Getting it Right from the Start
@getitrightonmj.bsky.social
Research, capacity building and advocacy to protect public health, youth and equity in cannabis policy. Website: www.gettingitrightfromthestart.org. Follow us on X too: @GetItRightonMJ
1/#rollcall: Congress moving to delay an important federal ban on #IntoxicatingHemp due these products being highly intoxicating, poorly regulated, misleadingly marketed, accessible to youth, & increasing poisonings/ER visits—all thanks to a 2018 farm bill loophole!
rollcall.com/2026/01/15/c...
rollcall.com/2026/01/15/c...
Comer wants spending bill to delay intoxicating hemp ban
Kentucky Republican hopes to win a two-year extension in spending legislation needed this month to head off a partial government shutdown.
rollcall.com
January 20, 2026 at 9:01 PM
1/#rollcall: Congress moving to delay an important federal ban on #IntoxicatingHemp due these products being highly intoxicating, poorly regulated, misleadingly marketed, accessible to youth, & increasing poisonings/ER visits—all thanks to a 2018 farm bill loophole!
rollcall.com/2026/01/15/c...
rollcall.com/2026/01/15/c...
Insightful op-ed by Susan Shapiro in @latimes.com: a reminder that legal doesn’t mean harmless.
Author connects rising #cannabis dependence to real health risks—& offers clear, compassionate guidance for recognizing a problem & getting help. #PublicHealth
Read more: bit.ly/49qDPx1
Author connects rising #cannabis dependence to real health risks—& offers clear, compassionate guidance for recognizing a problem & getting help. #PublicHealth
Read more: bit.ly/49qDPx1
Contributor: How I broke free of cannabis, and you can too
Pot is quickly becoming America's drug of choice, on track to replace alcohol, but its harms are becoming clear as well.
bit.ly
January 16, 2026 at 7:28 PM
Insightful op-ed by Susan Shapiro in @latimes.com: a reminder that legal doesn’t mean harmless.
Author connects rising #cannabis dependence to real health risks—& offers clear, compassionate guidance for recognizing a problem & getting help. #PublicHealth
Read more: bit.ly/49qDPx1
Author connects rising #cannabis dependence to real health risks—& offers clear, compassionate guidance for recognizing a problem & getting help. #PublicHealth
Read more: bit.ly/49qDPx1
1/New study of 160K U.S. teens by researchers at #Columbia published in @ameracadpeds.bsky.social's #Pediatrics finds that even #cannabis use 1-2x’s a month is linked to:
• more #depression & #anxiety
• worse school performance
• more impulsivity
Read article for more: bit.ly/4qN5zS9
• more #depression & #anxiety
• worse school performance
• more impulsivity
Read article for more: bit.ly/4qN5zS9
For Teens, Any Cannabis Use May Have Impact on Emotional Health, Academic Performance
Even occasional cannabis use is linked to worse school performance and emotional distress for teens, finds a new study led by Columbia University.
bit.ly
January 12, 2026 at 6:20 PM
1/New study of 160K U.S. teens by researchers at #Columbia published in @ameracadpeds.bsky.social's #Pediatrics finds that even #cannabis use 1-2x’s a month is linked to:
• more #depression & #anxiety
• worse school performance
• more impulsivity
Read article for more: bit.ly/4qN5zS9
• more #depression & #anxiety
• worse school performance
• more impulsivity
Read article for more: bit.ly/4qN5zS9
1/OpEd in @washingtonpost.com by #RANDCorporation’s @beaukilmer.bsky.social & #Standford’s #KeithHumphreys:
Legal #cannabis markets have surged — but regs haven’t kept up.
Today’s ultra-potent #THC (20%+ flower, 60–90% concentrates) means more impairment & risky driving.
bit.ly/49fAVto
Legal #cannabis markets have surged — but regs haven’t kept up.
Today’s ultra-potent #THC (20%+ flower, 60–90% concentrates) means more impairment & risky driving.
bit.ly/49fAVto
Opinion | States made marijuana use legal. Now they should get it off the road.
There’s no breathalyzer test for driving under the influence of cannabis. But there are other options.
bit.ly
December 30, 2025 at 5:48 PM
1/OpEd in @washingtonpost.com by #RANDCorporation’s @beaukilmer.bsky.social & #Standford’s #KeithHumphreys:
Legal #cannabis markets have surged — but regs haven’t kept up.
