SAN DIEGO COUNTY, Calif. — The American College of Obstetricians and Gynecologists (ACOG) has released new guidelines urging women to refrain from using cannabis during pregnancy and breastfeeding. 

The guidance, according to the recently released review, comes as cannabis use among pregnant and lactating women has increased nationwide. The increase is driven by legalization, availability, and the views that cannabis is a safe, natural alternative to prescription medication.

The College of OB/GYNs reports that using cannabis at any point in pregnancy has been linked to adverse outcomes, including preterm birth, low birth weight and possible developmental delays. 

The review found that THC—the main component in cannabis—crosses the placenta and is transferred to breast milk, raising concerns about long-term effects such as neurocognitive challenges, behavioral issues and increased risk of behavioral issues in children and adolescents.

According to the guidelines, obstetricians and health care professionals should advise their patients who are trying to become pregnant, are pregnant, or breastfeeding on the risks of marijuana use. 

“Obstetrician–gynecologists and other obstetric health care professionals should advise cessation of cannabis use during pregnancy and lactation,” reads the review. 

However, continued cannabis use is not considered a reason to discourage breastfeeding, due to the known health benefits of breast milk.

Cannabis use during pregnancy is rising, especially in the first trimester, as some expectant patients seek relief for symptoms such as nausea. Still, the OB/GYN group’s review highlights that safer non-cannabis options for symptom relief are available, and health professionals are encouraged to counsel patients about alternative treatments.

The new guidelines also address health equity concerns, noting that punitive drug testing and reporting policies disproportionately affect Black and minority birthing individuals, often with no clear benefit to newborn or parental health. The college recommends universal screening but discourages the use of biologic drug testing as an initial assessment tool.