When you put cannabis, motherhood and pregnancy into the same sentence it’s going to ignite some controversy – no matter what you’re saying. This is a hot button topic.

And reasonably so. We know that consuming alcohol during pregnancy causes birth defects and increases the risk of perinatal death, so does tobacco, so do opioids and so do most drugs generally. But what about cannabis? It’s a debate that is heating up among doctors, parents, and health consultants across the country, as legalization becomes more and more unanimous.

Can mothers use cannabis during pregnancy, safely?

“It’s one thing that almost all doctors will say, ‘Absolutely not, it’s as bad as alcohol and smoking and if you tell a mother that it’s even okay to use CBD during her pregnancy you’re basically performing malpractice,’” says Dr. Michele Ross. But, according to her, that is not true. Cannabis can actually be an asset for pregnant mothers, she says. And a healthy, helpful one at that.

Ross is a neuroscientist out of California. She recently developed an online course designed to educate mothers about the potential risks and benefits of using cannabis while pregnant or nursing. She’s been studying the effects of drugs on the brain for most of her career – and while she’s a pro cannabis activist today, she didn’t start out that way.

“I was a really hard-core anti-drug person,” she explained. Growing up she lived near a crack house in New Jersey and developed a really negative view of drugs in general. It’s a large part of what got her into neuroscience and drug studies in the first place. But as she learned more about cannabis, her views (at least of that substance) started to change drastically.

Today, she runs a cannabis non-profit called “Infused Health” focused on women’s health.

“Cannabis does not cause birth defects, unlike alcohol and other prescription drugs,” she writes on the Cannabis and Motherhood page of her website. “Cannabis can be a safer alternative than prescription opioids, antidepressants, anti-nausea, and epilepsy drugs for mothers.”

That’s not to say that pregnant women should start sparking up blunts and hotboxing their nursery rooms. Not by a long shot. But, we also shouldn’t throw the baby out with the bathwater. Because, while smoking marijuana as a pregnant woman can certainly cause issues, tinctures, edibles and CBD products could be really helpful in replacing some of the prescription drugs that are often used to treat women’s health problems, says Ross.

It’s an enticing idea. But one that still makes people uncomfortable. One that many doctors say we don’t have enough research to support.

And indeed, much of the literature out there on this subject comes to conclusions like, “Further research is needed to examine associations with birth outcomes by the quantity of cannabis used as well as the long-term effect of cannabis use during pregnancy on offspring.”

Ross agrees. More research is needed. But, she argues, places like California offer a positive (albeit informal) case study.

“California has had medical marijuana since 1996. So, there are children who were born to mothers that were using cannabis, and we’ve seen them grow into adulthood,” she says. “We know that in children born under a legal marijuana system, we don’t see increased birth defects. We don’t have an increase in all these things that they claimed would happen to children.”

If the tables were flipped, the outcome would not likely be the same. If alcohol had only recently been legalized in a state, the number of alcohol related birth defects and perinatal deaths would likely skyrocket. That didn’t happen with the legalization of medical marijuana. Not in California, at least.

And it hasn’t seemed to affect Jamaicans, either, Ross notes. There, people often make cannabis teas, which moms will drink throughout their pregnancies – and, according to Ross, they don’t have the level of birth defects and miscarriages that many claim happen when a mother uses while pregnant.

Okay. But what does the scientific literature say? Because, while California and Jamaica offer hopeful examples, they are a far cry from being definitive proof that it’s okay for pregnant mothers to start using cannabis all willie-nillie.

According to one study published by BJOG: an International Journal of Obstetrics and Gynecology, in 2003, mothers who used cannabis during their pregnancy were not increasing their chances of, “perinatal death or need for special care.”

“The results of this study suggest that the use of cannabis during pregnancy was not associated with increased risk of perinatal mortality or morbidity in this sample.” The study concludes.

That same study does note, however, that cannabis use during pregnancy seemed to correlate to a lower birth weight. But, Ross argues, it’s unclear whether that’s due to the method of cannabis consumption. “For a mom, smoking cannabis is a lot different than taking, say, 2-3 drops of a THC tincture to help you actually get your food down and not throw it up. It’s very different,” she says.

According to the Harvard Health blog, "Because babies are still developing, anything that affects that development can lead to permanent changes. THC can affect something called executive function. These are skills such as concentration, attention, impulse control, and problem solving; they are crucial skills for learning and life success."

Then, in another study, published last month in the International Journal of Epidemiology, researchers came to the conclusion that, “Prenatal exposure to maternal cannabis use is specifically associated with offspring behavioural problems, but not emotional problems.”

That study notes, also, that that’s likely not due to, “intrauterine cannabis exposure on fetal development,” since both maternal and paternal cannabis use were tied to these behavioral problems. More likely it has to do with family dynamics and parenting.

So… WTF? It seems like almost every study out there comes to a different conclusion and raises different questions about the true effects of pregnant cannabis use. The only thing they seem to agree on is that more research is needed.

Still, if a pregnant woman asks their OBGYN, “can I use cannabis or CBD to treat my morning sickness nausea?” the answer will almost invariably be: don’t even think about it. And in Colorado, when undercover researchers posed as pregnant women, asking budtenders around the state, what products to use for nausea, the public backlash was viscious when it turned out that 70-percent of those bud tenders actually offered suggestions.

Articles like the HuffPost’s “Marijuana Dispensaries are Giving Pregnant Women Bad Advice”, erupted out of the mainstream media. People were angry. They were upset that budtenders would dare to suggest cannabis to a pregnant mother.

In response, the Department of Health (along with several other health organizations) took a hardline stance on the issue: “Using marijuana during pregnancy can harm your baby, just like alcohol or tobacco. Being legal does not make it safe.”

“There’s no solid bases for it, it does not cause any birth defects,” says Ross. “It’s not like alcohol; any amount of alcohol is actually dangerous to the child. Cigarette smoking can be dangerous to the child. And yet no one is banning those substances from pregnant women and yet cannabis has not been proved to cause significant harm.”

So, the controversy endures. There are no definitive answers. Not yet, at least.

And, until there are, it’s really up for mothers to decide for themselves. Do your research, talk to your doctor and, if you’re interested in learning more from Dr. Ross, try out her online course for Cannabis and Motherhood.