A new public messaging effort has taken aim at legal cannabis in Ohio, specifically targeting expectant mothers with warnings about the health risks of using the plant during pregnancy. Spearheaded by the OneOhio Recovery Foundation, the initiative represents the first phase of a broader $20 million public education campaign where $250,000 specifically will target mothers who use cannabis during pregnancy. While OneOhio frames their messaging around evidence-based guidance, a closer examination reveals a different narrative.
The Campaign Perspective and Official Justifications
The campaign maintains that their primary motivation is public safety, pointing to internal survey data indicating a rapid shift in public attitudes following legalization. Commissioned polling by OneOhio found that forty-one percent of Ohio adults report using cannabis, with over half of pregnant or prospective mothers reporting use or considering it for symptom relief. State health officials argue that because non-medical cannabis is now widely accessible, the state has a fundamental duty to intervene, clear up conflicting messaging surrounding maternal health, and encourage open dialogues between patients and OB-GYNs.
Leadership from both OneOhio and the Ohio Department of Health say that the campaign is designed as a compassionate prevention effort aimed at protecting infant developmental health rather than punishing mothers. But where the money came for this campaign should raise suspicions about its message. State leaders formed this private, non-profit organization as part of a legal settlement to oversee and distribute 55 percent of Ohio’s multibillion-dollar opioid settlement funds from the pharmaceutical industry.
The Opioid Settlement Paradox
The OneOhio Recovery Foundation specifically distributes hundreds of millions of dollars in settlement funds paid out by major pharmaceutical companies for their direct role in fueling the national opioid epidemic. Millions of dollars paid out as penance for a deadly, mass-marketed prescription drug crisis are now being repurposed alongside state budget appropriations to run public relations campaigns targeting cannabis–a state-legal, plant-based alternative.
While tasked with a public health mission and bankrolled by public funds, OneOhio’s unique setup allows it to operate much like a quasi-governmental shell organization—receiving tens of millions in state appropriations while bypassing the strict transparency and public oversight standards normally required of state agencies. Rather than directly expanding community treatment access, a massive share of these resources are being directed toward private advertising, polling firms, and consulting groups. As we reported in our last story on this topic, none of One Ohio’s board or members are in the cannabis industry or have any formal education about cannabis.
Scientific Flaws and Methodological Gaps
Beyond the financial mechanics lies a deeply flawed scientific premise. The campaign is setting out to correct misconceptions that legal cannabis products are safe or natural to use for morning sickness, anxiety, or sleeplessness during pregnancy. But there’s just not real evidence that their claim is true. Much of what public health campaigns cite as evidence regarding cannabis risks comes from observational data that fails to isolate crucial variables, or what they call “coorelation does not equal causation” in the research community.
The historical data that we have on pregnant women doesn’t isolate the specific types of cannabis they used, potency levels, methods of consumption, or dosage frequencies. Even more importantly, these studies fail to separate cannabis use from overlapping factors. Did they also use other drugs, smoke cigarettes or drink alcohol? Did they undergo severe stress, experience poverty, and have inadequate prenatal care? Because researchers cannot ethically conduct randomized controlled trials (RCTs) that assign pregnant women to consume cannabis, all human data remains observational, making it impossible to establish direct causation rather than mere correlation.
And perhaps most importantly of all: Because the plant was illegal at the time of these studies, there is no way to know whether the cannabis the women used in these studies contained other drugs.
Modern Research and Rebutting Early Data
Modern data since legalization paints a far more nuanced picture. Systematic reviews and large-scale data analyses, including landmark evaluations from the National Academies of Sciences, Engineering, and Medicine, indicate that early claims of catastrophic birth defects were heavily exaggerated by unmeasured lifestyle factors. This often cited research measured children of pregnant women who used cannabis, but they only studied children of a low socioeconomic level. When isolating cannabis use from socioeconomic hardship, tobacco and poor nutrition, the evidence linking cannabis to developmental damage drops significantly, undermining the warnings pushed by the generously state-funded “non-profit” OneOhio.
Science that Supports Cannabis Use in Pregnancy
One of the most famous long-term observational studies on prenatal cannabis was led by anthropologist Dr. Melanie Dreher and published in Pediatrics (1994). Dreher tracked pregnant women in rural Jamaica, where drinking cannabis tea was culturally integrated to treat morning sickness. The study evaluated infants at 3 days and 30 days after birth. Researchers found no statistical differences in physical development or birth weight between cannabis-exposed and unexposed infants. Notably, at 30 days, infants of heavy-cannabis-using mothers actually scored higher on tests evaluating reflex responses, autonomic stability, and social alertness, which researchers attributed partly to the strong social support structures and higher socioeconomic stability of those specific mothers.
