USA Today International - 22.08.2019

sharp increase in the number of preg-
nant women smoking pot and an alarm-
ing link between cannabis use and pre-
term births, defined as 37 weeks or ear-
lier. Canadian researchers compared
the outcomes of birth by 5,639 mothers
who reported cannabis use during preg-
nancy with 92,873 mothers who said
they didn’t use it.
The authors concluded marijuana is
“likely unsafe” because preterm births
were twice as common in marijuana us-
ers vs. non-users (12% vs. 6.1%). That’s
despite finding a positive effect be-
tween marijuana use and lower inci-
dences of preeclampsia – a dangerous
condition that includes high blood pres-
sure – and gestational diabetes.
There are a lot more skeptical women
to convince, however.
Between 2002 and 2017, pregnant
women who used marijuana in the pre-
vious month increased from 3.4% to 7%
overall and from nearly 6% to just over
12% during the first trimester, according
to federal data published in the Journal
of the American Medical Association.
There are more than 16,000 members of
the group “Ganja Mamas” on the What
to Expect website.
Dr. Emily Dossett, a psychiatrist and
professor at the University of Southern
California’s medical school, now heads
Women’s Health and Reproductive Psy-
chiatry for Los Angeles County’s De-
partment of Mental Health. She also
works at the USC Medical Center, where
an increasing percentage of her patients
smoke marijuana during pregnancy.
She has had patients who were on
medication for depression and anxiety
or even prescriptions for epilepsy who
stopped taking them for the “more natu-
ral choice” of marijuana, despite the
lack of knowledge about exactly what’s
in even medical marijuana.
“We don’t have any evidence it is
safe, but many women at this point
don’t even question it as a potential
problem,” Dossett says. “It is often
coupled is a distrust of the medical sys-
tem and particularly medications for
mental illness.”

Mixed messages

Doctors are especially worried be-
cause THC – tetrahydrocannabinol, the
ingredient in marijuana that gets people
high – crosses the placenta. That means
babies’ brains could be being altered,
says Dr. Cynthia Rogers, director of the
Perinatal Behavioral Health Service at
Washington University in St. Louis.
The parts of the brain exposed are in-
volved in emotion processing and exec-
utive functioning, Rogers says. Recent
studies looking at older children related
behavioral problems to exposure to

marijuana in utero, she says.

Yet even doctors who support med-

ical marijuana say medical profession-

als aren’t warning women enough. They

say there is misinformation and an

overall lack of information on using can-

nabis products during pregnancy. Med-

ical marijuana is now legal in 33 states.

A National Institutes of Health study

out in June 2018 that included more

than 400 Colorado dispensaries found

nearly 70% recommended treatment of

morning sickness with cannabis.

“Women aren’t getting a consistent

message,” says Dr. Jordan Tishler, presi-

dent of the Association of Cannabis

Specialists and an advocate for legaliz-

ing medical marijuana.

Tishler, an emergency physician who

teaches at Harvard Medical School, says

marijuana dispensaries push their

products for all sorts of ailments, in-

cluding nausea caused by morning sick-

ness. “There’s an industry out there that

wants to sell a lot of marijuana-based

products regardless of whether it’s safe

or good for anybody,” Tishler says.

In the NIH study, officials called dis-

pensaries and told them that they were

pregnant and suffering from extreme

nausea. Transcriptions of phone con-

versations were recorded. In one case, a

dispensary employee told a woman,

“Edibles wouldn’t hurt the child, they’d

be going through your (digestive) tract.”

Dispensary employees also some-

times told women to consult with their

health care provider, but few did so

without being prompted. The study also

found 36% of recommendations said

cannabis use is safe during pregnancy.

Carmen, who is four months’ preg-

nant in Georgia, had to be hospitalized

to treat nausea during her first preg-

nancy six years ago. She decided to

use marijuana during her pregnancy

now because she’s afraid about phar-

maceutical side effects and also doesn’t

want to be hospitalized again. USA

TODAY is not using Carmen’s last name

or hometown because marijuana isn’t

legal in Georgia.

