Cocaine use and addiction has become a significant issue among women affecting not only the users themselves but also their unborn babies. It has been estimated that perhaps as many as one out of four Americans between the ages of 26 and 34 have used cocaine at least once in their lifetime. Some estimate that approximately 22 to 25,000,000 people have used cocaine in the United States and statistical trends suggest that cocaine use continues to steadily and significantly increase.

Consequently, cocaine use has become a public health concern of substantial proportions. SAMSHA estimates, for example, that cocaine-related emergency room visits increased from 5,000 in 1980 to 142,000 in 1995.

Pregnant women who use cocaine expose their unborn children to potentially severe and profound medical risks of cocaine use. Among these are:

• stillbirth
• spontaneous abortion-- miscarriage
• fetal stroke
• premature birth
• placental abruption -- the placenta detaches prematurely from the uterine wall
• low birth weight
• birth defects

Some of the birth defects that have been observed in babies born to mothers who use cocaine are malformations of:

• face
• skull
• brain
• heart
• arms and legs
• intestines
• urinary tract
• genitals

Cocaine-related birth defects occur because cocaine crosses the intrauterine placenta and enters the bloodstream of the fetus. Consequently, the unborn baby is directly exposed to the cocaine that is used by the mother.

Babies who were exposed in utero to cocaine may themselves become cocaine dependent and may experience cocaine withdrawal after delivery. Some of the symptoms of a newborn’s cocaine withdrawal are:

• unresponsiveness
• poor sleep
• restlessness
• tremors
• unusual crying
• feeding problems
• diarrhea
• muscle spasms
• abnormal reflexes
• vomiting
• seizures

While women who use cocaine during pregnancy directly expose their babies in utero to cocaine, they also have their own cocaine-induced health consequences that can severely compromise the ability to carry and deliver a healthy baby. Some of these complications are:

• increased norepinephrine in the blood which can induce premature contractions and delivery
• malnutrition which decreases fetal development
• interrupted blood flow to uterus, placenta and fetus which can inhibit development and cause birth defects

Children who were exposed to cocaine in utero can be affected in later development in many ways. Some of these children will have:

• an increased chance of SIDS -- Sudden Infant Death Syndrome
• developmental delays
• cognitive delays including retardation
• motor skill delays
• behavior problems
• hyperactivity
• attention problems

Additionally, women who use cocaine during pregnancy are at high risk for losing custody of their children. Babies who are born positive for cocaine are routinely removed immediately from parental care by agencies of child protection. Cocaine can be found in the urine, blood, meconium (stool excreted during the first 3 days of life) and hair samples of newborn infants that have been exposed in utero. Typically, newborns that test positive for cocaine are removed from the mother's care just after delivery.