Shailene Title lost 13 pounds during her third semester of pregnancy due to hyperemesis gravidarum, a form of toxemia characterized by severe nausea and vomiting that leads to dehydration and nutrient deficiencies in the body.
Her doctor told her to take Zofran three times a day, a medication that helps chemotherapy patients with similar symptoms.
Shaylene, who works as an attorney and advocates for liberalizing cannabis laws, immediately remembered that medical marijuana is used as an effective treatment for nausea in cancer patients.
But she also knew: although the use of marijuana as a prescription medication is legal in her home state of Massachussetts, using it to prevent nausea would be too risky. If traces of pot were found in the mother's or baby's blood after delivery, the baby could be taken away from her.
Her doctor told her to take Zofran three times a day, a medication that helps chemotherapy patients with similar symptoms.
Shaylene, who works as an attorney and advocates for liberalizing cannabis laws, immediately remembered that medical marijuana is used as an effective treatment for nausea in cancer patients.
But she also knew: although the use of marijuana as a prescription medication is legal in her home state of Massachussetts, using it to prevent nausea would be too risky. If traces of pot were found in the mother's or baby's blood after delivery, the baby could be taken away from her.
But Shaylene didn't want to take Zofran because she wasn't sure it was safe for pregnant women. Instead, she quit her job and spent three months bedridden, suffering from vomiting.
Now zofran manufacturer GlaxoSmithKline is a defendant in a class action lawsuit over its recommendations to use the drug during pregnancy without FDA approval. The authors of the lawsuit have provided evidence that taking the drug has led to a number of birth defects in newborns — wolf's mouth, clubfoot, saddle head and holes in the heart.
These days, the first clinical trials are underway in Colorado, where doctors are studying the effects of medical marijuana use during pregnancy.
Dr. Tori Metz, a specialist in complicated pregnancies and a faculty member at the University of Colorado School of Medicine, is conducting an in-depth study to help understand the effects prenatal marijuana use has on maternal and infant health.
Metz is interested in the link between cannabis and intrauterine developmental delays, hypertension in expectant mothers, stillbirth, premature birth and so on.
«If you analyze the scientific literature on this issue, you'll find a lot of contradictions. About half of the authors of the studies say there is a link between marijuana and disease, the other half are convinced there is not» — she states.
To increase representativeness, the experiment is being conducted on one hundred randomly selected female patients at the University of Colorado Hospital and Denver Medical Center, whom Metz will observe two days after delivery.
In order for the young mothers to respond more candidly, their answers will be recorded by computer, without face-to-face conversation. They will also be given certificates of non-disclosure of their answers. The study will use six-inch fragments of the babies' umbilical cords, which can be analyzed to detect traces of cannabis more accurately than traditional urine or fecal samples.
Marijuana use during pregnancy is not illegal in states where it is legalized, but due to the lack of scientific evidence and the resulting ignorance of fear of harming the baby, many mothers are afraid to smoke cannabis. Dr. Metz is currently the only hope women have for a clear answer as to whether or not it is safe to smoke marijuana during pregnancy.
«Marijuana is still difficult to study» — says Heather Thompson, a molecular biologist at Elephant Circle, an association that helps young parents through pregnancy and parenting. In order to study its effects, a person would have to voluntarily admit to using it to a doctor, but even then, its effects are difficult to separate from those of other drugs — alcohol, tobacco, other medications and narcotics.
Federal legislation also makes it difficult to study marijuana in controlled scientific experiments. In 1970, the United States placed cannabis on Schedule I (substances that have no medicinal properties), which not only banned its use as a medicine, but also closed the door to federal funding for related research.
By comparison, cocaine is in Schedule II, and government institutions can easily allocate money to research its effects.
It wasn't until 2015 that the Obama administration removed much of the legislative hurdles that faced those who wanted to study the effects of marijuana. In Colorado and California, cannabis research can now be funded at the state level.
Previous scientific publications emphasize the possible minor deleterious effects of pot, but they seem inconclusive.
In three major multi-year studies, conducted in Ottawa, Rotterdam and Pittsburgh, respectively, from 1978 to 2001, doctors monitored the families of only those mothers who had used illicit substances for 20 or more years. It is important to note that none of these studies sought to examine the effects of marijuana alone. Subjects included the effects of marijuana and tobacco smoking, marijuana and alcohol use (and a long list of other substances).