Today’s ultra-potent #THC (20%+ flower, 60–90% concentrates) means more impairment & risky driving.
bit.ly/49fAVto
Legal #cannabis markets have surged — but regs haven’t kept up.
Today’s ultra-potent #THC (20%+ flower, 60–90% concentrates) means more impairment & risky driving.
bit.ly/49fAVto
1/Must-read @nytimes.com opinion piece by
#AcademyHealth's @aaronecarroll.bsky.social: #Cannabis policy moved faster than the evidence—& today’s commercial market has outpaced our #PublicHealth response.
Question isn’t “legalize or not,” but whether we adjust to real harms.
Read: bit.ly/3Ya3IdX
#AcademyHealth's @aaronecarroll.bsky.social: #Cannabis policy moved faster than the evidence—& today’s commercial market has outpaced our #PublicHealth response.
Question isn’t “legalize or not,” but whether we adjust to real harms.
Read: bit.ly/3Ya3IdX
December 23, 2025 at 7:46 PM
1/Must-read @nytimes.com opinion piece by
#AcademyHealth's @aaronecarroll.bsky.social: #Cannabis policy moved faster than the evidence—& today’s commercial market has outpaced our #PublicHealth response.
Question isn’t “legalize or not,” but whether we adjust to real harms.
Read: bit.ly/3Ya3IdX
#AcademyHealth's @aaronecarroll.bsky.social: #Cannabis policy moved faster than the evidence—& today’s commercial market has outpaced our #PublicHealth response.
Question isn’t “legalize or not,” but whether we adjust to real harms.
Read: bit.ly/3Ya3IdX
1/Op-ed in @latimes.com by @rabcarian.bsky.social captures what many in #PublicHealth have been saying for years:
The #cannabis pendulum has swung from criminalization & #ReeferMadness to unchecked commercialization — & we must enact proper guardrails that put people over profits. bit.ly/4saUbkE
The #cannabis pendulum has swung from criminalization & #ReeferMadness to unchecked commercialization — & we must enact proper guardrails that put people over profits. bit.ly/4saUbkE
Column: Is the federal government finally transcending its 'Reefer Madness' view of cannabis?
Weirdly, Trump's executive order to reschedule cannabis coincides with an analysis casting doubt on whether pot actually helps with pain, insomnia and stress.
bit.ly
December 22, 2025 at 5:29 PM
1/Op-ed in @latimes.com by @rabcarian.bsky.social captures what many in #PublicHealth have been saying for years:
The #cannabis pendulum has swung from criminalization & #ReeferMadness to unchecked commercialization — & we must enact proper guardrails that put people over profits. bit.ly/4saUbkE
The #cannabis pendulum has swung from criminalization & #ReeferMadness to unchecked commercialization — & we must enact proper guardrails that put people over profits. bit.ly/4saUbkE
1/#Trump executive order on rescheduling #cannabis mistakenly treats all cannabis the same.
For example: High-potency flower, 90%+ #THC vapes, concentrates & high-dose edibles carry very different risks & have no proven medical use - so they don’t belong on Schedule III. #PublicHealth #Marijuana
For example: High-potency flower, 90%+ #THC vapes, concentrates & high-dose edibles carry very different risks & have no proven medical use - so they don’t belong on Schedule III. #PublicHealth #Marijuana
December 19, 2025 at 10:32 PM
1/#Trump executive order on rescheduling #cannabis mistakenly treats all cannabis the same.
For example: High-potency flower, 90%+ #THC vapes, concentrates & high-dose edibles carry very different risks & have no proven medical use - so they don’t belong on Schedule III. #PublicHealth #Marijuana
For example: High-potency flower, 90%+ #THC vapes, concentrates & high-dose edibles carry very different risks & have no proven medical use - so they don’t belong on Schedule III. #PublicHealth #Marijuana
1/#Kaiser study we co-authored in #JAMAOpenNetwork shows how inconsistent & inaccurate info about #cannabis use in pregnancy remains across CA retailers, including:
- 1 in 5 budtenders said it’s safe;
- Only 40% said it’s unsafe;
- <6% referenced the warning label
Read: bit.ly/496EkvK
- 1 in 5 budtenders said it’s safe;
- Only 40% said it’s unsafe;
- <6% referenced the warning label
Read: bit.ly/496EkvK
Study of cannabis retailers finds mixed advice on safety in pregnancy
Kaiser Permanente survey suggests employees are more focused on tobacco risks than those posed by cannabis.
