The use of medicinal marijuana has been in the news for quite some time, but the recent onslaught of CBD (short for cannabidiol) products—backed by celebs like Mandy Moore and Olivia Wilde—has made CBD oil the remedy du jour. It’s touted as the natural treatment for an impressive list of ailments like anxiety, muscle pain and nausea—symptoms that are all too common during pregnancy. With so many forms available, you can drop some CBD oil under your tongue (or in your coffee), snack on CBD gummies, massage achy feet with a CBD cream or even unwind with CBD bath bombs. But is CBD oil safe during pregnancy? Read on to hear what experts say about CBD oil benefits and safety issues for moms-to-be.
What Is CBD?
Once cannabis leaves are dried and made into powder, a machine uses high-pressure carbon dioxide to extract the cannabis oil paste (much like peanut butter). It’s then further refined using ethanol to look like actual oil. CBD is an isolated compound that’s cousins with THC (tetrahydrocannabinol), which is famously known for its “high” effect in recreational marijuana.
Unlike THC, however, CBD is not psychoactive and doesn’t cause negative mood side-effects, slowed motor-movement or addiction, according to studies. Our body actually produces its own version of cannabidiols, called endocannabinoids, to regulate the nervous system’s response to stress, sleep, metabolism and even ward against forgetting. “THC is the primary compound that directly interacts with this system in a profound way,” says Michelle Sexton, ND, assistant adjunct professor in the department of anesthesiology at the University of California San Diego. Some believe that CBD can also impact the endocannabinoid system by sending signals to the brain to help manage inflammation and anxiety, though the evidence is inconclusive in the scientific community.
CBD Oil Uses
The medicinal use of cannabis can be traced back to more than 5,000 years ago, but public and researchers’ curiosity about CBD oil uses and benefits has been recently piqued thanks to medical marijuana’s new legal status (now in 33 states). The National Institute of Health lists almost 200 clinical trials that study CBD oil’s effect on anxiety, PTSD, epilepsy, addiction and pain.
So what are people (read: not pregnant women specifically) using CBD for these days? “CBD oil for anxiety” and “CBD oil for pain” are common marketing promises touted by companies selling cannabis products. While science has yet to confirm that munching on CBD gummies will keep you zen, a study in the journal Neurotherapeutics does say that oral ingestion of 300 to 600 mg of CBD is a viable treatment for anxiety disorders. This cannabis compound is considered promising therapy for regulating anxiety because CBD may inhibit brain activity in the amygdala, also known as the fear center. “When you take CBD orally, the compounds will enter the bloodstream and interact with cannabinoid receptors throughout the body,” says Jodi Chapin, RD, a member of the American Cannabis Nurses Association and director of nursing with GreenNurse Group, a non-profit that provides education on medicinal cannabis.
Alternatively, CBD oil salves vow to mitigate muscle pain. Celebrities like Jennifer Aniston and Olivia Wilde, who have been raving about CBD as an alternative to painkillers, aren’t the only ones rubbing CBD oil cream onto their bodies. Chapin has noticed that patients bring their own CBD lotions to be used in massage during labor. “I have seen doulas use CBD-infused products as they massage the woman's feet, back, abdomen and pulse points,” Chapin adds. “It assists with pain relief as well as relaxation.”
Pregnancy hormones and the fact that you now have to balance a newfound baby bump can certainly wreak havoc on your muscles, joints and ligaments. The supposed benefit of applying CBD on top of your skin, instead of ingesting it, is that the compound shouldn’t end up in your bloodstream. “In theory, targeting a specific area with a topical would be a positive thing for a pregnant woman, as there shouldn’t be systematic distribution of CBD through your nervous system,” says Cinnamon Bidwell, PhD, an assistant research professor at the University of Colorado Boulder who studies the effects of abused drugs on psychological and physical health.