Carmen had to triple the dose of the

prescription drug Zofran during her first

pregnancy to relieve her extreme symp-

toms. She was so nauseous that she

couldn’t consume food for long periods

of time.

“Using marijuana was more effective

than taking multiple pills,” she says.

Carmen says she researched side ef-

fects of marijuana on the fetus when fig-

uring out whether to use cannabis dur-

ing pregnancy. But she says the studies

she saw covered both smoking marijua-

na and smoking cigarettes, without dif-

ferentiating. She says that because mar-

ijuana is more natural than the tobacco

products in cigarettes, she didn’t know

how to interpret the studies.

What especially worried Carmen

were reports about birth defects in ba-

bies whose mothers had taken Zofran,

the brand name for odansetron. But Sa-

mantha Parker, assistant professor epi-

demiology at Boston University and

lead author of a study on odansetron,

“this is a relatively safe medication for

treatment of nausea and vomiting dur-

ing pregnancy.”

In fact, HHS’ Gandotra says ondan-

setron and Phenergan, the branded ver-

sion of promethazine, are his top

choices for nausea in pregnant women.

The others are diphenhydramine and

metoclopramide.

Up to 13% of pregnant women with

nausea and vomiting take Zofran, Park-

er says.

There is more data on the possible

effects of prescription drugs on fetuses

compared with effects from cannabis,

even though doing actual studies on

pregnant women raises ethical con-

cerns.

HHS’ National Institute for Drug

Abuse has awarded grants to four uni-

versities, including the University of

Washington, to study pregnant women

who smoked marijuana during preg-

nancy with other pregnant women who

didn’t.

‘I don’t want us to cry wolf’

Pamela McColl, a Canadian child

rights activist, is working with an inter-

national group of physicians and the ad-

vocacy group Smart Approaches to

Marijuana to stop the research because

something that puts babies at risk

shouldn’t be done unless it’s a medical

necessity. She also says the researchers

have a responsibility to report the very

women they are studying under manda-

tory reporting laws.

“We have enough science to go out

there with public health messages that

pregnant women should not touch mar-

ijuana,” says McColl, citing research in-

cluding a May study of 12 million births

that was published in the Journal of Ob-

stetrics and Gynecology Canada.

Tricia Wright, a Hawaii doctor who

runs a research center for pregnant

women struggling with substance ad-

diction, says patients tell her their doc-

tors haven’t told them cannabis use dur-

ing pregnancy isn’t safe.

National Institute for Drug Abuse

Director Nora Volkow says marijuana

during pregnancy “is not worth the risk”

but defended the agency’s research

funding because “I don’t want us to cry

wolf.”

With mixed messaging on marijuana,

pregnant women in need of relief are

not able to make fully informed deci-

sions, physicians say.

“I don’t think any woman goes into

pregnancy wanting to hurt her child, so

if she’s using it it’s either because she

doesn’t understand the science or

hasn’t heard the science,” Wright says.

Rogers stressed that women experi-

encing side effects of pregnancy need to

speak with an obstetrician.

Many, however, are reticent about

speaking to their doctors about marijua-

na use. Online pregnancy groups are

filled with women worried about what

will happen if they test positive for pot.

Claire Alcindor says that’s one of the

reasons she is so skeptical about the re-

search on marijuana – there’s a far larg-

er universe of babies she believes are

unaffected by the exposure and not con-

sidered because their mothers didn’t

speak up.

Alcindor, whose content creation

firm is called Big Black Brands, is also

the owner of Zarico herbal skin care

products, which include postpartum

baths. She has about 10,000 followers

on Facebook, where “I always share my

story” of her natural lifestyle, including

home births.

“I did a ton of research” on marijuana,

Alcindor says. “It was my first pregnan-

cy where i was exploring marijuana, and

I never read anything about it being

harmful to the fetus. The moms were a

lot more calm, able to eat, able to be hap-

pier.”

Alcindor may not be convinced, but

Gandotra says she should be.