bit.ly
December 11, 2025 at 7:53 PM
1/#Kaiser study we co-authored in #JAMAOpenNetwork shows how inconsistent & inaccurate info about #cannabis use in pregnancy remains across CA retailers, including:
- 1 in 5 budtenders said it’s safe;
- Only 40% said it’s unsafe;
- <6% referenced the warning label
Read: bit.ly/496EkvK
- 1 in 5 budtenders said it’s safe;
- Only 40% said it’s unsafe;
- <6% referenced the warning label
Read: bit.ly/496EkvK
1/@psypost.bsky.social article covers our recent study with @ucirvine.bsky.social & #Kaiser showing CA 11th graders are using #cannabis more often since retail legalization. Findings:
• 30% higher odds of frequent use
• Use rose most where storefronts opened
• Lowest use in cities banning all shops
• 30% higher odds of frequent use
• Use rose most where storefronts opened
• Lowest use in cities banning all shops
December 10, 2025 at 5:57 PM
1/@psypost.bsky.social article covers our recent study with @ucirvine.bsky.social & #Kaiser showing CA 11th graders are using #cannabis more often since retail legalization. Findings:
• 30% higher odds of frequent use
• Use rose most where storefronts opened
• Lowest use in cities banning all shops
• 30% higher odds of frequent use
• Use rose most where storefronts opened
• Lowest use in cities banning all shops
1/#CNN’s #SandeeLaMotte details disturbing trend: #cannabis hyperemesis syndrome (#CHS)—intense abdominal pain + uncontrollable vomiting—is rising sharply, especially among teens & daily users of ultra-high-#THC products.
ER visits among adolescents increased 10X’s betw 2016–23.
ER visits among adolescents increased 10X’s betw 2016–23.
December 5, 2025 at 2:14 AM
1/#CNN’s #SandeeLaMotte details disturbing trend: #cannabis hyperemesis syndrome (#CHS)—intense abdominal pain + uncontrollable vomiting—is rising sharply, especially among teens & daily users of ultra-high-#THC products.
ER visits among adolescents increased 10X’s betw 2016–23.
ER visits among adolescents increased 10X’s betw 2016–23.
1/Newsweek’s Jasmine Laws covers a major new review of 1K+ studies on #MedicalCannabis.
Key Takeaways:
• Evidence for many medical claims limited/insufficient
• Nearly 1/3 medical #cannabis users develop #CUD
• High-potency daily use = cardiovascular & health risks
Read: bit.ly/4pjY0lS
Key Takeaways:
• Evidence for many medical claims limited/insufficient
• Nearly 1/3 medical #cannabis users develop #CUD
• High-potency daily use = cardiovascular & health risks
Read: bit.ly/4pjY0lS
Does cannabis actually have medical benefits?
The review found that 27 percent of adults from the U.S. and Canada have used cannabis for medical purposes.
bit.ly
December 1, 2025 at 9:03 PM
1/Newsweek’s Jasmine Laws covers a major new review of 1K+ studies on #MedicalCannabis.
Key Takeaways:
• Evidence for many medical claims limited/insufficient
• Nearly 1/3 medical #cannabis users develop #CUD
• High-potency daily use = cardiovascular & health risks
Read: bit.ly/4pjY0lS
Key Takeaways:
• Evidence for many medical claims limited/insufficient
• Nearly 1/3 medical #cannabis users develop #CUD
• High-potency daily use = cardiovascular & health risks
Read: bit.ly/4pjY0lS
1/Associated Press's Leah Willingham takes a deep dive into an emerging reality: for many daily #Cannabis users, especially with today’s ultra-high-potency products, pot can shift slowly from relief to dependence.
Because legal is not the same as harmless
Read article: bit.ly/3JWUdeP
Because legal is not the same as harmless
Read article: bit.ly/3JWUdeP
They relied on marijuana to get through the day. But then days felt impossible without it
As daily cannabis use rises to historic levels in the U.S., some longtime users are finding it harder to quit.
bit.ly
November 26, 2025 at 6:22 PM
1/Associated Press's Leah Willingham takes a deep dive into an emerging reality: for many daily #Cannabis users, especially with today’s ultra-high-potency products, pot can shift slowly from relief to dependence.
