Marijuana Use During Pregnancy: Cannabis, THC and the newborn drug screen — what happens?

Marijuana and other drug use during pregnancy is becoming more prevalent.  This post points out the dangers of smoking weed while pregnant and how CPS will be involved.  Will they take your baby away if you test positive for thc?

Pregnant women taking marijuana can have serious consequences (also during breastfeeding as well). Today we’re going to talk about the consequences of marijuana use in pregnancy.

How do I all all of this? Hi, I’m Hilary — many people know me as The Pregnancy Nurse 👩‍⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. 🩺​ Please note that this post is written from my own experience in working in two states and also interviews with other nurses around the country. This seems to be the standard of care for women in both states where it is “legal” and not legal, however guidance is constantly changing.

I know a lot of you don’t like this information (hence, comments are off since someone mentioned they would like my house to catch on fire and my family die in it). I really am just here to tell you what will happen and remind you that honesty is TRULY the best policy.

Don’t miss my post on my sister site about wine during pregnancy (and I dive deep into the studies in that one since there are so many).

But, if you’re really looking to get prepared for what happens at birth — come join me in The Online Prenatal Class for Couples where we get you prepared for all of it in just a few hours!

Will they take my baby away if I test positive for drugs?

Positive drug use often leads to a social services referal, which often leads to a call to CPS (child protective services). From there, it’s up to them (but most often doesn’t end up in anything more than possibly a visit and a record of it).

BUT it’s complicated, so let’s talk about it….

It’s important for you to undertand that in my state (and most states) it does require a CPS call by us to notify them — most often done by a social worker (however, if the social worker wasn’t available I have made the call before as the RN).  Drug use during pregnancy is considered a form of abuse and we are required to report all forms of abuse to CPS.

CPS may or may not visit you, but they will have a record of it in their system.  If you have questions about the requirements in your state, I would recommend you to ask your doctor.

During your prenatal check-ups they will likely ask about your drug useage, and it may be routine for them to do a drug test on you. In some states this requires consent, and in others it does not.

BTW, if you’re doing marijuana and might be pregnant it is important to take a pregnancy test so you can STOP as soon as you are (I also have a little online pregnancy test — which isn’t as accurate, but good if you’re just wondering). The vast majority of women do stop taking marijuana as soon as they find out they are pregnant.

Of course, marijuana isn’t the only type of drug that we are testing for in these screen. A positive drug test can come from many types of drugs. Many on the drug screen are taken more seriously by a social worker than marijuana — and at times you could have issues with child endangerment from law enforcement.

Prenatal drug exposure is taken really seriously (as it should be) by child welfare.

Please note that if the health care provider does NOT notify CPS (or social services) we can lose our license, and it would be illegal as we are mandatory reporters.

If you test positive for prescription drugs that you have a prescription for, they may also discuss your opioid use and the safety of your family. This isn’t just about marijuana — it is definitely about the safety of children overall.

Please note that any actions taken on the baby’s plan for where it will live after it leaves the hospital is not up to health care workers. We are required to report things, and then it is in the hands of child protective services.

I love that you’re planning for all of this — and that is a HUGE step. If you’re a planner, check out my pregnancy planner full of places for memories, managing it all and your medical info you’ll need!

Marijuana during Pregnancy

It is my firmest desire that babies are given the most benign environment to grow in during pregnancy.  That means limiting coffee, alcohol, drugs (especially those unstudied), etc — except when the benefits far outweigh the risks, and can’t be gotten in other ways.

That is what this article is about.  If you strongly believe Marijuana is great during pregnancy, you and I will just have to disagree.

Smoking Marijuana While Pregnant

Marijuana is becoming legal in more and more states both for recreational and medicinal uses.  Whatever side of the argument you stand on for that — the reality is that when you’re pregnant things are very different.

Is it illegal to smoke weed while pregnant?

It is illegal to take marijuana during pregnancy.  It is still a federally controlled substance.

While, in some states where marijuana is legal, there is a bit of grey area — they really encourage moms NOT to take marijuana during pregnancy, just as we encourage them not to drink or take other controlled substances.

