ACOG Recommends Universal Cannabis Screening During Pregnancy, Advises Abstinence Amid Rising Use

The American College of Obstetricians and Gynecologists (ACOG) has issued new clinical guidelines recommending universal screening for cannabis use among people who are pregnant, planning pregnancy, or breastfeeding. This guidance urges complete abstinence from cannabis during pregnancy and lactation due to studies linking its use to adverse outcomes such as preterm birth, low birth weight, neonatal intensive care needs, and potential neurocognitive and behavioral issues in children. Despite increasing legalization and social acceptance, cannabis exposure during pregnancy poses risks because THC crosses the placenta and passes into breast milk. ACOG emphasizes that screenings should be conducted through interviews or self-assessments in a nonjudgmental manner to prevent racial disparities and encourage open dialogue. The guidance also highlights that many patients perceive cannabis as a natural remedy for pregnancy symptoms or medical conditions, underscoring the need for education and alternative treatments. Given the rise in cannabis use among reproductive-aged individuals, the organization stresses the importance of these conversations to minimize risks and support maternal and child health.