Parenthood With Cannabis Use: What Are Implications?

Cannabis is the most commonly used illicit substance. The legalization of medical marijuana increased accessibility and public perceptions of its safety. Since the majority of cannabis users are young adults who are fertile, it is crucial to talk about parenthood with cannabis use and the different implications of it.

Cannabis use is a growing medical and social issue

Medical marijuana use is now permitted in a number of countries, including Canada, Australia, Denmark, Finland, and Germany. In the United States, almost 40 states have made cannabis legal for either medical or recreational use. Legalization increased the availability and perceived safety among people.

Cannabis use is more common among young people, specifically those between the ages of 15 and 24. Furthermore, according to survey data from the European School Project (ESPAD), 16% of teenagers (those between the ages of 15 and 16) have tried cannabis at least once.

Young adults in this age group are more likely to have unprotected sex and experience unplanned pregnancies, limited knowledge on the subject, and further risks and management, which makes the topic much more important to address.

Cannabis effects on fertility

Externally received cannabis may affect the innate endocannabinoid system. Receptors responding to cannabis are located in the hypothalamus and pituitary glands, secreting hormones to regulate gonads. Also, the ovaries and testes have those receptors, and external substance use may have an impact on ovulation, the menstrual cycle, and the production and quality of sperm.

Despite the large number of studies investigating marijuana's effects on fertility, it is difficult to reach firm conclusions. These studies come either from analyses of prior patient data or are observational. Furthermore, data gathered from self-reporting users with potential use of multiple substances makes it challenging to demonstrate a clear association.

Effects on female reproduction

A study surveying women with infertility showed that 13% of them used marijuana in their lifetime. The most recent users were more likely to think that marijuana is not harmful to reproduction. Additionally, there is a growing belief that marijuana in edible form is safer.

While a 1990s study suggested that marijuana smoking might reduce the chances of becoming pregnant within a year, more recent research found no association between substance use and time to conception.

According to a multicentric study, women who used cannabis prior to conception had a 41% lower chance of becoming pregnant or achieving a live birth with one menstrual cycle. Also, although imprecisely, the same study found a 20% lower live birth rate among cannabis users. There were not enough participants to conclude the association between early pregnancy substance use and pregnancy loss.

Marijuana use may also affect the results of infertility treatment. A study analyzed women who smoked marijuana within one year to their intention to get pregnant via in vitro fertilization (IVF). According to the findings, among substance users, 25% fewer oocytes were recovered, and 28% fewer oocytes fertilized. Also, another study working with women undergoing assisted reproductive therapy showed that marijuana smokers experienced more pregnancy loss after pregnancy was confirmed.

Effects on male reproduction

Sperm cells have a cannabinoid receptor, which makes them directly susceptible to the effects of external cannabis products. Animal and human studies indicate that marijuana use reduces sperm production and lowers sperm concentration. In comparison to non-users, recent marijuana use reduces sperm motility by 1.6 times, and high doses increase this risk up to 3.3 times. Marijuana use within the last three months is nearly twice as likely to be linked to poor sperm morphology.

Also, effects on the hypothalamus and pituitary glands, particularly the decrease in luteinizing hormone (LH), affect sperm production and testosterone synthesis. According to animal research results, chronic marijuana use may reduce the size of the testicles and prostate. Lastly, marijuana users experience twice as much erectile dysfunction.

However, since the literature information is predominantly from males seeking infertility treatment, it is not representative of the general male population.

Cannabis effects on pregnancy

When metabolized, cannabis is converted into tetrahydrocannabinol (THC). THC crosses the placental barrier, exposing the fetus to the effects of marijuana.

Studies from the 1980s focusing on the use of smoked marijuana showed that women using cannabis during their pregnancy experience more:

• Stillbirths
• Intrauterine growth delays
• Abnormalities in the development of the brain
• Cognitive development impairments in their offspring

However, recent studies do not show a direct association with stillbirth and miscarriage.

Nonetheless, there is increasing evidence that marijuana use increases the chances of:

• Risk of preterm birth
• Small gestational age
• Low birth weight
• Placental abruption
• Need for neonatal intensive care
• Death within the first year of life.

Although there is not enough evidence about the association between congenital abnormalities, some studies previously described heart, brain, genitourinary, and digestive organ pathologies.

Effects on parenting

Studies suggest an association between the legalization of cannabis use and increased likelihood of parental use. Through the "Cannamom" movement, which has gained popularity in recent years, women advocating for cannabis use rights share their experiences on how it has improved parenthood. In a recent study analyzing perspectives on cannabis use during pregnancy, participants stated that cannabis helped them with:

• Making deliberate decisions on their choice
• Aiding with circumstantial difficulties
• Improving their overall mood
• Providing pleasure
• Managing stress

Also, participants noted that they do not prefer to get information from healthcare providers due to the fear of judgment and lack of clarifying information. When needed, they turn to the internet or "literature," friends, and family members.

Some studies report that cannabis use by parents reduces child physical neglect and facilitates a calm and non-coercive parenting approach. However, results also indicate the potential for child maltreatment, physical abuse, corporal punishment, nonviolent forms of child discipline, and other maladaptive parenting styles.

Literature is limited on how parental cannabis use affects early childhood and child behavioral functioning. On the other hand, there is strong evidence regarding the connection between later psychological problems and substance abuse in children. These issues include parental neglect, school failure, and difficulties in peer relationships. Also, a large survey study comprising almost 25,000 respondents revealed that children living with marijuana-using parents have an increased risk of using cannabis as teenagers and young adults.

School-aged children experience:

• Difficulties in problem-solving skills
• Memory issues
• Decreased attention span
• Depression, and anxiety symptoms

The increasing accessibility and use of marijuana, particularly among young adults of childbearing age, requires a more cautious approach for cannabis users who desire fertility, are currently pregnant, or are breastfeeding. It is strongly encouraged to seek professional medical assistance if you or someone you know experiences a similar circumstance.