Better education can foster safe use of marijuana during pregnancy
“The science is there.
This isn’t anecdotal.” - Dr. Sanjay Gupta
The political and social landscape of medical cannabis has changed and continues to evolve in the United States. Although cannabis is still classified as a schedule 1 controlled substance, there has been a marked increase in the number of women who report using marijuana during their pregnancy. In an effort to create robust communication design targeted at women for the benefit of their own education and empowerment, I’ve developed a series of questions in the following categories that seek to unearth insights.
C
Questions for clarification
A
Questions that probe assumption
RE
Questions that probe reason and evidence
VP
Questions which challenge viewpoints and perspectives
IC
Questions that look at implications and consequence
Q
Questions about the questions
Pregnancy + Marijuana • 1
C
RE
_Why is marijuana the #1 illicit drug used by pregnant women in the U.S.? _What constitutes a medium to high quality medical marijuana study?
A
_What resources do women have now to guide them when deciding to use marijuana during pregnancy? _Why are so few studies on this matter? _What physical conditions do pregnant women face which can be helped by the moderate use marijuana? _What is hyperemesis Gravidirum? How many pregnant women suffer from this condition? _What shouldn’t be mixed with marijuana use during pregnancy? Why? How do we know? _How do we make medical marijuana safe? Accessible? _What are the barriers to entry for a woman considering marijuana during her pregnancy? _What is the risk of addiction? What is addictive behavior? _What does it mean to use marijuana with intention? _How can a pregnant woman establish a safe level of marijuana consumption for themselves?
2 • Pregnancy + Marijuana
any lasting impact of marijuana use during pregnancy? _Despite studies that have filtered
_Why do pregnant women turn to marijuana and how many are new users?
_How can I find out whether there is
out other factors in birth defects, early _Why do we think marijuana is
development, and premature birth,
dangerous for a mother to use
and have shown no negative impact
during pregnancy?
in directly caused by marijuana, why do
_Why do some experts and women believe in the efficacy of marijuana used during pregnancy? _How do we know if marijuana messes with brain development in a fetus? _Is it always true that marijuana can cause developmental problems? Does this hold true when you eliminate
some experts still say it’s unsafe or unknown? _How do we know marijuana use during pregnancy is safe or dangerous? Why are those opinions valid? Why are they invalid? _What has led us to believe that marijuana is dangerous?
tobacco, alcohol, and other socioeco-
_Why do we believe that marijuana leads
nomic factors?
to lower birth weight? Mental problems?
_Why would someone assume anyone
_Does measuring SGB-10 levels in a
who uses marijuana during pregnancy
fetuses brain halfway through the
or beyond is a bad parent?
pregnancy accurately capture a nega-
_Why do we assume of all the things women could use during pregnancy, that marijuana is the most dangerous? _What factors reinforce the assumption that marijuana is dangerous? Safe?
tive correlation between marijuana use during pregnancy & poor neurological development? _How can studies like the Hyatt Bocksher study, which relied heavily on information volunteered by mothers at a
_Do mom’s who use marijuana
free clinic with no drug testing to verify,
understand the quality and potency
be accurate or reliable?
of what they are consuming or intend to consume?
_If prenatal consumption of marijuana has the potential to mess with neoplasticity of a fetus, when is it most ideal to consume marijuana?
IC _What are scientists and experts implying when they say that women should not or can use marijuana during a pregnancy?
Q
_What impact would clearly presenting research and opinions have on women
VP
who are suffering negative symptoms
_Could fresh research, taking into
of pregnancy?
account the ambiguity, of previous
_What are the societal implications people fear? Hope for? _What are the consequence of
_How would a mother who has never used marijuana feel about marijuana use during pregnancy? _How safe is cannabis for consumption by pregnant women? _When you say western medicine is safe for pregnant women, are you implying that it’s safer than marijuana for the same condition? _Dr. Stacey Kerr believes, based on experience and research, that marijuana
using medical marijuana in a home with young children? _What are the long term implications
_At what point did people trust marijuana as a therapeutic aide?
advocates been influenced by
_What are the implications of using
special interest?
cannabis which contains pesticides or
_Does the question of pregnancy and
fungus while pregnant?
marijuana overlap with or relate to
_What are the legalities of mixing
recreational use?
marijuana & parenthood? How does one
_To understand the legal challenges
protect themselves?
around marijuana & parenthood, we
faces discussing or not discussing her
ranter than the opposite?
marijuana use with her doctor?
marijuana relationally, feel about
ask if marijuana is safe?
_How have pro or con marijuana
Why has she chosen this perspective
_How would a mother, who once used
_What do people assume when they
marijuana in utero?
_What are the consequences a mother
addiction feel about this topic?
marijuana use during pregnancy?
for a child that was exposed to medical
used with intention is safe and helpful.
_How would a person who has seen
studies confirm positive results of
have to ask what the restrictions are in each state? _What causes a mother to choose or not choose marijuana? _Is there harm in not recognizing external factors which skew the results of studies?
this topic? _What would a doctor who delivers babies in a medically legal state say? _What are the most common negative and positive perspectives on marijuana and pregnancy?
Pregnancy + Marijuana • 3
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What resources do women have now to guide them when deciding to use marijuana during pregnancy? This question brought up even more questions which I felt should be asked to properly vet information that will shape my design solution. I realized this is something that mothers, who might be considering marijuana use during their pregnancy, will face. It will be crucial to properly cite information for the benefit of my audience and their continued education on this topic. I developed a series of questions to ask as I gather resources for my project.
