Obtaining a medical cannabis card, which legally permits a patient to purchase and use cannabis for therapeutic purposes, becomes significantly more complicated during pregnancy. Whether a pregnant person can get a medical card depends entirely on the state’s specific laws and the individual’s medical circumstances. This unique situation introduces a conflict between a state’s legal framework for medical cannabis access and widely accepted medical safety guidelines for prenatal care. The application process, which typically requires proof of residency and a certifying physician’s recommendation, is overlaid with serious health considerations and potential post-natal legal risks.
State Laws Governing Medical Card Eligibility During Pregnancy
State laws regarding medical cannabis are diverse, creating a patchwork of eligibility rules across the country. In most states, the basic requirements for a medical card—such as being a resident and having a physician certify a debilitating condition—remain in place regardless of pregnancy.
Some states do not have explicit language either permitting or prohibiting a pregnant individual from applying, meaning the decision rests heavily on the discretion of the certifying physician. The physician must determine if the patient has a qualifying condition, like severe, persistent nausea or chronic pain, which might otherwise be a basis for certification.
A few states have specified that persistent nausea is a qualifying condition, but they often explicitly exclude nausea caused by pregnancy, effectively disqualifying many pregnant applicants seeking relief for morning sickness. Conversely, in a state like Pennsylvania, a pregnant woman may obtain a card if she has a qualifying condition and a registered provider certifies the need. The legal gateway often depends on whether a state’s definition of a “qualifying condition” is broad enough to include pregnancy-related symptoms or a pre-existing condition.
Medical Consensus on Prenatal Cannabis Use
The medical community is unified in advising against the use of cannabis during pregnancy and lactation due to concerns about fetal health and a lack of safety data. Major professional organizations, including the American College of Obstetricians and Gynecologists (ACOG), strongly recommend that individuals abstain from cannabis use while trying to conceive, throughout pregnancy, and while breastfeeding. This consensus is based on evidence indicating that the active component, delta-9-tetrahydrocannabinol (THC), crosses the placenta and is transferred to the developing fetus.
THC exposure during the prenatal period has been linked to several adverse outcomes, including an increased risk of low birth weight and spontaneous preterm birth. The developing fetal brain is particularly vulnerable to the effects of THC, which can interfere with neurodevelopment. Long-term studies suggest potential issues such as neurocognitive challenges, developmental delays, and behavioral problems in children prenatally exposed to cannabis.
Because cannabis products are not regulated by the Food and Drug Administration, their purity and potency are inconsistent, raising concerns about potential contaminants. For conditions like severe morning sickness, ACOG advises healthcare professionals to counsel patients on safer, non-cannabis alternatives for symptom relief. Physicians are encouraged to screen all patients for cannabis use and advise cessation, even if the patient is using it for a state-legal medical purpose.
Post-Natal Legal Consequences and Child Welfare
Even when a medical card is legally obtained during pregnancy, its use creates significant post-natal legal risks because of state child welfare laws. Many state hospitals have policies to test newborns or new mothers for the presence of illicit substances, and a positive result for THC metabolites can trigger a mandated report to Child Protective Services (CPS). This reporting obligation exists because, under federal law, cannabis is still classified as an illegal substance, and many state CPS agencies treat any drug exposure in a newborn as potential child neglect or endangerment.
CPS involvement means a formal investigation into the home environment and parental fitness will be opened. The investigation’s outcome varies widely by state. Some states have laws that prohibit removing a child based solely on a positive marijuana test, requiring evidence that the parent’s use causes significant impairment to the child’s well-being. However, the medical card itself does not provide blanket immunity from a child welfare investigation, as the focus shifts from the legality of possession to the safety of the child. Parents may face home visits, mandatory drug testing, parenting classes, or temporary loss of custody until the agency determines the child is safe.