Can You Use CBD While Pregnant?

Touted for offering numerous benefits, from pain relief to stress management, cannabidiol (CBD) has gone from the obscure to the mainstream. Many believe using CBD products is safe because it doesn't make you "high" like tetrahydrocannabinol (THC) does.

But can you use CBD while pregnant? Government agencies such as the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) strongly advise against using CBD while pregnant and lactating.

Animal research shows that high doses of CBD during pregnancy can have negative impacts on a fetus that can follow them to adulthood. But there is still a lot that researchers don't know about CBD, including what these findings mean for humans.

Keep reading to learn more about CBD, why experts recommend avoiding it during pregnancy and lactation, and tips on other, safer ways to relieve stress and pregnancy symptoms.

What Is CBD?

According to the FDA, cannabis is a plant containing more than 80 natural compounds called cannabinoids. The two most well-known are cannabidiol (CBD) and THC. When people think of marijuana, they likely think of THC, the psychoactive chemical that makes it famous for recreational use. But unlike THC, CBD does not make you high.

CBD can be derived from hemp and non-hemp plants. It is commonly used to relieve stress and minor pain, which may be why it has become popular to take CBD while pregnant.

Popular products such as CBD mocktails as alternatives to wine, CBD salve for caring for sore muscles, or CBD-laced bath bombs for soaking in a tub are particularly appealing for their stress-reducing effects.

But just because CBD doesn't make you feel high doesn't mean it is safe to consume or use while pregnant or breastfeeding.

Is CBD Legal?

Can you legally use CBD while pregnant? Well, that depends.

In 2018, the federal government passed a Farm Bill that made a legal distinction between hemp and marijuana. According to the Farm Bill, CBD products could be legal as long as they are derived from hemp and contain less than 0.3% THC. It also legalized moving the product across state lines and giving the green light to grow hemp anywhere in the U.S.

However, that stipulation came with plenty of caveats. The Farm Bill expressly gave states the power to choose how to control hemp and CBD, which is why CBD isn't fully legal in all 50 states yet.

Fully legal vs. conditionally legal

According to WiseVoter's interactive map, CBD is legal in many states and conditionally legal in others. The product must contain less than 0.3% THC in states where CBD is fully legal.

In other states, the legality of CBD is conditioned based on how the product is used. For example, in some states, you need a medical marijuana license or a medical doctor's prescription, but otherwise, CBD is illegal in that state.

As of 2023, states where CBD oil is considered fully legal include:

• Alaska
• Arizona
• California
• Colorado
• Connecticut
• District of Columbia
• Illinois
• Maine
• Massachusetts
• Michigan
• Montana
• Nevada
• New Jersey
• New York
• Oregon
• Vermont
• Virginia
• Washington

Laws restricting CBD are still evolving, so check with your state laws to find out what is legal—and what is not.

Implications for use even when legal

Even if you live in a state where CBD is fully legal, it's important to understand the implications of use in pregnancy.

"Regardless of whether CBD use is legal, the stigma of any substance use during pregnancy means that certain pregnant people will always be scrutinized and potentially punished for their choices," says Elizabeth Ling, JD, MSW, senior helpline counsel for If/When/How, an advocacy organization that provides free and confidential legal advice on questions about abortion, pregnancy loss, and birth.

So, Ling says, people with marginalized identities, including Black people, Indigenous people, people of color, people living in poverty, trans and queer people, and immigrant communities, are more likely to face risks when using any substance, including CBD, while pregnant.

Ling says legal risk may involve anything ranging from a criminal investigation or arrest to involvement with the family regulation system or immigration consequences. "For instance, allegations of substance use can lead to further probing and surveillance of everything a pregnant person does, which is incredibly disruptive and traumatizing," she says.

Can You Safely Use CBD While Pregnant?

Determining whether you can use CBD safely while pregnant is another concern that is similarly tricky to understand.

Cannabis research is restricted by federal law. That's because, even though marijuana is legalized in most U.S. states, it is still classified federally as a Schedule 1 drug by the Controlled Substances Act (CSA).

Substances under this classification are considered to have a high potential for abuse and no accepted medical use in treatment. This classification makes it difficult for researchers who want to study CBD.

There are no comprehensive human studies on the effects of CBD use during pregnancy on the developing fetus or pregnant person. It is, in part, this lack of research that leads many experts to advise avoiding CBD and CBD-containing products while pregnant.

While human studies are lacking, many experts point to animal research that suggests that CBD isn't safe for developing fetuses.

Linked to adverse effects in offspring

For example, in one study, scientists at the University of Minnesota used a "human-relevant dose" of CBD on pregnant rodents. They found that not only did CBD impact mood and cognition in their offspring after birth, but the risk for these negative impacts continued long after CBD exposure ceased.

