Can CBD help with morning sickness, and is it safe to use when pregnant?
- Results of a 2011 study, published in the British Journal of Pharmacology, revealed the antiemetic effects of cannabinoids in response to a toxic challenge. Cannabidiol (CBD), the primary non-psychoactive compound in cannabis, was shown to suppress nausea and vomiting within a limited dose range(1).
- There are studies that present scientific evidence about how CBD oil may help relieve pain, anxiety, depression, nausea, and other pregnancy-related issues.
- Still, without substantial evidence to prove that CBD is beneficial for maternal use during pregnancy, most experts strongly discourage pregnant women from using CBD products to deal with morning sickness.
Why Some Women May Be Thinking of Taking CBD During Pregnancy
The 2011 study that was conducted on animals demonstrates the regulation of nausea and vomiting by the manipulation of the endocannabinoid system (ECS)(2).
The results of the aforementioned study revealed the antiemetic effects of cannabinoids in response to a toxic challenge. Cannabidiol (CBD), the primary non-psychoactive compound in cannabis, was shown to suppress nausea and vomiting within a limited dose range.
However, there has been no long-term scientific research on humans exploring the efficacy and safety of CBD oil, as well as risks and side effects of CBD use in pregnant and breastfeeding women. Neither is there a study that proves that maternal CBD during pregnancy is dangerous to either mother or baby, or both. As with all medications during pregnancy, risk/benefit discussions need to be discussed with a physician specializing in obstetrics and gynecology.
The U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), ACOG, and the U.S. General Surgeon have warned women against using marijuana and its byproducts, including medical marijuana, during pregnancy.
According to a 2005 study published in the journal Canadian Family Physician, as a baby’s brain is still forming, THC may affect brain development(3).
CBD is not the same as marijuana. However, the studies mentioned above show how marijuana can affect the baby’s brain and the mother’s milk.
Lack of Research on CBD Use During Pregnancy
Most experts are hesitant to recommend CBD to pregnant women despite the positive anecdotal reports that abound on CBD use during pregnancy. The hesitation comes entirely from the limited research available on the topic.
The lack of pregnancy-specific research is typical when it comes to health supplements. Still, many supplements that are believed to be safe and effective are generally avoided due to the lack of substantial evidence to support their safe use.
There are several possible reasons why research on CBD use during pregnancy is lacking:
- It is difficult to get research on pregnant patients approved.
The research parameters of any study or investigation, especially on human subjects, requires the approval of a professional ethics board known as Investigational Review Boards. These boards are strict when it comes to pregnancy and would often deny any research requests if a substance has not been proven safe in non-pregnant people through other studies.
- The complexity of pregnancy makes it challenging to account for all the variables of the study.
Pregnancy is a complex chemical process that affects women differently. Every pregnancy is a unique experience, and the symptoms may be different for each pregnancy, as well.
Thus, a supplement or remedy that could work with one pregnant woman might not work for another. This variable makes it difficult to interpret the data into something conclusive.
- The best research takes place over extended periods and often involves a large number of participants or sample size.
Clinical studies for determining the safety of a health supplement like CBD often needs to be done over several years. This process is tedious and expensive.
A single double-blind, randomized clinical trial can cost several million dollars and at least ten years to complete. Some institutions may pay for research like this. However, as of yet, no group has studied the effects of CBD alone on pregnancy.
Relief from nausea and vomiting is one of the many reasons why a pregnant mother may want to try CBD. There are anecdotal reports that promote CBD as a remedy for typical pregnancy symptoms, such as headaches, muscle cramping, abdominal pain, insomnia, anxiety, and nausea.
Still, there is no evidence to support the safety of maternal CBD use during pregnancy. Neither are there studies available to prove or disprove the safety of this compound on the developing fetus.
Considering the lack of research and clinical trials on CBD oil and pregnancy, most physicians, gynecologists, and other healthcare providers tend to dissuade pregnant women from using CBD products unless standard remedies fail for intractable nausea and vomiting of pregnancy known as hyperemesis gravidarum.
What is Morning Sickness?