“I’m worried about this from a public

health standpoint that we are allowing

our better judgment to be swayed and,

most importantly, we are not fully rea-

lizing the risks and we won’t see the full

impact until a generation later.”

If you or your family members are

struggling with issues mentioned in this

story and you would like to connect with

others online, join USA TODAY’s “I Sur-

vived It” Facebook support group.

Get treatment options on SAMHSA’s

website or by calling its national

helpline at 1-800-662-HELP (4357) any-

time for referrals and information in

English and Spanish.

Pregnancy

Continued from Page 1A

“I needed to eat. I needed to stay alive

and survive this pregnancy,” says Claire

Alcindor, with her baby, Clarity. She

says smoking pot was the only way she

could keep food down. JORDAN PARKS

The family of Eric Garner vowed
Tuesday to continue its fight for justice,
and the New York City police officer
fired for placing Garner in a chokehold
said he would appeal the department’s
decision.
NYPD Commissioner James O’Neill
announced Monday, five years after the
incident that led to Garner’s death, that
officer Daniel Pantaleo would be dis-
missed.
Garner died after being subdued by
Pantaleo outside a Staten Island conve-
nience store. Garner repeatedly shout-
ed, “I can’t breathe,” which became a
rallying cry for the Black Lives Matter
movement.
Garner’s son, Eric Jr., told NY1 Tues-
day morning he wants to see Pantaleo in
jail.
“It had been a long five years, and
we’re still gonna fight,” he said. Garner
Jr. said it was a “relief ” when he heard
O’Neill’s decision.
“What Commissioner O’Neill did was
what every public official should do in
his situation,” Garner family attorney
Jonathan Moore said on the news pro-
gram.
Moore said the family would turn to
advocating for a state law to make
chokeholds illegal and calling for ad-
ministrative reviews within the police
department for the other officers in-
volved in the case.
“Their role in this should still be ex-
amined from a disciplinary standpoint,”
he said.
The calls echo those of Garner’s

daughter, Emerald Snipes Garner, on

Monday. Snipes Garner praised the de-

cision to fire Pantaleo but said more

needs to be done to hold other officers

accountable in the case and improve

policing practices.

“I should not be here standing with

my brother, fatherless,” Snipes Garner

said. She thanked O’Neill for “doing the

right thing” but said Pantaleo should

have been fired five years ago. Snipes

Garner said she wants congressional

hearings and will continue to push to

have a criminal case reopened.

Pantaleo was never charged, but

Snipes Garner said she believes some

officers lied to a state grand jury and

provided conflicting accounts about

what happened the day her father died.

Garner, 43, was accused of illegally

selling single cigarettes outside the con-

venience store when officers attempted

to arrest him in a struggle captured on

video.

Garner gasped repeatedly that he

could not breathe after Pantaleo and

other officers knocked him to the

ground. Garner’s death was ruled a

homicide, and an autopsy report said

the chokehold was in part what caused

his death.

O’Neill said Pantaleo was correct

when he initially used the chokehold,

but when Garner was under control, he

should have switched to a “less lethal”

alternative. He said that “had I been in

officer Pantaleo’s situation, I may have

made similar mistakes.”

Pantaleo will not receive a pension as

a result of the decision, though he will

be repaid what he put into the fund.

Stuart London, the former officer’s

lawyer, said Monday that he expects to

appeal the decision and go to court for

Pantaleo’s job.

Pantaleo had been on desk duty

when a departmental trial judge

recommended this month that the 13-

year department veteran be fired.

Contributing: John Bacon and The

Associated Press

Garner’s son expresses ‘relief,’ but fight goes on

Cop accused of chokehold

to appeal firing from NYPD

Ryan W. Miller
USA TODAY

“You may have lost your job, but I lost

a son,” Gwen Carr, mother of Eric

Garner, said after NYPD Commissioner

James O’Neill announced his decision

to fire officer Daniel Pantaleo. AP

NEWS USA TODAY ❚THURSDAY, AUGUST 22, 2019❚ 3A