because researcher Melanie Dreher and her team followed 24 pregnant Jamaican women who’d been exposed to marijuana prenatally and 20 pregnant women who had not.

They assessed the development and behavior of the participants’ children within the first month of their life and found that the babies who’d been exposed to cannabis appeared to do a little better in several areas, including stability and quality of alertness, compared to babies who hadn’t been exposed.

A five-year follow-up with those children found “no significant differences in developmental testing outcomes.” When Dreher sought federal funding to continue her research and check back with the children when they turned 9 and 10, she was denied by the National Institute on Drug Abuse, she said in an interview with Counterpunch.

In the late ’90s, Dreher told Cannabis Culture’s Pete Brady that “one of my goals with this research was to get the message to physicians: so women smoke a little marijuana — big deal. Let women enjoy their pregnancies. If there’s something seriously wrong with their baby it would have occurred no matter what — marijuana or not.”

Kayla, the mom in North Carolina, says the decision to continue cannabis use during her pregnancy wasn’t one she took lightly. Regardless, she faced backlash: Kayla says a nurse told her the state’s social services division was going to open a case on her because of her history with cannabis.

“We went home and waited for weeks with bated breath for a social worker to call and schedule an appointment, or worse, show up,” she recalls. Later, her doctor told her they didn’t find anything in her baby’s cord blood drug screening worth investigating.

Kayla says she did find comfort in the few interactions she had with other moms who said they also self-medicated during their pregnancy. “I wasn’t alone,” she says. “[But] finding other moms who consume is still a problem. Even though I live in one of the most liberal cities in North Carolina, it isn’t talked about.”

This story originally published in Carolina Cannabis News, a North Carolina-based online publication that shuttered in 2019.