Morning sickness is also referred to as nausea and vomiting of pregnancy (NVP). It is a common medical condition that affects 50% to 80% of pregnant women.
NVP can have a significant impact on a woman’s quality of life, whether its symptoms are mild, moderate, or severe.
NVP indications can vary from mild to severe and can happen at any time during the day or night. Symptoms can include retching, which may or may not be accompanied by vomiting, nausea, and dry heaves.
NVP typically manifests between the 4 and 9 weeks of pregnancy, and peaks between 7 and 12 weeks. In most cases, symptoms go away when a woman’s pregnancy reaches between 12 and 16 weeks. However, up to 15% of women continue to have symptoms until the 20th week of pregnancy or until the baby’s delivery.
Hyperemesis gravidarum (HG) is the most severe type of NVP, and it affects up to 3% of pregnant women. HG is a medical condition characterized by severe nausea and constant vomiting, which leads to dehydration and weight loss. Women with HG may require hospitalization.
If NVP is affecting a pregnant woman’s ability to sleep, eat, and perform her daily activities, a consultation with her healthcare provider is advisable.
NVP symptoms that first start at the 10th week of pregnancy or later may be due to other causes. They should be discussed with a medical professional as well.
NVP Due to Medical Conditions Other Than Pregnancy
Up to 85% of pregnant women experience symptoms, such as burping, burning pain in the chest, belching, burping, or nausea. Most of these symptoms manifest during the first trimester of pregnancy.
However, some NVP symptoms may be indications of other medical conditions like heartburn, indigestion, or acid reflux. In some cases, the symptoms are caused by Helicobacter pylori, a bacterial infection that has been linked to HG.
Experts recommend testing for this bacterium, especially for women with a history of severe HG or NVP. A woman who is positive for this bacterium can be treated during her pregnancy.
CBD as Anti-Nausea
In a 2018 review, the World Health Organization (WHO) noted that CBD is generally well-tolerated with an excellent safety profile, and adverse effects may be a result of drug-drug interactions between CBD and a patient’s existing medications(5).
As an antiemetic, CBD may also be an effective cure for both nausea and vomiting produced by chemotherapy or other therapeutic treatments, as indicated in a 2011 study published in the British Journal of Pharmacology(6).
A study published in the European Journal of Pharmacology in 2015 demonstrates how CBD controls nausea by influencing the serotonin receptors(7).
The results of the same study also suggest that CBD decreases the release of serotonin, reducing the body’s stimulation of the vomiting controls in the brain.
CBD may come in the form of an edible, tincture, or salve, and they may either be ingested or applied topically.
Marijuana for Morning Sickness: Is it Safe?
Studies on the use of CBD for morning sickness may be lacking and inconclusive, but can marijuana help with morning sickness?
Marijuana plants and hemp plants are different varieties of the Cannabis sativa species. Both varieties contain varying amounts of cannabidiol (CBD) and tetrahydrocannabinol (THC).
If the hemp plant contains over 0.3 percent THC, it is technically considered a marijuana plant.
Marijuana is a cannabis plant that contains substantial amounts of THC, which is the psychoactive component primarily responsible for inducing a euphoric and intoxicating effect on the user.
Marijuana’s recreational, as well as medicinal use, continues to gain widespread and legal support in the United States. The substance has also been proposed as a potential treatment for hyperemesis gravidarum.
A 2014 study, which was conducted by researchers from the Hawai’i State Department of Health in Honolulu, HI, found that women who reported marijuana use during pregnancy were more likely to report experiencing severe nausea and vomiting compared with those not experiencing these severe symptoms(8).
In the journal Complementary Therapies in Clinical Practice, a 2006 survey of medicinal cannabis use among childbearing women was presented. The survey assessed the patterns of cannabis use in pregnancy and efficacy against morning sickness(9).
Results of the above-mentioned survey revealed that 51% of the women using marijuana during their pregnancy reported using it for the relief of nausea and vomiting, and 92% of those women reported that marijuana was effective for those symptoms.
While the use of marijuana is being hailed on social media as a safe and effective treatment of nausea and vomiting of pregnancy (NVP), there are no known implications or recommendations at this time for its use during pregnancy. ACOG reiterated this fact in its Committee Opinion in 2015(10).
