Is CBD safe during pregnancy?

hile most women of childbearing age understand drinking alcohol while pregnant is harmful, they may be less skeptical about the safety of cannabidiol (CBD), even though there is no evidence to support that belief, suggests a study being presented at the ANESTHESIOLOGY® 2019 annual meeting.

Researchers surveyed women 18-44 years old, physician anesthesiologists, certified nurse midwives and doulas (trained non-medical companions who support women during pregnancy and the birthing process) about CBD, alcohol and marijuana use during pregnancy. While only 9% of the women said they believed one drink of alcohol a week was safe, 29% thought topical CBD was safe. Physician anesthesiologists and certified nurse midwives were more skeptical (18% of physician anesthesiologists and 20% of certified nurse midwives thought it was safe), but doulas generally thought it was OK - 70% said they believed it was safe during pregnancy.

"We observed women and doulas using CBD lotions during pregnancy and labor to reduce nausea, anxiety and pain, although no studies have examined its benefits, no safety data exists, and its effects are largely unknown," said Mark Zakowski, M.D., FASA, senior author of the study and chief of obstetrical anesthesiology at Cedars-Sinai Medical Center, Los Angeles. "That's concerning because CBD may interact with commonly used anesthetics that might be needed during labor and delivery. And ongoing CBD use has shown the potential to act like a common class of antidepressants, SSRI inhibitors, which can adversely interact with other drugs."

While CBD is a compound from the cannabis (marijuana) plant, it does not cause euphoria, or a "high." However, CBD is unregulated and products have been found to have different potencies and potentially harmful contaminants, he said.

Online surveys were completed by 315 women of reproductive age, 113 physician anesthesiologists, 48 doulas and 9 certified nurse midwives, all of whom live or work in California. 

Among women of childbearing age surveyed:

• 66% have seen CBD for purchase.

• 20% would consider using any form of CBD to reduce anxiety during pregnancy and 28% would consider using it during labor. Their attitudes towards using CBD for nausea and pain were similar.

Among providers surveyed:

• 7% of physician anesthesiologists would consider using CBD to reduce anxiety in women during pregnancy or labor

  • o 12% would consider it to reduce nausea during pregnancy and 8% during labor

    o 13% would consider it to reduce pain during pregnancy and 12% during labor

• 42% of certified nurse midwives would consider using CBD to reduce anxiety in women during pregnancy and 33% would consider it during labor

• 54% of doulas would consider using CBD to reduce anxiety in women during pregnancy and 44% would consider it during labor

• 62% of physician anesthesiologists said they never ask pregnant women about topical CBD use and 57% said they never ask about it being taken orally

"Pregnant women and anyone having surgery or needing anesthesia should tell their physician anesthesiologist if they use CBD, or other herbal products, and physician anesthesiologists should ask their patients whether they use it," said Dr. Zakowski. "Clearly we need more research to determine if CBD is safe for pregnant women."