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The first time Sandra* was pregnant and unable to find relief from her extreme morning sickness, she stumped every doctor in her path. "Hyperemesis is no joke," she told VICE, referring to hyperemesis gravidarum, a rare but serious form of morning sickness diagnosed in an average of 60,000 pregnancies each year in the United States. The condition is far more severe than normal morning sickness, causing dehydration, weight loss, headaches, fainting, and extreme fatigue, and is often a threat to the life of the fetus and even the mother if left untreated.
"We threw everything but the kitchen sink at it," Sandra said, "and I was still met with, 'well, abortion is an option'—until I found cannabis."
Sandra lived in Texas, where medical marijuana was not legal, and so she hid her usage from her obstetrician, getting it from illegal sources, constantly worrying that she would be reported.
As more and more states loosen marijuana restrictions (24 have now legalized medical use), an increasing number of women are opening up about pot for morning sickness. Facebook groups like NORML Women's Alliance and Moms for Marijuana International are two of the sites leading the discussion; the latter has gained 544 new followers just in the past week, and a quick Google search turns up scores of pregnant tokers asking for legal advice. But getting high while pregnant is still far from a medically acceptable treatment option. The American Congress of Obstetricians & Gynecologists (ACOG) has put pressure on its members as well as governing bodies to classify marijuana alongside alcohol and tobacco as dangerous substances for use during pregnancy, citing insufficient data regarding its effects.
Meanwhile, a review published this month in the medical journal BMJ Open linked marijuana use in pregnancy with low-birthweight babies and placement in the neonatal intensive care unit after birth. While the researchers indicate that pregnant women should abstain from marijuana usage, they also acknowledge that most study subjects also smoked cigarettes and consumed alcohol, which makes isolating the effects of marijuana impossible.
But unlike cigarettes and alcohol, there is clear medicinal value in marijuana. And mainstream treatments for extreme morning sickness, like Zofran, are poorly studied and could be linked to side effects for the fetus, including heart defects. Originally intended for chemotherapy patients seeking relief from extreme nausea, Zofran has become a popular treatment for morning sickness in spite of not having FDA approval for this purpose. Given this reality, some pregnant women feel marijuana is their best option.
Kelly in Kansas, who is currently seven months pregnant, has been warned by her doctor that Child Protective Services (CPS) might take her baby at birth because Medicaid requires she be tested for drugs. (At present, there is no legal cannabis usage in Kansas.) Kelly has been upfront about her usage, and has continued to test positive for marijuana and negative for all other illegal drugs, but she worries that her honesty might cost her custody of her baby. Kansas law requires CPS be notified of positive drug tests, and repeat positives can result in the removal of children. Like Sandra, though, Kelly felt she had little other option: Before she tried marijuana, she was unable to eat or drink.
"I was extremely reluctant to try it," Kelly told VICE, "but one day I was headed to the ER and a friend said, 'Take one hit of this. If it doesn't help, I'll pay you $100 and never ask you to try again.' I said fuck it, and tried. I avoided the ER for a week thanks to that one bowl. I will consume any form of THC offered. I've vaped, dabbed, eaten, smoked. And afterward, I notice my baby moves. My baby is happy. She gets food and water after I smoke."
Of the six obstetricians approached for this story, none felt comfortable being named, and most were unwilling to comment on using marijuana to treat morning sickness. One in particular who specializes in hyperemesis gravidarum said that she would need to "visit the studies for more information" as she had never before considered using marijuana for treatment, despite practicing in a state where it's legal.
In response to queries about treating HG with marijuana, an ACOG spokesperson sent a statement by email from Joseph R. Wax, MD, Vice Chair of ACOG's Committee on Obstetric Practice: "Our number one priority as ob-gyns is a safe outcome for mother and baby. Although we still need more research on the topic, the data we do have raises concerns regarding negative effects of marijuana on the growing fetus, and, because of this, we recommend that women not use marijuana during pregnancy."
Twelve of the 15 women interviewed for this piece who used marijuana to treat their HG felt it had played an important role in their health. Some credited it with saving their lives and that of their babies. But there are women for whom smoking marijuana did not help. Stella from Tennessee had great success with it in her first pregnancy, but lamented that "it didn't work for my second baby. The smell of it, even if it wasn't being smoked, made me sick. I lost him," she said, adding that HG was likely a factor in her miscarriage.
Laura from Cambridge, England, used pot pre-pregnancy as a means of controlling her IBS symptoms. When she developed HG in pregnancy, she tried smoking marijuana and became violently ill almost immediately. "Honestly, it magnified the nausea so much for me," she told VICE. "One go was enough to tell me my body did not want weed in it with a baby on board."
But the majority of women VICE spoke to with extreme morning sickness found relief in pot. After being diagnosed with hyperemesis gravidarum, Addy, a stay-at-home parent from Massachusetts, found herself reluctantly trying marijuana as a treatment. "I dabbled with pot in my teens, but I didn't like the way it made me feel, so I hadn't used it in quite some time before becoming pregnant," she told VICE.
Unable to keep any food or water down, Addy gave marijuana a try. She smoked it and felt instant relief. "My husband would encourage me to use more often because he'd get to see a glimpse of the person I was before pregnancy," she said. "Hyperemesis gravidarum had turned me into a shell of the person I used to be. With marijuana, I could converse. I was able to laugh and smile. Without marijuana, I couldn't do much more than sleep and vomit."
Medicinal marijuana is legal in Massachusetts, but that doesn't mean a pregnant woman can find a pot-friendly OB/GYN there. While states with looser restrictions don't explicitly forbid marijuana usage for pregnancy, doctors are hesitant to go against ACOG, which provides board certification. As a result, obtaining a medical marijuana card from an actual obstetrician is rare.
Not long after giving birth to to a healthy baby boy, Sandra from Texas moved to California and was pregnant for a second time. "I started off with the notion that I would again use cannabis, but from the get go , and I would not get so desperately sick," she said.
This time, Sandra was in no danger of police involvement, since medical marijuana was legal in her new home state. In an unusual move, her OB/GYN even supported her in obtaining a cannabis card. She carried her pregnancy to full term at 40 weeks, never once requiring a visit to the emergency room for IV fluids and medication, as she had multiple times in her first pregnancy.
Sandra's doctor was happy that she chose a more natural course of treatment and avoided Zofran and other antiemetics. But he was nonetheless unwilling to have his name associated with this story, as were his colleagues at the cannabis-friendly clinic she went to. Until the larger medical community is more accepting of the idea that marijuana might sometimes help a pregnant women's health, it seems, doctors are hesitant to admit their involvement, despite some being willing to treat individual cases. As one commented, "I don't need the angry hate mail surrounding this issue."
*The subjects in this story asked to be identified by pseudonyms to protect their privacy.
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