Importantly, says lead researcher Nicole Flack, DVM, PhD, "We did not use cannabis in our research. We used Epidiolex, which is an FDA-approved CBD isolate used to treat seizures. It contains only CBD, while hemp and full-spectrum CBD oils contain minor cannabinoids, terpenes, and other compounds in addition to CBD."

Dr. Flack's research used mice as models for humans. "The pregnant animals in that study tolerated CBD without issue. However, female offspring exposed to CBD in the womb had altered memory and anxiety behavior as adults. Adult offspring also had epigenetic changes in multiple brain regions, which could affect gene activity," she says.

The FDA also points to older research that showed that high doses of CBD given to pregnant animals can cause issues with the reproductive system of developing male fetuses.

A 2019 review also summarized the following CBD adverse effects in pregnant animals:

• Developmental toxicity
• Embryo-fetal death
• Decreased growth
• Delayed or altered reproductive development
• Altered fertility in offspring
• Neurobehavioral changes
• Decreased fetal weight

In other words, while they can't say the same would happen in humans, experts are justifiably concerned that exposure to CBD during pregnancy could potentially harm human babies, too.

Health organization recommendations

Dr. Flack says that researchers cannot make health recommendations. However, they encourage people to speak to their doctors and reconsider using CBD during pregnancy and nursing. "Even though CBD is widely available and lacks the "high" of THC, it is not inherently safe for a developing baby," she says.

Since the health effects of CBD use during pregnancy are unknown and animal studies have found adverse effects on developing fetuses, the CDC advises against CBD use while pregnant.

Can You Use CBD While Breastfeeding?

As with CBD use during pregnancy, there is little to no research on the safety of CBD use while breastfeeding or chestfeeding. Current research suggests, however, that, like THC, CBD may pass to breastfed infants through breast milk, which could carry short- and long-term effects.

A 2021 prospective study of 20 breastfeeding parents found that CBD, like THC, accumulates in breast milk. In another study, researchers evaluated the breast milk of participants who were six to eight weeks postpartum. They found that compared to non-users, those who used cannabis while lactating had altered breast milk composition.

Dr. Flack says it's also important to note that retail CBD products are poorly regulated. In fact, the FDA's website lists news releases and statements about brands who have made illegal health claims on their website or product packaging or who have been disciplined by the FDA.

"These products may contain much more CBD than listed on the label, much less, or none at all," says Dr. Flack. "Depending on where and how the hemp was grown, these products can also be contaminated with pesticides, heavy metals, or illegal levels of THC."

Ways To Relieve Stress That Don't Include CBD

Pregnancy can invite added stress thanks to elevated hormones and unpleasant symptoms like morning sickness, food aversions, and all those weird aches and pains. But instead of reaching for CBD, consider some classic, tried-and-true ways to lower your stress and nurture calm.

Morning sickness and food aversions

If morning sickness and food aversions are stressing you out, try changing your approach to eating. Here are a few quick ways to curb those waves of nausea:

• Eat smaller meals more frequently throughout the day.
• Avoid foods with strong smells or flavors that make you feel green.
• Go for bland foods like bread, pasta, and rice that can help settle your belly.
• Stay hydrated by sipping water throughout the day—water can help prevent nausea.
• Keep ginger on hand for when nausea strikes.

Pregnancy fatigue

Pregnancy fatigue can really take the wind right out of your sails. But when you have a mile-long checklist, feeling exhausted can make everything feel that much more stressful.

Here are a few ways to beat that fatigue and lower your stress:

• Add exercise to your daily routine to help your energy.
• Stay hydrated—keep a water bottle with you throughout the day.
• Try to reduce your activities by asking for help with errands and chores.
• Schedule a daily nap to help get more rest.
• Find ways to reduce stress, which can eat up your energy.
  

Pregnancy aches and pains

All of those stretching ligaments and sore muscles can leave you feeling wiped out. These simple and effective tips relieve common pregnancy-related aches and pains. Ask a health care provider if these activities are safe for you:

• Book a pregnancy massage.
• Sign up for a prenatal yoga class.
• Buy some supportive shoes to help your back.
• Check your posture when sitting or standing—slouching can cause soreness.
• Invest in a body pillow to sleep more comfortably on your side.

General stress and anxiety

Sometimes pregnancy can elevate your stress and anxiety simply because it can bring a lot of uncertainty. Try adopting a few of these stress-reducing activities that you can use long after pregnancy to help center and calm your nerves:

• Try a guided meditation app to calm your stressful thoughts.
• Practice mindfulness to help slow yourself down and recenter your thoughts and feelings.
• Practice good sleep hygiene; being well-rested can help ease stress and anxiety symptoms.
• Talk to a trusted friend or family member about your feelings and worries.
• Make healthy diet and fitness choices.