Interestingly, none of the states with legal medicinal marijuana laws list pregnancy as a contraindication for recommending or dispensing medicinal marijuana.
Marijuana Use and Pregnancy: What Research Says
CBD is different from marijuana, but when dealing with morning sickness, both are not recommended by experts.
In a clinical report published in the American Academy of Pediatrics (AAP) journal, researchers provided data on the prevalence of marijuana use among pregnant and lactating women. Several state-specific surveys revealed that the rate of marijuana use among pregnant women is on the rise, and the results elicit serious concerns(11).
The Centers for Disease Control and Prevention (CDC) says that women who are pregnant or thinking of getting pregnant should avoid cannabis use. The agency says that chemicals in marijuana, specifically tetrahydrocannabinol (THC), cause many health complications in newborn babies, including still or low birth weight.
CDC cited several research and studies that reiterate how marijuana passes through one’s system and harm the baby’s development.
The research was conducted in 2011 by doctors from the Cain Foundation Laboratories, Jan & Dan Duncan Neurological Research Institute at Texas Children’s Hospital. They examined the lasting impacts of prenatal cannabis exposure (PME) demonstrates that prenatally cannabis-exposed children exhibit cognitive deficits, which implies that maternal cannabis consumption has hindered the proper maturation of the baby’s brain(12).
In another 21011 study on PME, with data collected between 1982 and 1985, researchers found a relationship between PME and delinquent behavior(13). The results were published in the Neurotoxicology and Teratology Journal.
The researchers concluded that an intervention to stop marijuana use during pregnancy would decrease the rates of delinquency in the offspring and may help children with high levels of depressive symptoms or attention deficits.
Pediatric Research published a 2012 study that examined the association between cannabis use before and during pregnancy and birth outcomes. Results showed that cannabis use in pregnancy was associated with low birth weight, preterm labor, admission to the neonatal intensive care unit, and small for gestational age(14).
—Nathaniel G. DeNicola, MD, MSc, University of Pennsylvania Social Media & Health Innovation Lab
The American College of Obstetrics and Gynecologists (ACOG) also recommends that marijuana use should be avoided during pregnancy, claiming that THC can pass through the placenta, causing developmental problems. THC permeates quickly into the placenta, blood, liver, brain, and breast milk and also clears quickly from these tissues.
Nathaniel G. DeNicola, MD, MSc of the University of Pennsylvania Social Media and Health Innovation Lab, said that marijuana is on a similar level as smoking or alcohol use during pregnancy.
He explained further that there is no recommended safe amount of tobacco or alcohol during pregnancy, and there is also no recommended safe level of marijuana when pregnant.
According to DeNicol, there is some evidence of decreased fetal growth, low IQ scores, attention problems, and reduced cognitive function in children exposed to marijuana in utero.
U.S. Surgeon General Jerome Adams, M.D., M.P.H., delivered an advisory on the health risks related to marijuana use in adolescence and during pregnancy.
He urged physicians and health care professionals to educate the youth and pregnant women about the potential dangers of marijuana on the developing brains of infants and adolescents.
—U.S. Surgeon General Jerome Adams, M.D., M.P.H.
Dr. James Lozada, an OB/GYN anesthesiologist at Northwestern University, believes that CBD interacts with cannabinoid receptors differently from THC.
Dr. Lozada is concerned because the said receptors impact neonatal fetal brain development. Thus, he cautions women to take a safe approach by entirely avoiding CBD use.
The same sentiments are held by Dr. Talitha Bruney, medical director for the Comprehensive Family Care Center, Department of Obstetrics & Gynecology and Women’s Health at Montefiore Health System. She is worried about the unregulated nature of the CBD oil industry, saying that there are no consistent formulations of CBD oil, as well as no firm guidelines on the delivery form and recommended dosage.
In BMC Pharmacology and Toxicology Journal, a 2016 study on mice shows that THC inhibits the development of embryonic cells. While cannabis exposure in utero has been connected to early pregnancy failure, congenital abnormalities, and developmental delay, the mechanisms of such outcomes are mostly unexplained(15).