By comparison, cocaine is in Schedule II, and government institutions can easily allocate money to research its effects.
It wasn't until 2015 that the Obama administration removed much of the legislative hurdles that faced those who wanted to study the effects of marijuana. In Colorado and California, cannabis research can now be funded at the state level.
Previous scientific publications emphasize the possible minor deleterious effects of pot, but they seem inconclusive.
In three major multi-year studies, conducted in Ottawa, Rotterdam and Pittsburgh, respectively, from 1978 to 2001, doctors monitored the families of only those mothers who had used illicit substances for 20 or more years. It is important to note that none of these studies sought to examine the effects of marijuana alone. Subjects included the effects of marijuana and tobacco smoking, marijuana and alcohol use (and a long list of other substances).
In the short term, the only effects found affecting neurobehavior were tremor and increased anxiety — the same symptoms that nicotine use leads to.
Long-term findings find a possible negative effect of mother's habits on child behavior and development, but again, there is no way to test whether this is a consequence of marijuana or other factors that affect children similarly —such as parental poverty, low social status, or nicotine and alcohol use.
These unsubstantiated findings gave the impression that marijuana was harmful to newborns. It subsequently led to the prosecution of women who smoked cannabis — they were accused of child abuse.
Even in states where marijuana use has been legalized, its use by pregnant women has been equated with drinking and smoking tobacco, and is similarly discouraged by doctors.
Manipulating the results of research on prenatal substance use is not a new trend. In the late '80s, the press whipped up hysteria about «crack babies», taking data from an incompetently staged experiment and turning it into a racist and class war against women.
In 2011, an Alabama resident was arrested for «endangering the life of a child by poisoning» after testing revealed the presence of tetrahydrocannabinol, the main psychoactive compound found in cannabis, in her system. She denied using marijuana during her pregnancy. Another mother in Ohio lost her baby because she drank hemp tea instead of prescription painkillers to relieve postpartum pain.
«We don't care at all about the fact that many children are living below the poverty line, but when you talk about their mothers' marijuana use, society goes ballistic» — Thompson said.
Prohibitionist policies against marijuana use during pregnancy have no scientific basis. «Claims as if a child born to a woman who smoked cannabis during pregnancy was 'physically abused' or 'neglected' are contrary to scientific facts» — says Dr. Peter Fried, a critic of the Ottawa study.
Moreover, a 1994 study that Dr. Melanie Dreher conducted in Jamaica, where «ganja» is traditionally widely used, found only a slight difference between normal toddlers and children exposed to marijuana — a difference that spoke in favor of the latter. They were less anxious, more emotionally stable, showed greater self-control and were more affectionate towards their parents.
Mile Backes, author of «A Practical Guide to Medical Marijuana», argues that marijuana's effects on the body are so complex and comprehensive that scientists may be depriving pregnant women of an effective treatment for toxicity solely because they can't figure out how pot works.
Moreover, a 1994 study that Dr. Melanie Dreher conducted in Jamaica, where «ganja» is traditionally widely used, found only a slight difference between normal toddlers and children exposed to marijuana — a difference that spoke in favor of the latter. They were less anxious, more emotionally stable, showed greater self-control and were more affectionate towards their parents.
Mile Backes, author of «A Practical Guide to Medical Marijuana», argues that marijuana's effects on the body are so complex and comprehensive that scientists may be depriving pregnant women of an effective treatment for toxicity solely because they can't figure out how pot works.
With more and more countries legalizing marijuana, we are now at the beginning of a long public debate on a crucial issue that affects the rights of mothers.
Recently, the New York City administration ruled that bars and restaurants may not refuse to sell alcohol to pregnant women (despite the fact that the devastating effects of alcohol on the fetus are a proven fact). The authorities explained the decision by saying that «it is illegal to use safety as a pretext for discrimination». Perhaps in the future such a policy will also apply to the use of cannabis during pregnancy, whether prescribed by a doctor or not.
Recently, the New York City administration ruled that bars and restaurants may not refuse to sell alcohol to pregnant women (despite the fact that the devastating effects of alcohol on the fetus are a proven fact). The authorities explained the decision by saying that «it is illegal to use safety as a pretext for discrimination». Perhaps in the future such a policy will also apply to the use of cannabis during pregnancy, whether prescribed by a doctor or not.