Q. I take several different drugs for my mental condition. I became pregnant and my doctor told me not to take them. I have anxiety so badly that I have resorted to smoking marijuana to relax and calm down--a replacement for my prescription medications. I would like to know the effects on my unborn child, and also any legal steps that can be taken against me if the marijuana shows up in my system or my baby's system at birth.

A. This sounds like a very difficult time for you. It's hard to say, in your specific case, what the effects of your marijuana (MJ) use might be on your unborn child. This may depend on how often you smoke MJ, how potent the particular batch was, whether it contained any impurities (e.g., PCP, angel dust), and when, in the course of pregnancy, you used the MJ. (Drug effects on the developing fetus are usually greater during the first three months of pregnancy, at least as far as development of vital organs is concerned).

We don't know precisely how MJ use during pregnancy affects the developing baby. Some research suggests that maternal MJ use may lead to decreased birth weight, and negative effects on learning and attention skills in the baby (Walker et al, Child Adolesc Psychiat Clin N Am 1999; 8:845-67). However, one Danish study failed to find major differences in birth outcome in children of mothers who used MJ during pregnancy, compared with controls, except for lower birth weight, shorter length, and slightly smaller head size in the maternal MJ group (Balle et al, 1999).

I can't really give you a legal opinion regarding what, if any, penalties you might face, should MJ show up in you or your baby at the time of delivery. My guess is that this will depend on the state and/or county you reside in, and what your local district attorney chooses to prosecute under the heading of child abuse and neglect. To get an informed legal opinion, I would suggest that you contact your local chapter of the National Alliance for the Mentally Ill (NAMI). Their hot-line number is 800-950-NAMI. You can also try contacting the Bazelon Center of Mental Health Law (http://wwww.bazelon.org/) or the Center for Patient Advocacy (800-846-7444).

Finally, I would encourage you to discuss these matters with your psychiatrist and/or obstetrician. There may be medications for your anxiety that might be less risky to you, and to your baby, than smoking marijuana. Your psychiatrist should also be able to provide, or refer you for relaxation therapy. You might also find "The Relaxation and Stress Reduction Workbook," by Martha Davis et al, of help to you. I hope all goes well with you and your baby.

April 2001

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