Consumption of Ayahuasca by Children and Pregnant Women: Medical Controversies and Religious Perspectives

Ayahuasca, a psychoactive brew made from Banisteriopsis caapi and Psychotria viridis that contains DMT, is used in Amazonian indigenous and Brazilian urban religious contexts such as Santo Daime and União do Vegetal (UDV). Although these ayahuasca religions have gained social legitimacy and some legal recognition in Brazil, the participation of pregnant women, children and adolescents in rituals remains controversial. Media reports and public debate have repeatedly raised concerns about potential risks to fetuses and young consumers despite a sparse empirical literature addressing these questions. Labate sets out to map the main issues in the Brazilian debate over ayahuasca use by pregnant women and minors. The paper combines a review of regulatory history and available biomedical and social-science literature with consultations of selected biomedical specialists and an in-depth interview with a Santo Daime follower who is also a doula and mother. The aim is to highlight points of agreement and contradiction across biomedical, anthropological and user perspectives, and to indicate implications for policy and future research.

This article is an anthropological comment that draws on three complementary sources: (1) a review of the history of regulation and of the limited published literature regarding ayahuasca use by pregnant women and children; (2) consultations with a select group of biomedical and health specialists directly involved in ayahuasca research, conducted primarily by email in February 2010; and (3) a single, extended ethnographic interview with a Santo Daime practitioner, Clarice Andreozzi, conducted by email between February 17 and March 4, 2010. The author states that specialists were chosen for their direct involvement in ayahuasca research, producing a very select sample of expert opinion. The documentation of regulation includes official Brazilian resolutions and their interpretations. The biomedical component summarises one published study of adolescents associated with UDV and mentions an unpublished or incomplete retrospective pilot study announced by UDV's Medical-Scientific Department. The ethnographic element consists of a full interview with a practicing doula and mother who reports on dosing practices, baptismal rituals and family customs within Santo Daime. Interviewees were informed of the study purpose and consented to be interviewed; one participant requested anonymity. The author acknowledges limited ethnographic sources and the selective nature of expert consultations as methodological constraints.

Regulatory history: During the 1980s and subsequently, Brazil negotiated the religious use of ayahuasca against drug-control laws. By 2004, CONAD (the National Council on Policies about Drugs) interpreted article 1.634 of the Civil Code to treat consumption of ayahuasca by pregnant women and minors as falling under the exercise of parental rights. Resolution No. 5/2004 allowed parents or guardians to decide on ayahuasca use by minors and left pregnant women responsible for their own participation, while noting a lack of sufficient scientific evidence and calling for caution. Later CONAD guidance (2010) reaffirmed respect for religious practices while calling for further research. Biomedical evidence and expert opinions: The extracted text reports no published biomedical studies directly addressing the effects of ayahuasca on pregnant women or fetuses. A retrospective pilot study announced by UDV's Medical-Scientific Department aimed to assess obstetric outcomes and neuropsychological development in children born to mothers who used ayahuasca, but further information or publication was not obtained. One published study evaluated 40 adolescents from UDV against 40 matched non-ayahuasca-using adolescents and found broadly similar neuropsychological and psychiatric test results; the UDV adolescents reported lower rates of alcohol and substance use and lower anxiety in that sample. Several researchers provided emailed commentaries. Dartiu Xavier da Silveira emphasised the absence of evidence proving harm and urged more research, noting that lack of observed adverse outcomes in some cases does not establish safety. Charles Grob reported that studies of UDV adolescents and adults revealed no evidence of injurious effects and in some measures suggested lower substance use and anxiety among hoasca-exposed youths. Jaime Hallak and others urged caution: Hallak recommended avoiding ayahuasca in pregnancy until safety data exist. Rafael Guimarães dos Santos noted that while adolescent data from UDV are reassuring, there are preclinical toxicology signals for harmala alkaloids (for example harmine) and limited understanding of their implications for humans. An anonymous German pharmacologist summarised that no animal or human data address teratogenic, embryotoxic or uterotonic effects of DMT or related compounds, and stressed both the paucity of evidence and the need for caution. Synthesis of expert positions: The commentators display two recurring lines of reasoning: one that treats psychoactive substances as potentially harmful in the absence of evidence to the contrary (a ‘‘guilty until proven innocent’’ stance), and another that adopts an agnostic or permissive attitude pending definitive evidence. Despite differences, most experts agree on the need for precaution and further study. Religious/ethnographic findings: In the interview, Clarice Andreozzi described Santo Daime practices concerning pregnant women and children. Dosing is adjusted by age and circumstance: pregnant women and children receive smaller doses, and participation is optional. Santo Daime practices include use of daime during labour (often at small doses) and a baptismal rite for newborns that may include a drop of daime administered with water and salt; infants may receive minute quantities (drops or the dregs of the glass), increasing with age. Children participate in age-appropriate sessions, song-teaching and catechism-like activities; families vary in whether they give daime to their children. Andreozzi reported that all four of her children were raised within the doctrine and had freedom of choice as they matured. Author's recommendations reported in results/concluding material: Labate highlights the need for interdisciplinary research, proposing longitudinal matched-cohort studies of UDV or Santo Daime children, developmental designs that consider timing and frequency of exposure (in utero, infancy, childhood, adolescence), and cautious experimental work under ethical approval. The author also calls for social-science studies on identity formation, an ‘‘ethnography of power’’ examining how biomedical discourses influence policy, and comparative analyses with substances such as alcohol and tobacco. The author notes significant ethical, legal and methodological challenges to research on pregnant women and children.

Labate interprets the findings as revealing a field marked by contradictory discourses and a relative scarcity of direct scientific evidence regarding ayahuasca use in pregnancy and childhood. The paper emphasises that legal regulation in Brazil emerged from dialogue among governmental agencies, scientists and religious representatives, leading to a framework that privileges religious freedom while recognising the need for further study. Within this framework, parental rights have been invoked to justify permitted use by minors and pregnant women under guardians' decisions, but such permissions continue to provoke public controversy. The discussion positions the limited biomedical literature—principally the adolescent UDV study and unpublished pilot efforts—against ethnographic evidence that rituals exert strong dose- and context-based controls. Labate stresses that religious practices include structured dosing rules and monitoring within ritual settings, which believers and practitioners cite as protective mechanisms. At the same time, several researchers cited in the paper underline unknowns about harmala alkaloids and the absence of teratology data for DMT-related compounds, reinforcing the call for caution. Key limitations acknowledged by the author include paucity of empirical studies on pregnancy and childhood exposure, the selective nature of expert consultations, and ethical and methodological hurdles to conducting rigorous research in these populations. Labate also notes the political and media dynamics that amplify both precautionary and permissive narratives. Implications for research and policy: The paper calls for interdisciplinary, ethically approved research—developmental cohort studies, careful experimental work where appropriate, and expanded social-science inquiry into identity, power and how biomedical evidence is mobilised in legal debates. Labate suggests comparative work with well-studied substances such as alcohol and tobacco to clarify standards of evidence and policy responses. Finally, the author frames the debate as one balancing parental rights to determine upbringing against claims that children should be protected from religious indoctrination or exposure to psychoactive substances, and advocates that future decisions rest on expanded empirical, social and ethical reflection.