Because legal is not the same as harmless
Read article: bit.ly/3JWUdeP
Because legal is not the same as harmless
Read article: bit.ly/3JWUdeP
1/AP’s Laura Unger debunks a persistent myth: you can’t get addicted to #cannabis.
#Stanford’s Dr Smita Das explains why #CannabisUseDisorder is real—& rising—as today’s products reach 20–40% #THC & higher.
CDC Data: ~3 in 10 people who use #marijuana develop #CUD.
Read: bit.ly/4ppIZ1b
#Stanford’s Dr Smita Das explains why #CannabisUseDisorder is real—& rising—as today’s products reach 20–40% #THC & higher.
CDC Data: ~3 in 10 people who use #marijuana develop #CUD.
Read: bit.ly/4ppIZ1b
It's possible to get addicted to pot. Here's what to know
Doctors say it's possible to get hooked on pot. There's a widespread misconception that marijuana is not addictive, and it's expanded as a growing number of states legalize pot.
bit.ly
November 24, 2025 at 10:49 PM
1/AP’s Laura Unger debunks a persistent myth: you can’t get addicted to #cannabis.
#Stanford’s Dr Smita Das explains why #CannabisUseDisorder is real—& rising—as today’s products reach 20–40% #THC & higher.
CDC Data: ~3 in 10 people who use #marijuana develop #CUD.
Read: bit.ly/4ppIZ1b
#Stanford’s Dr Smita Das explains why #CannabisUseDisorder is real—& rising—as today’s products reach 20–40% #THC & higher.
CDC Data: ~3 in 10 people who use #marijuana develop #CUD.
Read: bit.ly/4ppIZ1b
1/MJBizDaily reports on a major potential shift in #cannabis products: consumers are moving away from the potency race & toward lower-dose (safer), effect-based products, indicating shoppers increasingly want controlled, functional #THC, not ultra-high-potency products.
Read: bit.ly/4rk3qi6
Read: bit.ly/4rk3qi6
Can 'functional THC' move cannabis past the potency race?
Cannabis retailers and product manufacturers are moving away from potency and embracing products that offer "functional THC."
bit.ly
November 17, 2025 at 7:36 PM
1/MJBizDaily reports on a major potential shift in #cannabis products: consumers are moving away from the potency race & toward lower-dose (safer), effect-based products, indicating shoppers increasingly want controlled, functional #THC, not ultra-high-potency products.
Read: bit.ly/4rk3qi6
Read: bit.ly/4rk3qi6
1/#Hemp loopholes are flooding the market w. psychoactive products that threaten kids & public health. Congress could vote TODAY on a fed ban on hemp-derived intoxicants like Delta-8 #THC.
Use Smart Approaches to Marijuana's action page. Tell Congress to KEEP THE HEMP BAN! bit.ly/3LMYmCi
Use Smart Approaches to Marijuana's action page. Tell Congress to KEEP THE HEMP BAN! bit.ly/3LMYmCi
#TakeAction with ActionButton
ActionButton helps people take quick action to create powerful change.
actionbutton.nationbuilder.com
November 10, 2025 at 6:09 PM
1/#Hemp loopholes are flooding the market w. psychoactive products that threaten kids & public health. Congress could vote TODAY on a fed ban on hemp-derived intoxicants like Delta-8 #THC.
Use Smart Approaches to Marijuana's action page. Tell Congress to KEEP THE HEMP BAN! bit.ly/3LMYmCi
Use Smart Approaches to Marijuana's action page. Tell Congress to KEEP THE HEMP BAN! bit.ly/3LMYmCi
1/New study by #UCSD researchers in Tobacco Control finds #cannabis use may increase #tobacco addiction risk among U.S. youth. Early exposure to pot linked w. later nicotine dependence—a reminder of how interconnected these industries are now.
Fox 5 San Diego story: fox5sandiego.com/news/health/...
Fox 5 San Diego story: fox5sandiego.com/news/health/...