Researchers of the above-mentioned study also found that anandamide hinders the development of embryo cells.
Anandamide, a fatty acid neurotransmitter, plays an essential role in the endocannabinoid system. In the body, it performs similarly to the cannabinoids, activating the endocannabinoid system so it can maintain homeostasis. Anandamide is vital in thought processes, memory, and control of movement.
A 2017 review by Eugene Scharf of the Department of Neurology in Mayo Clinic in Rochester, Minnesota, showed that CBD increases anandamide levels(16).
Some Exceptions: CBD Oil on a Positive Perspective
Given the warnings from reputable organizations, along with results from studies that suggest adverse prenatal and neonatal outcomes linked to marijuana use during pregnancy, one may be inclined to conclude that any CBD oil product containing a significant amount of THC is unsafe for pregnancy.
However, as the existing body of research is limited, the question of whether CBD oil use for pregnancy is safe or not may be subject to debate for most people.
In a study published in the journal Obstetrics & Gynecology in 2016, scientists found that using CBD-rich cannabis to cure acute and chronic symptoms during pregnancy did not result in significant adverse neonatal outcomes unless there were other risk factors such as cigarette smoking(17).
Researchers believe that the association between maternal marijuana use and adverse outcomes are due to related tobacco use, indicating that CBD oil and marijuana use cannot be blamed solely for any unfavorable pregnancy consequences.
Medical researcher and Medical Marijuana, Inc. president Dr. Stuart Titus, Ph.D., explained the science behind CBD’s benefits and the body’s cannabinoid system.
According to Dr. Titus, CBD helps with the development of healthy brain cells. He also confirms that he has seen pregnant mothers thrive on CBD-rich diets and give birth to healthy babies.
The leading researcher also added that physicians and obstetrician-gynecologists (OB-GYNs) do not recommend CBD oil use during pregnancy due to a lack of conclusive, longitudinal human studies on the subject.
Given that long-term studies and extensive research on the effects of CBD oil use on the fetus are not currently available, experts advise pregnant women to consult with their doctors before using CBD during their pregnancy.
Morning Sickness Remedies
Morning sickness can be debilitating, and frequent vomiting can lead to dehydration, which is dangerous for both the mother and baby. Most pregnant mothers are not too keen on taking pharmaceuticals that may cause adverse side effects.
Experts advise women looking to relieve morning sickness to try the following lifestyle and home remedies.
- Carefully select foods. Choose foods that are easy to digest, rich in protein, and low in fat.
Avoid foods that are seasoned with too much spice or cooked in too much oil. Bland foods like rice, bananas, applesauce, and toast are good options, and they are easy to digest.
Salty foods, as well as foods that contain ginger, are sometimes helpful.
- Snack frequently. An empty stomach can make nausea worse. Nibbling on small quantities of food throughout the day, rather than eating three large meals can help prevent nausea.
- Increase fluid intake. Sip water or ginger ale, and aim for at least six cups of non-caffeinated beverages daily.
- Avoid nausea triggers. One should keep away from foods or smells that seem to make nausea worse. Breathe fresh air as much as possible.
- Take prenatal vitamins with caution. Taking the vitamins with a light snack or before bed may help one to avoid feeling nauseous.
Alternative Medicine for Morning Sickness
Several alternative remedies have been suggested for morning sickness, including:
- Acupressure. Results of a 1994 study, which was published by the National Institutes of Health, indicate that acupressure at the PC-6 anatomical site is effective in reducing the symptoms of nausea but not the frequency of vomiting in pregnant women(18).
Acupressure wristbands may be purchased without a prescription in most pharmacies. Makers of wristbands say the products work to relieve nausea by applying pressure to the point on the inside of the wrist, stimulating the nerves and sending interfering signals to the brain that may disrupt the nausea signals.
Reviews on acupressure wristbands have had mixed results, but some women seem to find the wristbands helpful.
