In North Carolina, the legal landscape surrounding cannabis is increasingly complex, with readily available products like CBD, Delta 8, Delta 10, and THCA. While these may be marketed as "natural" alternatives, the unregulated nature of this market raises significant concerns about product purity and accurate labeling. Given the rising rates of cannabis use among pregnant and postpartum individuals, often for self-medication of common pregnancy symptoms like nausea and anxiety, it's crucial to understand the implications for maternal and infant health. 

So what exactly are the consequences of consuming cannabis products during pregnancy?

Erin McClain and Megan Williams from the UNC Collaborative for Maternal and Infant Health's You Quit, Two Quit program talk through:

• Demystifying Cannabis: Learn the differences between THC (marijuana) and CBD, and explore the various forms of cannabis products available, including Delta 8, Delta 10, and THCA.
• North Carolina's Confusing Landscape: Understand the legal status of cannabis in North Carolina, including the nuances of the 2018 Farm Bill and the unique situation on the Qualla Boundary.
• The Problem with a Gray Market: Discover the significant lack of oversight in the unregulated cannabis market, and why this poses potential risks due to inaccurate labeling and contaminants like lead and mold.
• Why are Pregnant Individuals Using Cannabis? Gain insight into the reasons behind the uptick in cannabis use among pregnant individuals, often for self-medication of symptoms like nausea, anxiety, and sleep issues, and the influence of aggressive marketing.
• Risks of Cannabis Use in Pregnancy: Explore the growing evidence on the potential harms, including increased risk of low birth weight, preterm birth, gestational hypertension, and infant death. The episode also highlights the magnified risks when cannabis is co-used with tobacco.
• Empowering Providers: Get practical advice for healthcare providers on how to approach conversations about cannabis use with patients in a nonjudgmental, proactive, and positive manner, similar to strategies used for tobacco cessation.
• Managing Nausea and Vomiting in Pregnancy: Learn about evidence-based alternatives for managing nausea and vomiting in pregnancy, emphasizing effective, safer options over cannabis. For more in-depth information, a previous episode on hyperemesis and the safety profile of Zofran is also referenced.
• Cannabis and Postpartum Safety: Understand the dangers of secondhand exposure to smoke and vape products for infants, and the critical importance of keeping all cannabis products (including edibles) out of reach of young children due to poisoning risks.
• Breastfeeding and Cannabis: A crucial discussion on how cannabis, being fat-soluble, stays in breast milk for weeks, making "pumping and dumping" ineffective. While the benefits of breastfeeding generally outweigh the negatives of occasional cannabis use, heavy use can suppress infant feeding cues and responsiveness.
• Resources for Support: Discover valuable resources for individuals and families in North Carolina seeking help for substance use disorders, including the Alcohol and Drug Council of North Carolina.

Resources Mentioned in this Episode:

• You Quit, Two Quit: YouQuitTwoQuit.org
• Alcohol and Drug Council of North Carolina:
  • Website: alcoholdrughelp.org
  • Phone: 1-800-688-4232
  • Text: 919-703-1872
• Poison Control: 1-800-222-1222
• Cannabis (marijuana) and cannabinoids: What you need to know. National Center for Complementary and Integrative Health. Accessed May 27, 2025. https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know. 
• Cannabis (marijuana) and cannabinoids: What you need to know. National Center for Complementary and Integrative Health. Accessed May 27, 2025. https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know. 
• Lo JO, Ayers CK, Yeddala S, Shaw B, Robalino S, Ward R, Kansagara D. Prenatal Cannabis Use and Neonatal Outcomes: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2025;179(5):e250689. doi:10.1001/jamapediatrics.2025.0689
• Young-Wolff KC, Sarovar V, Tucker LY, Ansley D, Goler N, Conway A, Ettenger A, Foti TR, Brown QL, Kurtzman ET, Adams SR, Alexeeff SE. Trends in Cannabis Polysubstance Use During Early Pregnancy Among Patients in a Large Health Care System in Northern California. JAMA Netw Open. 2022;5(6):e2215418. doi:10.1001/jamanetworkopen.2022.15418
• Crosland BA, Garg B, Bandoli GE, et al. Risk of adverse neonatal outcomes after combined prenatal cannabis and nicotine exposure. JAMA Netw Open. 2024;7(5):e2410151. doi:10.1001/jamanetworkopen.2024.10151
• Avalos LA, Adams SR, Alexeeff SE, Oberman NR, Does MB, Ansley D, Goler N, Padon AA, Silver LD, Young-Wolff KC. Neonatal outcomes associated with in utero cannabis exposure: a population-based retrospective cohort study. Am J Obstet Gynecol. 2024;231(1):132.e1-132.e13. doi:10.1016/j.ajog.2023.11.1232
• America’s Poison Control Centers. Edible Cannabis Exposures: Patients 0-19 Years of Age. Accessed March 26, 2025. https://poisoncenters.org/track/edible-cannabis
• You Quit, Two Quit patient education flyer: https://youquittwoquit.org/wp-content/uploads/2025/05/YQTQ-Cannabis-and-Pregnancy-Flyer_Final-5.14.24.pdf
• You Quit, Two Quit practice bulletin: https://youquittwoquit.org/health-professionals/#practice-bulletins
• Hyperemesis podcast: https://pod.link/1775232218/episode/1c298879ccf952c96507669945f953e7

About The MomBaby Podcast:

The MomBaby Podcast is a production of the UNC Collaborative for Maternal and Infant Health, dedicated to providing evidence-based information and support for healthy pregnancies, births, and infancy.

In this episode, Dr. Allison Lee, obstetric anesthesiologist from the University of Pennsylvania, and Dr. Alison Stuebe, maternal-fetal medicine physician and breastfeeding expert from UNC-Chapel Hill, tackle the myths surrounding breastfeeding after non-OB anesthesia. The discussion covers why there’s a common misconception that mothers must stop breastfeeding post-anesthesia, the 2019 ASA guidelines, and the effects of various pain medications on lactation. Dr. Lee and Dr. Stuebe emphasize the importance of evidence-based decision-making, shared communication between healthcare providers, and the impact of pain management on the postpartum experience. 

In this episode, host Kimberly Harper talks with Dr. Andrew Hausolder, an emergency physician and founder of the HG and Morning Sickness Clinic in Birmingham, Alabama. Dr. Hausolder discusses the complexities of Hyperemesis Gravidarum (HG), its genetic underpinnings, and the critical role healthcare providers play in managing this severe condition. He provides insights into screening practices, treatment protocols—including misinformation about the use of Zofran—and the importance of early intervention. This episode is essential listening for medical professionals looking to enhance their understanding and care of patients suffering from HG.

Join Liz Soto as she speaks with Dr. Allison Lee, a leading obstetric anesthesiologist and board member of the Society of Obstetric Anesthesia and Perinatology (SOAP). In this episode, Dr. Lee provides an in-depth look at different types of anesthesia used in labor and delivery, including spinal, epidural, and general anesthesia. She highlights why epidurals are typically preferred and addresses concerns about general anesthesia. Additionally, Dr. Lee examines the racial disparities in anesthesia practices, including why Black women are more frequently administered general anesthesia for C-sections. Dr. Lee discusses the factors behind this disparity and offers practical advice for both patients and healthcare providers to ensure informed, equitable care.

In this episode, Liz Soto is talking with Dr. Allison Lee and Dr. Melanie Stanislaus from the Society for Obstetric Anesthesia and Perinatology (SOAP) to explore the ins and outs of post-dural puncture headaches (PDPH) following epidurals and spinals. Tune in to learn about:

• What PDPH feels like: Understand the symptoms, including the distinctive throbbing headache that worsens when upright.
• When it starts: Discover the typical onset timing and what to expect in the days following delivery.
• At-home remedies: Get practical advice on managing symptoms with pain relievers, hydration, and caffeine.
• Advanced treatments: Learn about the blood patch procedure, its effectiveness, and the recovery process.
• Preventative measures: Hear expert tips on how to reduce the risk of PDPH in future pregnancies.