_Who published these resources?
_How reliable is the information?
_Is the information anecdotal or scientific?
_What is their motivation to bring this information to the public?
_Is this information universal, repeatable, or is it an isolated source?
4 • Pregnancy + Marijuana
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What medical issues do pregnant women face which can be helped by marijuana? One major insight I found while researching the answer to this question was Hyperemesis Gravidirum. HG is a severe form of morning sickness that effects roughly 2% of all pregnancies in the U.S. HG is the #2 reason women are hospitalized during their pregnancies. Treating cases is estimated to cost $200 million annually in the U.S. alone. Treatment can be as mild as a dose of antacids or as serious as hospitalization and drugs which have major risk factors associated with their use. Of all the potential uses during pregnancy, HG was the most compelling due to the severe nature of the symptoms, treatment, and occasional loss of life. Further investigation into how pregnant women utilize cannabis will be essential to my project goals.
50-90% of women experience morning sickness in their pregnancies
_Dizziness _Insomnia _Appetite _Anxiety _Cramps _Hyperemesis Gravidirum _Normal morning sickness
Pregnancy + Marijuana • 5
C
What are the barriers to entry for a woman considering marijuana during her pregnancy? Research for this question revealed many layers of complexity that one must navigate when considering marijuana use. I found that the concerns of women who are open to discussing this issue vary depending on their personal situation, local laws, and support systems. One particular insight I found interesting was the stigma around marijuana. It’s not just what society feels but also what the individual feels about using and how they perceive themselves. Another insight was related to child welfare laws and the risks associated with marijuana use as a mother. It depends greatly on the legal status of marijuana in the state, but even in a legal state there remains a risk which must be respected. Understanding my audiences challenges could shed greater insight for my project.
Do I tell my children?
Social stigma
Personal stigmas
I might need cannabis
Is it safe?
How much? Legal risk
Information
Should I talk with my doctor?
6 • Pregnancy + Marijuana
What to use? How to use?
A
Do mothers who use marijuana understand the quality and potency of what they are consuming or intend to consume? During my research I discovered that the marijuana market is becoming as fragmented as wine in that there are a variety of strains each with it’s own unique profile for head and body impact. This can be overwhelming for a someone just starting to use cannabis. I did find several testimonials which describe how those mothers approached dosing. It covered a large range from using a vaporizer to smoking and even eating. One key insight I found is that it varied greatly depending on how severe the symptoms were and if they could ingest food as well as the mother’s personal views, whether or not they believed in smoking the traditional way. Dr. Stacey Kerr recommends to her patients that they start slow and give themselves time to see how it will impact them before re-dosing, and to always get their cannabis tested before consumption to verify it’s purity. Further investigation in dosing and strains could greatly benefit my topic.
_What kind of weed should a pregnant woman look for?
_What is the safest form of consumption?
_What is the most discreet method of dosing?
_Do growers use pesticides to grow cannabis? Are there organic strains? _What kind of risks does cannabis tainted with mold or parasites pose to mother and child? _How frequently should I dose? Will I still be able to go on with my day? _What’s the risk of addiction? Pregnancy + Marijuana • 7
RE
How do we know marijuana use during pregnancy is safe or dangerous? Why are those opinions valid? Why are they invalid? _Which studies exclude alcohol and tobacco? _Is there a lower risk of negative birth outcomes in a mother of higher socioeconomic status? Why is that? _What other factors outside combined with marijuana use increase risk for mothers? _What is the best way to outline these risks and disseminate the information for the benefit of mothers everywhere? _Are women who are considered high risk/ at a lower socioeconomic status at a disadvantage when it comes to accessing information which could benefit them during their pregnancies?
8 • Pregnancy + Marijuana
The answer to this question depends on what study you read and how deeply you read into them. This is a problem for mothers who are trying to understand how safe or how risky the choice to use cannabis is. Many longitudinal studies which look at pregnancy and cannabis use find negative impacts to the child but they can not say definitively if it’s because of marijuana or other factors related to the low-socioeconomic status of the subjects and other factors like In a review and summary alcohol and tobacco use. Some of two studies, Maternal studies conclude there is an Health Practices and Child increased risk of negative birth Development Study and the outcomes. Further research and Ottawa Prenatal Prospective investigation on the most valid Study the Journal Neuroscience studies on this topic and speand Behavioral concluded, “that cifically what makes them valid if an association between prewould benefit my project and natal cannabis exposure and my audience. certain neuro-behavioral and cognitive deficits exists, it is a “subtle” one and appears to be primarily associated with children exposed to heavy amounts of cannabis as well as alcohol and/or tobacco.”
VP
What are the most common negative/positive perspectives on marijuana & pregnancy?
Therapeutic herb
Harmless in moderation
Positive
Improves ability to parent
More effective than pharmaceuticals
Great for nausea
In my research I looked at open discussions on the topic of cannabis use during pregnancy to get a feel for the positive and negative perspectives. Both sides were concerned with the welfare of the unborn child. I did notice that the mothers who experienced the more severe morning sickness were more open to trying cannabis but reluctant to try at first because of the fear of legal repercussion. I think my project would benefit from more research on the legal repercussions related to my topic and how mothers can protect themselves and their child.
Fear of talking to doctor
Developmental problems
Improves quality of life
Neurological damage
Behavioral issues
Parent pot head
Judgement Legal risk
Negative
Pregnancy + Marijuana • 9
monica arellano mctarellano@gmail.com