Taking marijuana during your pregnancy is a bad idea and is illegal — in some states. 

ACOG (American College of Obstetricians & Gynecologists ) has said that because there is very limited research, they recommend against marijuana use during pregnancy. This statement is also echo’d by The American Academy of Pediatrics.

It is illegal for a doctor to give you a marijuana prescription while you are pregnant.

Consequences for your baby for smoking marijuana during your pregnancy

**Honestly, there aren’t a lot of studies that have tracked babies of moms who smoked marijuana (because it’s illegal, and moms are unwilling to come forward for such a study.

There doesn’t seem to be anything specific like birth defects that they notice at birth. Which is good.

However, there are studies showing that marijuana use during your pregnancy can cause:

• low birth weight
• premature birth
• small head circumference
• decreased length
• stillbirth

If you’re interested in this, the CDC has a whole page on marijuana use during pregnancy.

Some drugs can cause a placental abruption due to the changes in blood flow in your body with these types of drugs.

There is a new study about marijuana use in pregnancy increasing kid’s anxiety and hyperactivity, showing there is a correlation between it and behavioral problems.

Studies are still being done, and the research on this topic is PRETTY poor, but most things show those consequences above are possibilities.

After birth, babies exposed to marijuana in utero have changes in brain development — things like changed responses to visual stimuli, higher-pitched cry or trembling.  While it doesn’t appear that babies go through withdrawal, the longer term studies are noting things like change in school performance, memory, impulse control or attention spans.

You can learn more about these consequences in this article  from the NIH.  I’ve read a few studies and it seems that there just aren’t many out there.  While the results are fairly inconclusive (and many studies seem to contradict each other) the majority point to possible brain issues as the child develops.

There is a recent study out of Australia that continues to link it to lower birth weight and complications.

Smoking weed while pregnant — cps involvement

Depending on your state, your provider can sometimes take a urine drug screen with or without your consent.

In my state, we do need a consent to test YOUR urine but we do not need one to test your baby. So, if you refuse, we just test the baby’s — and it also looks extremely suspicious.

Remember that honesty is always the best policy and CPS will note that if they are required to come.

The results of that urine drug screen (which always includes a screening for marijuana) will be noted in your chart. BTW, you can also test at home.

If you test positive for marijuana during your prenatal care, the hospital will likely ask to test you at delivery. They will also make a call to social work, and they will follow CPS guidelines for their area.

**If you plan to refuse the drug screen, we will screen your baby (that does not require consent).  We will also call social work about your refusal and that refusal will be noted.**

From that point, it is out of our hands.  It is in CPS’s hands at that point.

Nurses may also take your baby’s first stools to test it for marijuana to see how far into your pregnancy you took the drug (which may be a relief for those who mistakenly took it early in their pregnancy, before they knew — those stools will back you up). This is called a meconium screen.

If you are currently pregnant and using marijuana you need to stop.  If you are taking it for a “medical condition” you need to talk to your doctors about alternative methods that could be safer.

**If you disagree with this article I strongly encourage you to talk with your doctor about your drug use and what to expect after delivery. **

As a note, often marijuana use during pregnancy can also show as other substance use disorders, or use of other illicit drugs — so that will be considered by child protective services as well. Substance abuse while caring for children (or growing them in your womb) is certainly a cause for concern. They may talk about drug treatment programs with you.

Nurses will also keep an eye on baby using the Neonatal Abstinence syndrome scoring to make sure baby isn’t having any withdrawls from illegal substances.

Baby Testing Positive for THC at Birth

So, in summary, if a mom or a newborn tests positive for THC at birth they will send a social work consult, which will then go to CPS and they may follow-up with you. Most often, nothing at the hospital happens — although the nurses may watch baby closer for any withdrawal symptoms (although most often there aren’t visible signs from withdrawal from cannabis).

In some states they also can’t assist you with breastfeeding if you test positive for THC (we’ll talk more about breastfeeding in a bit).

Can they take your baby away for smoking pot while pregnant?