Cannabis use may boost tobacco addiction risk in young Americans, study finds
New research from UC San Diego found that cannabis use among youth may be responsible for 13% of new cases of regular tobacco use in the US, suggesting that cannabis use should be considered a majo…
fox5sandiego.com
October 31, 2025 at 4:48 PM
1/New study by #UCSD researchers in Tobacco Control finds #cannabis use may increase #tobacco addiction risk among U.S. youth. Early exposure to pot linked w. later nicotine dependence—a reminder of how interconnected these industries are now.
Fox 5 San Diego story: fox5sandiego.com/news/health/...
Fox 5 San Diego story: fox5sandiego.com/news/health/...
1/The #cannabis industry’s rapid commercialization has led to potent, highly intoxicating products—from 99% #THC to “hemp-derived” synthetics.
Our fact sheet breaks down what’s in today’s pot, how it’s used, & why it matters for health/prevention.
Read: bit.ly/4hpFfKg
Our fact sheet breaks down what’s in today’s pot, how it’s used, & why it matters for health/prevention.
Read: bit.ly/4hpFfKg
October 23, 2025 at 10:11 PM
1/The #cannabis industry’s rapid commercialization has led to potent, highly intoxicating products—from 99% #THC to “hemp-derived” synthetics.
Our fact sheet breaks down what’s in today’s pot, how it’s used, & why it matters for health/prevention.
Read: bit.ly/4hpFfKg
Our fact sheet breaks down what’s in today’s pot, how it’s used, & why it matters for health/prevention.
Read: bit.ly/4hpFfKg
1/Our new study w. researchers at @UCIPublicHealth & @UCLAchpr in @ijdrugpolicy.bsky.social finds violations of #cannabis delivery bans common in CA in 2021–22.
Nearly all census block groupe reached by delivery businesses—even jurisdictions where delivery illegal.
@publichealthinst.bsky.social
Nearly all census block groupe reached by delivery businesses—even jurisdictions where delivery illegal.
@publichealthinst.bsky.social
October 17, 2025 at 3:01 PM
1/Our new study w. researchers at @UCIPublicHealth & @UCLAchpr in @ijdrugpolicy.bsky.social finds violations of #cannabis delivery bans common in CA in 2021–22.
Nearly all census block groupe reached by delivery businesses—even jurisdictions where delivery illegal.
@publichealthinst.bsky.social
Nearly all census block groupe reached by delivery businesses—even jurisdictions where delivery illegal.
@publichealthinst.bsky.social
1/New #DailyReview story highlights our (@publichealthinst.bsky.social's Getting it Right from the Start) peer-reviewed study with #UCIrvine & #KPDR finding daily #cannabis use among CA teens rose since legalization.
“This study shows legalization changed how teens use cannabis.” —Bethany Simard
“This study shows legalization changed how teens use cannabis.” —Bethany Simard
October 16, 2025 at 5:10 PM
1/New #DailyReview story highlights our (@publichealthinst.bsky.social's Getting it Right from the Start) peer-reviewed study with #UCIrvine & #KPDR finding daily #cannabis use among CA teens rose since legalization.
“This study shows legalization changed how teens use cannabis.” —Bethany Simard
“This study shows legalization changed how teens use cannabis.” —Bethany Simard
1/New study from researchers at UC Irvine, UCLA &
@publichealthinst.bsky.social’s Getting it Right from the Start shows more teens are using #cannabis more frequently & more intensely (reversing a prior decline) after retail stores opened in 2018 - raising serious health risks for California youth.
@publichealthinst.bsky.social’s Getting it Right from the Start shows more teens are using #cannabis more frequently & more intensely (reversing a prior decline) after retail stores opened in 2018 - raising serious health risks for California youth.
October 14, 2025 at 7:52 PM
1/New study from researchers at UC Irvine, UCLA &
@publichealthinst.bsky.social’s Getting it Right from the Start shows more teens are using #cannabis more frequently & more intensely (reversing a prior decline) after retail stores opened in 2018 - raising serious health risks for California youth.
@publichealthinst.bsky.social’s Getting it Right from the Start shows more teens are using #cannabis more frequently & more intensely (reversing a prior decline) after retail stores opened in 2018 - raising serious health risks for California youth.
Our new Journal of Adolescent Health study (w. #UCLA & #UCIrvine)—featured by Fox 5 San Diego—found daily #cannabis use among CA 11th graders has risen since legalization, reversing prior declines. Youth use stays lower where retail sales banned. Stronger safeguards needed.
