Does Cannabis Have A Place In The Delivery Room?

The processes of pregnancy, delivery, and post-partum recovery put women’s minds and bodies through quite an ordeal. During pregnancy, women experience an array of symptoms that can range from mild to severe and which include migraines, nausea, vomiting, sciatica, mood swings, back pain, itchiness, impaired vision, and really anything.

During delivery, mothers must bear down the pressure that is an eight-pound baby through the vaginal canal. If a vaginal delivery is not an option, women are put under the knife during a cesarean-section, a highly invasive surgical procedure during which the baby is removed from its mother through an incision made in the uterus and abdomen. Both of these methods of delivery are physically traumatic. 

Cannabis could potentially replace epiduralsImmediately after delivery, a new mother is left with the emotional odyssey of navigating parenthood.  She must figure out how to breastfeed or determine what formula is best for her infant. She must balance the intense emotions she is experiencing with the practical necessity of tending to a newborn. She may develop post-partum depression or anxiety and will have to reckon with the stigma and emotional fatigue of that burden. Even if she does not develop a childbirth-related mental disorder, she is going to experience an enormous amount of physical and emotional stress.

Managing the Symptoms of Pregnancy, Labor, and Delivery

Women are often prescribed a cocktail of drugs to mitigate the array of childbirth-related symptoms.

During pregnancy, women who experience morning sickness may be prescribed an antiemetic like ondansetron (Zofran).  Though fears that Zofran caused birth defects emerged in the past decade, a 2016 study found that they were unfounded. However, there is still a lack of consensus on the drug’s safety during pregnancy. Additionally, Zofran may interact with a host of other medications including anti-depressants and migraine medications. Regardless of its safety, the truth is that pregnant mothers need to eat to nourish their own and their babies’ bodies. If morning sickness prevents a pregnant woman from receiving the nutrition she and her baby need, it must be medicated.   

Women do not have to medicate at all during childbirth, though many do. To induce labor, women may be injected with Pitocin, synthetic oxytocin. One of the primary side effects of Pitocin is the increased intensity and frequency of contractions. Sometimes the intensity is so great, it can push the baby down quicker than the cervix effaces or dilates. When this happens, a woman may need an emergency C-section.

The pain of labor is intenseThe pain of labor is intense, and many women choose to mitigate it or numb it all together. The most common pain relief is an epidural. Epidural blocks can reduce up to 100% of the pain caused by labor. Epidurals work by blocking nerve signaling from the lower half of the spine, a mechanism that severely reduces sensation in the lower body. The chemicals used for an epidural include a local anesthetic such as lidocaine or bupivacaine and are typically administered in combination with opiates like fentanyl. In most cases, the epidural allows delivering mothers to remain fully alert during vaginal and cesarean births.

The greatest risk of using an epidural is that the drug concoction may make it too difficult for a mother to push. Prolonged pushing can result in the use of forceps or a cesarean. Other potential side effects include a sudden drop in blood pressure, prolonged numbness after delivery, itching or soreness at the site of the epidural injection, and the potential that the baby will have respiratory depression, heart rate variability, and/or mal-positioning. Each of these risks elevates the likelihood of a cesarean, delivery by forceps, and/or episiotomy. Finally, babies may have difficulty latching on to the nipple during breastfeeding upon delivery.

Post-Partum Recovery

Post-partum recovery comes with its own set of challenges. The uterus will continue to sharply contract upon delivery for the next several days. This is an important process because it stops the uterus from hemorrhaging and shrinks the organ back to its pre-pregnancy size and location. These contractions are not nearly as frequent as labor contractions, but they are quite painful. Physicians may prescribe opiates like Nubaine to relieve the pain.   

For the most part, these medications work. But they’re risky. Pitocin and epidurals elevate the need for a cesarean, cesareans elevate the likelihood of maternal mortality (which has already reached frightening heights in the US), and opiates prescribed for pain relief after delivery are addictive, dangerous, and can pass to the baby through breast milk.

Cannabis is Worth the Research

There isn’t nearly enough research on the effects of cannabis on pregnancy, childbirth, breastfeeding, and post-partum recovery, but there is one aspect of the plant that deserves immediate and rigorous attention: cannabis has the potential to be medically useful in each of these phases. 

More research needs to be done. The research on cannabis’ utility as an antiemetic is conclusive.  Cannabis reduces nausea and vomiting. This is why one of its most common medical uses is in the palliative care of cancer patients who deal with debilitating chemotherapy-induced nausea and vomiting. While THC passes through the placenta and may have adverse effects on a fetus’ developing brain, women who have hyperemesis gravidarum, a severe form of morning sickness that can be life-threatening, can and have benefited from cannabis when nothing else worked.

Another one of cannabis’ well-known uses is pain management. Again, the evidence that cannabis can relieve chronic pain is definite. The American Academies of Sciences, Engineering, and Medicine found that “in adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pains symptoms.” Chronic pain is not the same thing is labor pain, but this finding invites research into the question of cannabis’ effect on all types of pain, including pain that is labor-induced.   

By no means does current evidence conclude that cannabis use during pregnancy and childbirth is a good idea. What it says is that it could be, but there needs to be more research. Unfortunately, studies about cannabis’ effect on pregnancy and childbirth are not only outdated and rare, but they also use a pool of women who smoke tobacco, drink alcohol, and consume other illicit drugs in addition to weed. There are too many confounding variables in existing studies to really conclude one thing or another about cannabis. There are no studies in which the subjects abstain from other toxic substances while ingesting cannabis without smoking it (smoking cannabis is more dangerous than consuming it otherwise).

Until more research is done, mothers will continue to turn to the cocktail of risky medications considered the gold standard, risking potentially fatal adverse reactions. Given that maternal mortality continues to rise in the United States, it is time to try something new.

Does Cannabis Have A Place In The Delivery Room? was last modified: by
Dianna Benjamin

About the author: Dianna Benjamin is a freelance writer, teacher, wife, and mom horrified and fascinated by social justice and our inability--yet constant pursuit--to get it right.