Pain management during pregnancy can be difficult. Some over the counter pain medications should be avoided during pregnancy, making it harder for pregnant women to find safe and reliable pain relief. In a search for more option’s some are turning to more natural products, such as cannabidiol, or CBD. But is this a safe option to use during pregnancy?
Traditional Pain Treatments and Pregnancy
Typically, when you think of over the counter (OTC) pain medications, you think of acetaminophen (aka Tylenol) or NSAIDs such as ibuprofen (aka Advil or Motrin) or naproxen (aka Aleve). Unfortunately, these drugs are harmful and not considered to be safe during pregnancy. OTC drug use should cease during pregnancy, and preferably they should be finished before the pregnancy begins, although this can be a challenge when the pregnancy is unplanned. Therefore, all NSAIDs should be avoided during pregnancy (including aspirin) leaving Tylenol as the other OTC option.
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Tylenol was the preferred drug of choice for OTC pain relief in pregnant women for many years before new evidence suggested the possible link between Tylenol use during pregnancy and ADHD (attention-deficit/hyperactivity disorder) and autism in children. Although the FDA is still investigating this risk, pregnant women do not want to risk their children’s health. It is essential to look at the labels of the OTC drugs you are buying because many everyday products for colds and sleep contain acetaminophen as well. Natural options like hot packs, cold packs, light massage, or physical therapy can help decrease pain or even avoid the use of pain medications altogether. However, sometimes these options are not enough, and stronger help is needed. Could something natural like CBD be the answer?
CBD and Pain Relief
When looking at how CBD works in the body, evidence shows that it can amplify the effects of endogenous opioid receptors, meaning the body may be able to achieve similar pain relief to lower doses of opioid medications prescribed for pain. A 2016 study showed how CBD was used to help with arthritis and inflammation of the joints. While conducting the research, they used a topical CBD gel on rats to see if it reduced inflammation and pain. The results showed that CBD decreased joint swelling and pain in a dose-dependent manner. Which means higher CBD dose’s lower the inflammation and swelling of joints which helps with pain management.
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CBD and Pregnancy
In general, CBD is thought to be safe with hardly any side effects. The World Health Organization (WHO) gave a statement regarding the safety of CBD. In June 2018, the WHO released their report saying that CBD is safe and non-habit forming, or non-addictive. After studying CBD use in both animals and humans, they concluded there are no safety concerns. There is no evidence of any public health or safety issues related to CBD use according to this report. Though, this did not specifically talk about pregnancy.
Overall, there is hardly any data on CBD and pregnancy. When looking at the prescribing information for Epidiolex, which is an FDA approved drug for rare forms of epilepsy that contain CBD. There are only animal-based studies. They state that administration of CBD to pregnant animals produced evidence of developmental toxicity, such as decreased fetal body weight and increased embryofetal mortality. However, these effects were noted at extremely high doses (125 mg – 250 mg/kg daily). To put that into perspective, a 110-pound woman would need to take 6250 mg per day to be at a dose of 125mg/kg. Of note, the recommended dose of Epidiolex is 5-20 mg/kg so these doses are higher than what people usually take with CBD.
Preclinical studies suggested that CBD may impact the permeability of placenta in pregnant women, meaning CBD might cause drugs or toxins enter the placenta easier and affect the fetus. Another study demonstrated how CBD might reduce contractions during labor, but overall studies are lacking conclusive evidence to say whether CBD will affect pregnancy in humans.
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What Does This Mean?
Although as of now there are no severe effects observed in humans from taking CBD while pregnant, there is still a lot that is unknown. Animal studies have shown at higher doses CBD may be harmful in pregnancy. Therefore that may translate the same in humans, but the study was conducted with extremely high doses. In theory, if pregnant women were to take low doses of the oils/tinctures, it would not produce these effects. They could also use topical products such as balms or lotions, which do not get absorbed into the bloodstream as much as the tinctures would and apply them wherever they have pain. Other advice would be to look for CBD products that have 0% THC in them, especially since the risks of THC in pregnancy is controversial. After searching through all the limited data, it is probably best to stick with the non-drug pain relief options such as hot and cold packs, massage, or physical therapy. If the pain is still bothering you, then talk with your healthcare professional for the best pain relief option for you.
Overall, there is always a risk when taking any medications or supplements while pregnant. It is always best practice to talk with your healthcare professional before starting any new medications or supplements, especially while pregnant. They will be able to take into account all other medications you might be taking and discuss the risks and benefits of using them while pregnant.