Article: bit.ly/3W8Cvay
Article: bit.ly/3W8Cvay
October 14, 2025 at 7:02 PM
Our new Journal of Adolescent Health study (w. #UCLA & #UCIrvine)—featured by Fox 5 San Diego—found daily #cannabis use among CA 11th graders has risen since legalization, reversing prior declines. Youth use stays lower where retail sales banned. Stronger safeguards needed.
Article: bit.ly/3W8Cvay
Article: bit.ly/3W8Cvay
1/#SB378 (#ScottWiener) passed the #CALeg with overwhelming support.
It cracks down on unregulated #hemp products flooding CA — often ultra-high #THC, synthetic, & sold online to youth with no age checks.
We urge @gavinnewsom.bsky.social to sign this important bill!
It cracks down on unregulated #hemp products flooding CA — often ultra-high #THC, synthetic, & sold online to youth with no age checks.
We urge @gavinnewsom.bsky.social to sign this important bill!
October 1, 2025 at 5:32 PM
1/#SB378 (#ScottWiener) passed the #CALeg with overwhelming support.
It cracks down on unregulated #hemp products flooding CA — often ultra-high #THC, synthetic, & sold online to youth with no age checks.
We urge @gavinnewsom.bsky.social to sign this important bill!
It cracks down on unregulated #hemp products flooding CA — often ultra-high #THC, synthetic, & sold online to youth with no age checks.
We urge @gavinnewsom.bsky.social to sign this important bill!
1/CBS Sacramento’s Brady Halbleib interviews our own Dr. Lynn Silver on @gavinnewsom.bsky.social's signing #AB564 — a bill that breaks #Prop64’s promised funding for youth, prevention & the environment.
A big tax break for #BigCannabis, nothing to fix the real drivers of the illicit market.
A big tax break for #BigCannabis, nothing to fix the real drivers of the illicit market.
September 24, 2025 at 10:26 PM
1/CBS Sacramento’s Brady Halbleib interviews our own Dr. Lynn Silver on @gavinnewsom.bsky.social's signing #AB564 — a bill that breaks #Prop64’s promised funding for youth, prevention & the environment.
A big tax break for #BigCannabis, nothing to fix the real drivers of the illicit market.
A big tax break for #BigCannabis, nothing to fix the real drivers of the illicit market.
1/The #CALeg just passed #AB564, betraying voters’ intent in #Prop64.
Instead of funding childcare, youth prevention, environmental restoration & public safety as promised, this bill hands #BigCannabis a massive tax break & raises serious questions of legality. #cannabis
Instead of funding childcare, youth prevention, environmental restoration & public safety as promised, this bill hands #BigCannabis a massive tax break & raises serious questions of legality. #cannabis
September 11, 2025 at 3:36 PM
1/The #CALeg just passed #AB564, betraying voters’ intent in #Prop64.
Instead of funding childcare, youth prevention, environmental restoration & public safety as promised, this bill hands #BigCannabis a massive tax break & raises serious questions of legality. #cannabis
Instead of funding childcare, youth prevention, environmental restoration & public safety as promised, this bill hands #BigCannabis a massive tax break & raises serious questions of legality. #cannabis
1/#NatureCommunications study (via
@cnn-news.bsky.social/#kcranews) finds #marijuana may damage human eggs (esp. higher #THC)—raising risks of infertility, miscarriage & genetic defects. #Cannabis use during pregnancy has tripled since 2002. Study adds to mounting evidence of risks when pregnant.
@cnn-news.bsky.social/#kcranews) finds #marijuana may damage human eggs (esp. higher #THC)—raising risks of infertility, miscarriage & genetic defects. #Cannabis use during pregnancy has tripled since 2002. Study adds to mounting evidence of risks when pregnant.
September 10, 2025 at 5:31 PM
1/#NatureCommunications study (via
@cnn-news.bsky.social/#kcranews) finds #marijuana may damage human eggs (esp. higher #THC)—raising risks of infertility, miscarriage & genetic defects. #Cannabis use during pregnancy has tripled since 2002. Study adds to mounting evidence of risks when pregnant.
@cnn-news.bsky.social/#kcranews) finds #marijuana may damage human eggs (esp. higher #THC)—raising risks of infertility, miscarriage & genetic defects. #Cannabis use during pregnancy has tripled since 2002. Study adds to mounting evidence of risks when pregnant.