Still, that doesn’t mean slathering a CBD cream on your swollen footsies will actually have true anti-inflammatory benefits. “There have been no human trials yet to measure the effects on topical administration,” Sexton says. “There’s some evidence that CBD may be a therapy for psoriasis, atopic dermatitis and wound healing. I would say the science is still definitely ‘out’ on topical use, particularly for pain.”
Animal studies have also shown that CBD may suppress queasiness and vomiting, making CBD oil for nausea a beacon of hope for anyone suffering from morning sickness. Then again, something that works on a mouse might not keep you from running to the bathroom every time you smell bacon.
Can You Safely Use CBD While Pregnant?
It’s a straightforward question with a not-so-straightforward answer. There’s no conclusive evidence that shows taking CBD during pregnancy is (or isn’t) safe. Many experts say it’s best to err on the side of caution and skip CBD while pregnant until scientists better understand how it affects your body and growing baby.
It’s understandable that moms-to-be would perk up at the mention of a remedy to ease anxiety. There’s plenty about pregnancy that can be stressful, and ignoring symptoms of anxiety or depression puts you and baby at risk. To some, the appeal of CBD as opposed to synthetic medication (think: antidepressants) is that CBD oil comes from a plant. “People have an assumption that if it’s natural then it’s safe, but that’s just not the case,” says Catherine Monk, PhD, a professor of medical psychology in the departments of obstetrics and gynecology, and psychiatry at Columbia University Irving Medical Center in New York. “We don’t have enough data to say if it’s dangerous or safe.” And while conventional medications do have potential side-effects, they’ve been studied for much longer than CBD oil side-effects, so doctors have an idea of what to expect.
Given that there are few human studies on CBD oil effects and safety—not to mention absolutely no studies on pregnant women and babies who’ve been exposed to CBD— conclusive scientific evidence that it or isn’t safe for a developing fetus doesn’t yet exist. “Just because there’s nothing negative doesn’t mean it’s positive. That’s when we get into trouble,” says Catherine Birndorf, MD, co-author of What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood and medical director and co-founder of The Motherhood Center of New York, a treatment center for pregnant women and new mothers experiencing anxiety and depression. “Alcohol is legal and it’s highly problematic and potentially lethal.”
The American College of Obstetricians and Gynecologists does not support marijuana use for medicinal and therapeutic purposes during preconception, pregnancy and lactation. The primary reason is that it’s suggested that THC (CBD’s cousin) crosses the placenta and appears in breast milk. THC may also interfere with baby’s brain development and function and could be linked to stillbirth at or beyond 20 weeks of gestation.
But CBD isn’t THC, you might say. While it’s deemed a much safer compound, with minor CBD oil side-effects like tiredness and diarrhea, its functions are still largely unknown and may even affect hormones—not something you want to mess around with right now. What’s more, CBD products aren’t FDA approved, which means you have to trust that the companies producing CBD oils, edibles and salves actually put in what they promise and avoid contaminants like THC, heavy metals and bacteria—and that can be a big leap of faith.
Before you even consider taking CBD while pregnant or using a CBD cream, talk to your doctor, just as you would with any other medication.
Keep in mind that CBD falls into the marijuana category, and while some states have legalized marijuana for medical or recreational use, the DEA still considers it a Schedule 1 drug (aka a government-controlled drug defined as having no accepted medical use and a high potential for abuse). To avoid running afoul of the law, “women need to be well educated on the state laws and policies of providers where they’re delivering,” Chapin says. “If medicinal marijuana use is against policy, it could mean a visit from Child Protective Services. The legal ramifications could hurt women and families more than the product itself.” Do your homework, even if you plan on delivering at home, because you never know if an emergency will send you to the local hospital.
As with other medicines, there could be a huge placebo effect when it comes to CBD, Monk points out. The neurobiological effect of thinking you’re feeling better can actually make you feel better. Monk suggests behavioral and cognitive therapies as the first step to dealing with anxiety and depression, particularly when pregnant. Sometimes taking a bath is all you need to calm down—even without a CBD bath bomb.
Published April 2019
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