Pregnant women are well advised to stay away from alcohol, hard drugs, and cigarettes. The evidence on all of these substances is clear: They do real harm to fetuses, harm that can follow a baby into childhood and beyond.

woman-smoking-marijuana-140121Smoking while pregnant can result in birth defects, low birth weight, and even fatality: Babies born to mothers who smoke are at greater risk of sudden infant death syndrome. Drinking while pregnant causes fetal alcohol syndrome. And illegal drug use can lead to miscarriage, infant addiction, and fetal death.

But what about marijuana? Is it OK to toke while pregnant, or will you do more harm than good?

Warning labels on cannabis products

As it turns out, this is a hotly debated issue right now. In November, the American Medical Association, the nation’s largest group of doctors, proposed a warning label for cannabis products: “Marijuana use during pregnancy and breastfeeding poses potential harms.”

Contrast that with one of the warnings required on every tobacco product: “Smoking by pregnant women may result in fetal injury, premature birth, and low birth weight.” Note the cigarette warning is much more specific than the proposed cannabis label.

The reason for the distinction is that we have a lot more evidence that tobacco hinders fetal development than we do that marijuana is harmful in pregnancy. The same is true of alcohol and drugs such as cocaine and heroin.

Lack of research on marijuana’s effect on pregnancy

It’s not an academic issue. In October, an Ohio couple temporarily lost custody of their newborn daughter after hospital blood tests returned a positive result for non-psychoactive metabolites of THC. The tests did not provide evidence the fetus had been exposed to THC or its psychoactive effects; in other words, it never got high.

Hollie Sanford acknowledged she used a marijuana tea to treat her morning sickness and to alleviate chronic pain caused by a pinched sciatic nerve. She said she researched the drug and determined it was much safer than prescription pain pills. Statistically speaking, she was right.

But a judge didn’t see it that way, and took the child from Hollie and her husband. The girl was returned after several days following a higher court ruling. But Hollie was forced to promise not to use cannabis, even though it’s safer than the alternatives.

Cannabis is safer than opiate alternatives

Marijuana TeaWhy the fuss if there’s no evidence cannabis harms fetuses? More than anything, it’s probably an attempt by doctors, lawmakers, and regulators to mitigate the inevitability of marijuana reform.

Legalization is coming, and many physicians are unhappy about it. They insist cannabis should be evaluated by the FDA before patients may use it – a political and practical impossibility – and often discourage patients from toking even if it helps them.

The AMA may be issuing its proposal in hopes it can at least limit the public’s exposure to marijuana. And by doing so, the nation’s doctors may end up sending patients like Holly straight into the arms of notoriously addictive opiate painkillers – and those really do hurt babies.

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