CBD During The Childbearing Year
CBD Oil is one of the newer purported cure-alls in the world of alternative medicine (and some pockets of allopathic medicine). Even I use it for pain and anxiety with surprising to me success.
Because the use of CBD Oil is mostly legal in the U.S., even in some places where Cannabis is not legalised or decriminalised, it has gained a lot of popularity. It has even become popular with parents looking for new ways to treat their children and with pregnant and lactating people who are looking for natural ways to manage pain and anxiety. I have been asked many times by other birthworkers and clients what my opinions are on the use of CBD Oil during pregnancy and lactation. Long and short of it is that we do not know a lot about its safety during the childbearing year.
What is CBD Oil?
Essentially it is a cannabinoid constituent that is extracted from the plant Cannabis sativa (Cannabis), from both strains of the plant, the industrial Hemp strain, which is high in Cannabidiol (CBD) and low in the psychoactive Tetrahydrocannabinol (THC) and the strain used for recreational and medicinal purposes, which is high in THC and low in CBD. The extraction process is supposed to be done in a way to produce a pure CBD oil without THC* or terpenes. People then consume the oil in a variety of delivery methods for a myriad of reasons. *There can be trace amounts of THC and there are whole plant extract versions that have THC and other constituents of the Cannabis plant; these whole plant extracts are only legal where Cannabis is legal. In theory, CBD Oil made from organic Hemp will not have any THC present.
Because Cannabis is a Schedule 1 drug, the FDA does not regulate products made from the plant. This means that unless the company CBD Oil is sourced from has a Certificate of Analysis (CoA), there is no guarantee as to what is actually in the CBD Oil a person might consume (like pesticides). It also means that there is no standardised dosage and people have to experiment to find a dosage that produces the effects they desire. This is extra concerning when a pregnant or lactating person decides to use CBD Oil.
Research on use during pregnancy
Essentially there are no studies on humans. There is self reported data from pregnant people stating that CBD Oil has helped with various discomforts of pregnancy, namely nausea or morning sickness, pain, and anxiety. While there are studies that can support the claims that CBD Oil helps with nausea, pain, and anxiety, there have been no human trials and there are no large data sets to even ponder over and the information and research concerning THC and pregnancy is a mixed bag with peer reviewed studies contradicting one another. The general feelings about its use by those who do use it is that it is not THC with the known risks of THC and its potential risks appear to be less than those of many regularly prescription medications. Romper has a fairly good read on CBD Oil usage during pregnancy.
Research on use during lactation
Again, sadly there just hasn't been enough studies to make any kind of conclusive ruling on whether or not CBD Oil used while lactating is safe for baby or if it has any significant impact on amount of milk produced. We do know from research on lactation and THC that cannabinoids like to bind with fats and there are fats in human milk. While a reliable method for measuring the amount of THC and other cannabinoids (including those naturally occurring in human milk) in milk has not been developed yet. By our current methods, the amounts of THC detected in even heavy use by lactating people has not been found to be sufficient enough to discourage parents from nursing their babies or pumping milk for them. This might bring some comfort for parents needing to address their postpartum mental health issues or other health concerns that they know CBD Oil works for or hope it will work for, but we do not yet know if CBD is concentrated and transferred to human milk the same ways as THC.
So, what do you tell your clients?
I tell my clients the same information that I have shared here. I explain how there is no substantial evidence for or against the use and there is not evidence (anecdotal or otherwise) about any possible long term effects of CBD Oil use during pregnancy and lactation. I explain that while, like any anarchist, I am a huge supporter of and believer in Cognitive Liberty and will support and respect my client's health care choices, most other birthworkers and health care providers do not support the use of any Cannabis products during pregnancy and lactation, even under the guidance of a physician or psychiatrist.
I also caution them about possible legal implications if they are using products that have or may have THC as well as CBD, because there is always the likelihood, despite it not being legal, that a non-consensual urine or blood drug screen can be performed on them and or their newborn if we are need to transport from home to hospital during labour or postpartum. Additionally, it is not uncommon for hospitals to seek out warrants for patients who refuse to be tested or to legally test newborns when their gestational parent refuses to be tested. While typically, CYF does not separate parents and children solely based on the use of Cannabis, being investigated* by CYF is highly likely and definitely NOT on my list of optimal ways to spend the early weeks of bonding with a newborn.
*It is still unknown in Pennsylvania how Medical Marijuana use during pregnancy and lactation is or will be handled by health care providers, social services, or law enforcement.
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