If it is illegal in your state — I do believe that they can take your baby away (but only with other issues of neglect or a lack of safety).  That does not mean that they WILL take your baby away.  Family court’s goal is to always keep families together if at all possible.

Will they take my baby if I test positive at birth?

Likely, no.  However, it will trigger a CPS visit to you, and possibly one to your home.  If they find other mitigating circumstances, that could become a real possibility.  It could also be a possibility for any other children you have in your care as well.

They may also commit to some random drug tests to make sure you are a safe parent.

Cleaning system while pregnant third trimester

While it varies, you can test positive for around 3 weeks after you’ve smoked.  There is a good article here that talks about how long marijuana stays in your system.

There really isn’t anything you can do to clean your system out in that time frame.

I have really heard it all before:

• “I haven’t smoked for MONTHS”
• “I was just in a room where other people were smoking”
• “I never smoked”

A positive, is a positive, is a positive. If you believe there is a false positive, you can ask that they take bloodwork. I have seen false-positive results in a pregnant mother, but they are extremely rare.

And once we have a positive — we can test your baby’s stools to see when during your pregnancy you smoked.

If you believe it is a false positive, ask for a blood test to be taken (which is more sensitive).

What happens if I fail a drug test while pregnant?

Your health care providers will likely council you on it and will note it in your prenatal care record. Most providers do a drug test on the first prenatal visit as part of universal screening for many things (like chlamydia, ghonorrhea, anemia etc). They may or may not need your consent to specifically do a drug screen.

The most important thing is to always be honest with your doctor, so that he/she can give you the care you need.  If/when CPS visits you, honesty will be super important for them!

Honestly, what that provider does with the info really varies, but most often they will at least council you to stop.

I think we all understand that new mothers really are trying to do their best for their baby. They want families to stay together.

Using a planner can help you keep track of any information you need to stay honest and on top of things.

Alternatives to Use of Marijuana during pregnancy

A lot of women take Marijuana during their pregnancy because of morning sickness, or other medical conditions.

I’d encourage you to talk to your healthcare provider about other options. A lot of people take this with this (but talk to your doctor first). I have a whole post on Unisom use during pregnancy on my sister site.

Check with your provider, and be specific with your symptoms, to see what they think will be right for YOU.

Marijuana and Breastfeeding

The compounds in Marijuana are found in higher concentrations in breast milk than they are in the user’s bloodstream.  It can have similar consequences for your baby as noted above, and also noted in the study above.

In Arizona, we are unable to help you breastfeed if you have had a positive screen during pregnancy. It was not like that in California, but it is something to keep in mind.

FYI, my friend Katie has a great Breastfeeding & Alcohol Calculator — in case you’re looking to drink and breastfeed.

Marijuana in Pregnancy Faq’s

My baby is smarter than other kids because I took marijuana.

While not a question, I do get this a lot in the comments. Again — as I said above, the studies are pretty poor, but most do point to some delays as kids get older.

Will my baby have withdrawl symptoms from marijuana

No, they will not. There has been some noted irritability in babies of moms with substantial marijuana use, but nothing tangible.

What if I test positive for other drugs?

Again, we will call CPS. That’s all the hospital does, but CPS makes calls like that, not us. Other drugs are certainly more problematic for both you and the baby.

Will my baby have withdrawls from other medication

Yes, we have moms who take both prescription and elicit drugs during their pregnancy and their baby will have withdrawals. It was on the most painful things to watch as we wean that baby from the medication. So sad. 🙁

Where do you get off telling me what to do?

I don’t. I am just explaining what will happen. I am also sharing that as a labor nurse who has seen THOUSANDS of babies, the less we can do to affect their environment, the better.

A note on comments:  I turned them off. People just couldn’t be civil.

And, like I said your best starting point to get prepared is The Online Prenatal Class for Couples. It GUARANTEES you’ll be more prepared for birth — and studies show you’re going to be happier about the whole process too.

Or, if you’re not quite ready for the full class, check out my free prenatal class — It’s your first step towards being your own birth boss.