- Acupuncture. In a 1997 review published by the National Institutes of Health, researchers found clear evidence that needle acupuncture is effective for adult post-operation and chemotherapy-induced nausea and vomiting, and probably for the nausea of pregnancy(19).
- Ginger. Ginger supplements may help alleviate morning sickness for some women. Research led by Mengjian Ding from the School of Nursing and Midwifery at the University of Queensland in Australia in 2013 suggests that ginger is a safe and effective treatment for pregnancy-induced nausea and vomiting (PNV)(20).
- Hypnosis. A 2015 study published in the Journal of the Advanced Practitioner in Oncology examined the use of hypnosis for the management of anticipatory nausea and vomiting (ANV)(21). Results show that the safety and efficacy of hypnosis are well established.
- Aromatherapy. Although there is limited research on the topic, certain scents, using essential oils (aromatherapy), can help some women deal with morning sickness
Results of a 2014 review published in the Iranian Red Crescent Medical Journal suggest that lemon scent can be useful in reducing nausea and vomiting of pregnancy(22).
Moderate to severe NVP may lead to dehydration and an imbalance of electrolytes, such as sodium or potassium, putting the health of both mother and baby at risk.
A consultation with a doctor, such as an OB-GYN, is one’s best course of action when dealing with nausea. Doctors can recommend a safe option based on the severity of one’s symptoms.
The American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the Centers for Disease Control and Prevention (CDC), the U.S. Surgeon General, the U.S. Food and Drug Administration (FDA) strongly advise pregnant women and breastfeeding mothers to avoid marijuana altogether.
Experts do not consider CBD oil safe for use during pregnancy, as CBD products may still contain trace amounts of THC.
There are not enough studies on the use of CBD during pregnancy. Its effects on mothers and babies are still unknown.
Thus, most health professionals recommend that pregnant women, breastfeeding mothers, and those contemplating pregnancy not to use CBD.
Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011;163(7):1411–1422. doi:10.1111/j.1476-5381.2010.01176.x
Josephine Djulus, MD, Myla Moretti, MSC, and Gideon Koren, MD, FRCPC. Marijuana use and breastfeeding. Can Fam Physician. 2005 Mar 10; 51(3): 349–350.
Sheryl A. Ryan, Seth D. Ammerman, Mary E. O’Connor. Marijuana Use During Pregnancy and Breastfeeding: Implications for Neonatal and Childhood Outcome. Pediatrics September 2018, 142 (3) e20181889; DOI: https://doi.org/10.1542/peds.2018-1889.
Expert Committee on Drug Dependence. (2018). Cannabidiol (CBD). Retrieved from https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf.
Parker et al. op cit.
Sharkey KA, Darmani NA, Parker LA. Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system. Eur J Pharmacol. 2014;722:134–146. doi:10.1016/j.ejphar.2013.09.068.
Roberson EK, Patrick WK, Hurwitz EL. Marijuana use and maternal experiences of severe nausea during pregnancy in Hawai’i. Hawaii J Med Public Health. 2014;73(9):283–287.
Westfall RE, Janssen PA, Lucas P, Capler R. Survey of medicinal cannabis use among childbearing women: patterns of its use in pregnancy and retroactive self-assessment of its efficacy against ‘morning sickness’. Complement Ther Clin Pract. 2006 Feb;12(1):27-33. Epub 2005 Dec 22. DOI: 10.1016/j.ctcp.2005.09.006.
Committee on Obstetric Practice. Committee opinion no. 722: Marijuana use during pregnancy and lactation. Obstet Gynecol. 2017;130(4):e205–e209.
Sheryl A. Ryan et al. op cit.
Wu CS, Jew CP, Lu HC. Lasting impacts of prenatal cannabis exposure and the role of endogenous cannabinoids in the developing brain. Future Neurol. 2011;6(4):459–480. doi:10.2217/fnl.11.27.
Day NL, Leech SL, Goldschmidt L. The effects of prenatal marijuana exposure on delinquent behaviors are mediated by measures of neurocognitive functioning. Neurotoxicol Teratol. 2011;33(1):129–136. doi:10.1016/j.ntt.2010.07.006.