Published in Obstetrics & Gynecology in 2016, another comprehensive systematic review analyzed data from 31 studies evaluating the link between maternal cannabis use and adverse birth outcomes (such as low birth weight and preterm birth). The data initially showed higher risks for low birth weight and premature delivery among cannabis users. However, when researchers adjusted the data specifically for tobacco use and other confounding variables, the increased risk of low birth weight, preterm birth, and small-for-gestational-age infants completely vanished. The authors concluded that early claims of harm were largely driven by tobacco co-use and socioeconomic factors rather than cannabis itself.
In late 2024, researchers with Kaiser Permanente Northern California published multiple large-scale population studies evaluating children exposed to cannabis in early pregnancy up through early childhood. The team tracked clinical diagnoses across thousands of pediatric records up to age 5 and age 11. The studies found no increased risk of speech or language disorders, motor delays, global developmental delays, autism spectrum disorder, or ADHD in children whose mothers used cannabis during early pregnancy compared to non-exposed peers.
The Pharmaceutical Double Standard and Western Medicine Alternatives
The scrutiny placed on cannabis during pregnancy also ignores a long historical record. For thousands of years across various cultures, women have safely relied on the plant to ease debilitating morning sickness, nausea, and loss of appetite during pregnancy.
In contrast, Western medicine relies on prescription pharmaceuticals to manage nausea and vomiting during pregnancy. These medications are far from risk-free. The primary FDA-approved treatment for morning sickness is Diclegis, a combination of doxylamine succinate and pyridoxine hydrochloride. While categorized as safe, its antihistamine component commonly causes heavy sedation and dizziness. Official prescribing guidelines explicitly warn mothers against breastfeeding while using it due to risks of infant irritability and respiratory complications.
When Diclegis fails, off-label prescriptions like Zofran (ondansetron) or Reglan (metoclopramide) are prescribed. Zofran carries documented risks of complications including sudden cardiac arrest and potential drug interactions that can lead to serotonin syndrome. Reglan carries an FDA black-box warning for tardive dyskinesia, a severe and sometimes irreversible movement disorder. Despite these known risks, modern pharmaceuticals are pushed, while natural alternatives face immediate vilification from health care providers since they “don’t know the risks.”
Institutional Interests and Financial Motives
The motivations behind weaponizing maternal health in this manner are deeply tied to institutional interests. As adult-use legalization spreads and consumers increasingly substitute synthetic prescription drugs with plant medicine, traditional healthcare systems and pharmaceutical-adjacent interests stand to lose big money.
Targeting pregnant women is a classic public relations tactic designed to generate emotional panic, re-stigmatize legal users, and justify expanding bureaucratic oversight. For quasi-governmental entities like One Ohio, manufacturing a new substance crisis is the easiest way to secure more multi-million-dollar state grants.
What Would Happen if I Use Cannabis While Pregnant in Ohio?
In Ohio, a woman cannot be criminally charged for “drug use during pregnancy” solely for testing positive for THC, nor is substance use during pregnancy legally categorized as criminal child abuse under state law. However, testing positive for THC while pregnant can trigger severe civil child welfare interventions and legal complexities depending on the specific circumstances.
Healthcare workers are not strictly mandated by Ohio law to report every instance of prenatal cannabis use. However, it is standard practice for hospitals to report a positive newborn or maternal toxicology screen to a Public Children Services Agency (PCSA) if they suspect a child may be born “at risk”. A report can trigger a child welfare investigation, an assessment of the home environment, and the implementation of a safety plan. A positive test alone does not mean a baby will automatically be removed from the home; there must be other indicators of potential neglect or inability to care for the infant.
Reclaiming Truth and Maternal Autonomy
Ohio women deserve compassionate, science-based, and non-judgmental reproductive care, not fear-based campaigns bankrolled by opioid settlement money. Whether you use cannabis or not while you’re pregnant, it should be your choice alone.
By exposing the financial interests behind the $250,000 OneOhio public health campaign intended to vilify cannabis for pregnant women, the team at MedicateOH hopes to help provide information rooted in genuine truth rather than corporate greed. MedicateOH nor this author receive any compensation for this article or our coverage on this topic.
Have an experience to share about using cannabis while pregnant? We’d love to hear about it. Email us to share your story.
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