Cannabis risk during pregnancy: American College of Obstetricians and Gynecologists’ updat

September 20, 2025

Cannabis risk during pregnancy: American College of Obstetricians and Gynecologists' updated guidelines every mom should know

Cannabis use among pregnant women in the US has been climbing steadily in recent years, driven by changing social attitudes and widespread legalization. Many women view it as a “natural” remedy for pregnancy symptoms like nausea, anxiety, and insomnia.However, new research and leading medical organizations are sending a clear warning: using cannabis during pregnancy can put both mothers and babies at serious risk.

The latest guidance on cannabis and pregnancy

On September 19, the American College of Obstetricians and Gynecologists (ACOG) issued updated recommendations urging women to avoid cannabis before, during, and after pregnancy. The guidance emphasizes universal screening for marijuana use among women planning to conceive, currently pregnant, or breastfeeding.Despite the growing popularity of cannabis, medical experts stress that it is not considered safe for expecting mothers.

Why some pregnant women use cannabis

Many pregnant women turn to cannabis for relief from common pregnancy issues:Some see marijuana as a “cleaner” alternative to prescription medications or alcohol. However, research on the safety and effectiveness of cannabis during pregnancy is limited, and what evidence exists points to potential harm for both mother and child.

The risks of cannabis use during pregnancy

Recent studies, including large-scale analyses from Kaiser Permanente and publications inJAMA Pediatrics, have identified several pregnancy complications linked to prenatal cannabis use:Premature birth & low birth weight – Babies exposed to marijuana in utero are more likely to be born early or underweight.NICU admissions – These infants often need intensive care due to poor adaptation or developmental delays.Behavioral and cognitive issues – Prenatal cannabis exposure has been linked to increased risk of developmental delays and behavioral problems in children.Maternal health risks – Cannabis use can raise the likelihood of gestational hypertension, preeclampsia, and abnormal weight gain during pregnancy.A meta-analysis led by Dr. Jamie Lo at Oregon Health & Science University, reviewing over 21 million pregnancies, found moderate evidence that marijuana use increases risks of preterm birth, low birth weight, and small-for-gestational-age infants. Another Kaiser Permanente study of over 316,000 pregnancies confirmed higher rates of gestational hypertension and preeclampsia among cannabis users, with risks rising alongside usage.

How cannabis affects the baby and placenta

THC and other cannabinoids cross the placenta easily, where they can disrupt normal fetal development. Research indicates that marijuana may:Animal studies have shown that THC exposure can stunt fetal growth and interfere with placental blood vessel development. Human research echoes these findings, showing narrowed placental vessels and mitochondrial damage, both of which can negatively affect a baby’s health.

Debunking common myths

One persistent myth is that because cannabis is “natural,” it must be safe. Medical experts strongly disagree, emphasizing that natural does not equal harmless—especially for developing fetuses.ACOG and other organizations now recommend that doctors discuss cannabis openly with all patients, not just those who self-report usage.

What about CBD products?

Some pregnant women consider CBD as a non-psychoactive alternative. Experts caution that all cannabis-derived products should be avoided during pregnancy, as research on CBD safety for expecting mothers is extremely limited.

Safer alternatives for pregnancy symptoms

Expecting mothers struggling with nausea, anxiety, or sleep issues are encouraged to talk to their healthcare provider about proven, safer alternatives. Options include:Using cannabis during pregnancy carries significant risks for both mother and baby. From preterm birth and low birth weight to behavioral and developmental issues, the research is clear. With guidance from ACOG and other medical authorities, the safest approach is to avoid cannabis and all derivatives before conception, during pregnancy, and while breastfeeding.If you’re expecting and experiencing discomfort, it’s worth exploring safe, doctor-approved alternatives. Your baby’s health—and your own—are too important to gamble with cannabis.

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