Why some mothers keep using cannabis during pregnancy and breastfeeding
About 5 to 15 per cent of pregnant women in Canada are using cannabis, say obstetricians
After living with chronic pain since adolescence, being diagnosed with Crohn's disease in her 20s and undergoing two bowel surgeries by her early 30s — which removed more than 100 centimetres of her small intestine — a Montreal-area woman finally got a prescription for medical cannabis.
But it was her rheumatologist who suggested it — to cope with her rheumatoid arthritis pain.
Amidst all these health challenges, the last thing she and her husband expected was a pregnancy.
The thought of using cannabis while pregnant was a big adjustment, said "Kate" — whose real name CBC agreed to withhold because she works with children and fears losing her job.
"I was very concerned that, even though I was being careful…perhaps I wasn't providing my child with the best start to life," she said.
Kate knows the risks as outlined by the medical community.
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Health Canada warns that substances in cannabis pass from the mother's blood to her fetus and pass into breast milk, and that can lead to low birth weight and longer term development effects.
"There is sufficient good evidence that the component THC within cannabis interferes with development of the fetal or newborn brain and, as such, may cause behavioural and learning disabilities in the child," said Dr. George Carson, former president of the Society of Obstetricians and Gynaecologists of Canada.
When it comes to using cannabis during pregnancy or breastfeeding, his advice to women is "don't do it," said Dr. Carson, adding that five to 15 per cent of pregnant women are using it.
Even though I'd been followed by all my physicians, still there was that judgment.- 'Kate', mother living with chronic pain
CBC contacted two of Kate's health care providers who confirmed Kate has made a considerable effort to educate herself about potential risks.
Before taking medical cannabis, Kate was prescribed opioids — Oxycontin and Dilaudid — and did not want to take those medications while pregnant.
In some cases of pregnant women living with chronic pain, using cannabis "does seem to be sometimes the least evil of the possible alternatives," said "Julie," a Montreal area obstetrician whose real name CBC agreed to withhold because she fears professional repercussions.
It's difficult to advise patients about cannabis use during pregnancy because the research on its long-term effects is limited, based on small sample sizes and often focused on recreational use involving smoking, Julie said.
In newborns whose mothers used cannabis during pregnancy, "as far as we know, there are not any withdrawal symptoms and we have no idea what the long-term effects are," she said.
Doctors supported cannabis use
Kate says her doctors supported her decision to use cannabis throughout her pregnancy.
She did not smoke it — she used a vaporizer and reduced her weekly dosage.
They also recommended she stop using consumables, such as oils, because they remain in the system longer, Kate said.
"They told me to diminish the amount of THC to lowest possible and to keep a higher CBD [the component that does not produce a high]," she said.
Still, her concerns about potential risks to her child led to her experiencing anxiety.
She consulted a psychologist, who recommended no cannabis use and suggested Ativan for anxiety plus a narcotic for pain, Kate said.
Kate's obstetrician disagreed, arguing cannabis was the safer option, Kate said.
A team of physicians was involved in her case and a team of pediatricians assessed her baby at birth, finding no sign of any problem, Kate said.
Kate's breastfeeding now and still using cannabis, at a lower dosage than prior to her pregnancy.
Her baby, a few months old, is followed by a pediatrician, who says there are no signs of THC consumption, Kate said.
Kate is relieved but says she has felt the stigma from health professionals not familiar with her case.
"Even though I'd been followed by all my physicians, still there was that judgment," she said.
Jordana Zabitsky is on a mission to stamp out judgment against mothers who use cannabis.
She used cannabis to cope with anxiety and pain during pregnancy, despite criticism from some friends and family members.
"I advocated for myself to my doctors, to my [obstetrician,] to everybody" she said.
Zabitsky says during her first pregnancy she developed symphysis pubis, a condition that left her on bedrest from 18 weeks until the baby's birth.
She says cannabis helped cope with the pain, but she limited her use because she says there was a lack of information about possible effects.
"I didn't know if I was harming my children but … I had to feel better because I was in a very bad depression," Zabitsky said.
After her son's birth she co-founded Mothers Mary, a Facebook group for mothers who use or support the use of cannabis.
Zabitsky says it's a community free of judgment, that has boosted her mental health.
She now has a prescription for medical cannabis, which she says has reduced her use of antidepressants.
She also has a second child and is no longer worried about her children's development.
"My kids hit every milestone, my kids flourish," she said.
Many mothers who use cannabis are far less outspoken than Zabitsky.
Nemerice Sangowicz was nervous to be interviewed, fearing other parents' reactions.
"That was my biggest worry — that parents wouldn't let their kids play with my kids," she said.
Sangowicz says she uses cannabis recreationally and to treat various health conditions: arthritis, a digestive disorder, anxiety and depression.
While pregnant and breastfeeding, she cut down but continued using cannabis and says her children, now 3, 5, and 6 years old, show no signs of negative effects.
"They are very bright … and that shows in their reports cards," she said.
Meanwhile, Kate is still second-guessing herself.
"I'm a good mother, I take good care of my child but still there's this sense I've done something wrong," she said.
She hopes legalization will bring change, as more parents open up about their use.
"Hopefully we'll have more research to be able to give mothers real information," Kate said.