Hayatbakhsh MR, Flenady VJ, […], and Najman JM. Birth outcomes associated with cannabis use before and during pregnancy. Pediatr Res. 2012 Feb;71(2):215-9. doi: 10.1038/pr.2011.25. Epub 2011 Dec 21.
Friedrich J, Khatib D, Parsa K, Santopietro A, Gallicano GI. The grass isn’t always greener: The effects of cannabis on embryological development. BMC Pharmacol Toxicol. 2016;17(1):45. Published 2016 Sep 29. doi:10.1186/s40360-016-0085-6.
Scharf EL. Translating Endocannabinoid Biology into Clinical Practice: Cannabidiol for Stroke Prevention. Cannabis Cannabinoid Res. 2017;2(1):259–264. Published 2017 Oct 1. doi:10.1089/can.2017.0033.
Conner SN, Bedell V, […], and Tuuli MG. Maternal Marijuana Use and Adverse Neonatal Outcomes: A Systematic Review and Meta-analysis. Obstet Gynecol. 2016 Oct;128(4):713-23. doi: 10.1097/AOG.0000000000001649.
Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol. 1994 Aug;84(2):245-8.
Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; month, day]; 15(5):1-34.
Ding M, Leach M, Bradley H. The effectiveness and safety of ginger for pregnancy-induced nausea and vomiting: a systematic review. Women Birth. 2013 Mar;26(1):e26-30. doi: 10.1016/j.wombi.2012.08.001. Epub 2012 Aug 28.
Kravits KG. Hypnosis for the Management of Anticipatory Nausea and Vomiting. J Adv Pract Oncol. 2015;6(3):225–229. doi:10.6004/jadpro.2015.6.3.4.
Yavari Kia P, Safajou F, Shahnazi M, Nazemiyeh H. The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: a double-blinded, randomized, controlled clinical trial. Iran Red Crescent Med J. 2014 Mar;16(3):e14360. doi: 10.5812/ircmj.14360. Epub 2014 Mar 5.
Foods That Can Alleviate Morning Sickness
The food choices a woman makes during her pregnancy can go a long way toward combating the effects of nausea. Some foods that pregnant women should eat to avoid nausea during their pregnancies include:
- Apples: By eating apples, pregnant women add more fiber into their diet, which can soothe the stomach and alleviate other problems, such as constipation or diarrhea. The best way to eat apples for nausea relief is raw or unsweetened since sugars can increase nausea.
- Ginger: This cure-all has been used for thousands of years to battle stomach ailments, especially nausea and vomiting. It can be eaten with meals, digested as a tea, or even sucked on as a ginger lozenge.
- Nuts: When pregnancy nausea takes over, it can make eating enough protein difficult. However, nuts are a safe way to help increase a woman’s protein without adding anything harsh into their digestive system. Nuts are best eaten raw or lightly cooked, ideally without any salt or sweetener added.
- Electrolyte Drinks: Having small drinks of electrolyte drinks, such as sports drinks, can help stave off dehydration. The goal is only to have a sip or two every few minutes. It is often enough to keep a pregnant woman from experiencing dehydration. A caution when drinking sports drinks: if a pregnant woman is throwing up, a sports drink increases the acid in her mouth. It could lead to oral health issues, making eating more difficult even when she is feeling better.
Medicines That Can Help with Morning Sickness
Doctors have many medicinal options when it comes to bypassing nausea and vomiting, whether it stems from morning sickness or another ailment. These types of medicines have been used for decades to help with problems stemming from issues such as chemo, the flu, and motion sickness. Common medications that can help alleviate the symptoms include:
- Zofran is commonly prescribed to help alleviate nausea and vomiting.
- Emetrol is an over-the-counter medication to alleviate nausea.
- Benadryl is available both over the counter and in the prescription form to help reduce nausea and help a pregnant woman sleep better during her discomfort.
- Gravol can alleviate nausea and vomiting for 12 hours instead of 4-6 like most other medications.
- Dramamine is available in over-the-counter strength and prescription form to bypass nausea most commonly associated with motion sickness.
- There are even some over-the-counter vitamins that can help reduce nausea, such as vitamin B6.