The American College of Obstetricians and Gynecologists (ACOG) has issued new guidance strongly advising against cannabis use during pregnancy and breastfeeding. This recommendation, released to address the rising prevalence of cannabis use among pregnant individuals in the United States, emphasizes the importance of universal screening for cannabis use before, during, and after pregnancy.
The increased social acceptance and legalization of cannabis have contributed to a significant rise in its use among pregnant women. A 2019 study by the National Institute on Drug Abuse revealed a more than doubling of cannabis use among pregnant women between 2002 and 2017. This alarming trend prompted ACOG to develop evidence-based guidelines for healthcare providers to counsel patients and implement effective strategies to reduce cannabis use during pregnancy.
While cannabis may not be associated with birth defects, the new ACOG guidelines highlight significant concerns. Research shows that cannabinoid receptors are present in the developing fetus as early as five weeks, and THC, the primary psychoactive component of cannabis, readily crosses the placenta and enters breast milk. This exposure has been linked to adverse pregnancy outcomes, including low birth weight, neonatal intensive care unit admission, and increased perinatal mortality.
Furthermore, exposure to cannabis during pregnancy poses potential neurodevelopmental risks for the child, potentially leading to attention deficit disorders, memory problems, and intellectual disabilities. The ACOG emphasizes the need for a nuanced understanding, acknowledging the difficulty in quantifying the precise relationship between cannabis use and adverse outcomes. The primary goal of these guidelines is to promote risk reduction strategies to support healthier pregnancies.
The guidelines also address the crucial issue of screening methods. The ACOG strongly discourages the use of drug tests involving hair, urine, or other biological samples due to documented bias against racial and ethnic minority groups. Instead, they advocate for universal screening through non-judgmental interviews and self-reporting, allowing for early intervention and promoting equitable healthcare practices.
The new recommendations highlight the importance of open, supportive communication between healthcare providers and patients. Many women may use cannabis to manage pregnancy-related nausea, anxiety, or stress. Providers should address underlying symptoms and explore alternative management strategies, such as dietary changes, exercise, or medication, fostering personalized patient care. The emphasis is on education and risk reduction, not punishment. The goal is to empower pregnant individuals to make informed decisions that prioritize the health of both themselves and their babies.
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Originally published at: https://edition.cnn.com/2025/09/18/health/cannabis-pregnancy-acog-recommendation
