Cocaine addiction’s impact on unborn children

When talking about addiction, the consequences extend far beyond the individual, reaching into the lives of those most vulnerable- the unborn.

A meta-analysis from 2015 indicates that the number of babies born with evidence of cocaine exposure in their system ranges between 5 and 45%. Whilst these numbers are somewhat vague, they do suggest that the risk of prenatal cocaine exposure in the Western world is relatively high.

But what impact does foetal cocaine exposure have on the child, and can these effects be managed? What are the risks associated with maternal cocaine use from both medical and ethical perspectives, and what kinds of support can you access for addiction whilst pregnant?

What is Prenatal Cocaine Exposure?

Prenatal Cocaine Exposure ( also known as PCE or in utero cocaine exposure) refers to foetal contact with cocaine. This happens when the mother of a child uses cocaine during gestation, leading to the child being exposed to cocaine at some point throughout the pregnancy.

PCE was first conceptualised in the 1970s, and subsequent publicity around the risks of maternal cocaine use has led to the development of the slang terms ‘crack baby’ and ‘coke kids.’

Medical Risks

Cocaine is teratogenic. This means that it is a substance that can cause abnormalities in the health and development of a child if they are exposed to it before birth.

Whilst there is somewhat of a myth that this kind of harm can only take place during the early stages – particularly in the first trimester – this kind of exposure has risks at any stage during the pregnancy.

These effects of PCE can manifest in a multitude of ways depending on a range of factors, including:

  • How regularly cocaine is used


  • The strength of the cocaine used


  • If the cocaine is ‘pure’ or ‘cut’ (mixed with other substances)


  • If the cocaine is used adjacently to other substances, such as other illicit drugs or alcohol


  • The general health of the mother


  • The mother’s metabolism


  • The age of the mother


Whilst the impact of prenatal cocaine exposure will vary depending on these factors, generally speaking, ‘studies suggest that infants exposed to cocaine in utero have reduced growth, delays in sensory-motor development, attentional deficits, and depressed responsivity to social stimulation.’

This indicates that exposure to cocaine in the womb is a significant detriment to the development health of a child.

Legal and Ethical Perspectives

Researchers indicate that ‘substance use during pregnancy and motherhood’ is not only an issue of ‘public health’ but also a significant ‘criminal justice concern.’

Some groups have rallied for the implementation of criminal consequences for maternal use of drugs whilst pregnant, indicating that mothers have the responsibility to protect the health of their children first and foremost.

However, this is much more complicated than it may first appear, as it also opens up discussions on the role of free will and bodily agency and whether introducing criminal consequences for situations such as maternal cocaine use risks privileging the health and safety of the foetus over the needs, desires and will of the mother.

This is a heated and ongoing debate. If a child is born with PCE today, however, it is very unlikely for legal action to be taken.
However, suppose the situation suggests to medical or social care professionals that maternal cocaine use indicates a continued risk to the child. In that case, there is a chance that motions could be made to protect the child’s interest in their care.

Cocaine and pregnancy: Cocaine’s impact on foetal development

We know that maternal cocaine use can lead to potential developmental complications for children. But why does that happen?

The Role of the Umbilical Cord

During pregnancy, the mother supports the foetus through the umbilical cord. The umbilical cord is a special kind of tissue made up largely of blood vessels that connect both the mother and the body of the foetus in utero.

Through this tissue, the mother’s body carries resources the foetus needs to survive. This is how a foetus is sustained through gestation, as the mother’s blood – containing oxygen and nutrients – blows through the umbilical cord before entering the system of the foetus.

This means that whatever substances enter the mother’s body are very likely to enter the unborn child’s body as well. This is why pregnant women are particularly encouraged not to drink alcohol, smoke cigarettes or take specific medications, as all of these substances can be teratogenic.

How Cocaine Impacts the Foetal System

But once the cocaine is in the system of the foetus, why does it then cause issues? What is cocaine’s actual impact on the foetal body and brain?

Cocaine is a stimulant. This means that it largely acts on the central nervous system (CNS). The CNS is a complex mechanism that encompasses both the spinal cord and the brain and is responsible for processing and responding to stimuli. The CNS, then, is perhaps the most complex – and delicate – structures in the human body.

Cocaine is known to affect the central nervous system of a fully grown adult, meaning that a still-developing foetus in utero is very likely to experience detrimental effects if exposed to cocaine.

Research has found that PCE can lead to higher risks of foetal hypoxia, when the oxygen supply from the placenta is insufficient.
This can itself lead to complications with foetal cerebrovascular autoregulation, where the flow of blood to the heart and brain is compromised.

Children and adults who have experienced prenatal cocaine exposure may be underweight and experience issues with concentration and potential learning difficulties.

How Does This Happen?

There are certain situations where the risk of exposure to drugs in utero is increased.

For example:

  • If a woman does not know that they are pregnant


  • If a woman is struggling with substances, leading to maternal cocaine addiction


  • If a woman is being influenced to use drugs against her will

The Effects and Potential Risks of Prenatal Cocaine Exposure

Babies born with PCE are likely to experience Neonatal Abstinence Syndrome. This happens when a child experiences withdrawal from the drugs it has been exposed to in utero.

Neonatal Abstinence Syndrome

A diagnosis for Neonatal Abstinence Syndrome (NAS) is given every 25 seconds in the United States.

NAS refers to various symptoms associated with the autoimmune, respiratory, gastrointestinal and central nervous systems.

Key symptoms include:

  • Shaking, tremors, convulsions or twitching


  • A ‘tightness’ to the muscles


  • Excessive crying


  • Issues with feeding


  • Issues with breathing


  • High temperature, fever, or sweating


  • Cold like symptoms


  • Sickness and diarrhoea


  • Slow (or limited) weight gain


  • Jaundice


  • Sudden infant death syndrome


Typically, these symptoms will be experienced within the first 72 hours following birth, but in some instances, they can be delayed. NAS can be experienced for up to 6 months.



Support for Pregnant Women With Addiction

There are ways that you can limit the risks that prenatal cocaine exposure can have on your unborn child, as well as how to mitigate the difficult experience of maternal addiction.

  • If you are pregnant, inform your medical provider about your drug use


  • If you are pregnant, do not stop taking the drug you are using immediately. Instead, look for ways to detox safely


  • If you are struggling with addiction, you can use birth control until you feel ready for pregnancy


The best step you can take to prevent PCE and tackle your cocaine addiction is to access support from a specialist provider.

At UKAT, we are proud to offer non-judgemental support for individuals with addiction no matter their current circumstances. This includes cocaine detox programmes to help you beat cravings and withdrawals, as well as inpatient rehab support tailored to your personal needs.

Get Help for Cocaine Addiction

If you’re pregnant and dealing with cocaine addiction, our team can provide confidential support, guidance, and information about UKAT rehab centres. It’s crucial to seek help promptly, as continuing drug use poses risks to both you and your child. Attempting to quit without proper medical attention, especially during pregnancy, can be challenging.

To receive non-judgmental, confidential advice from industry professionals you can contact our team today to learn how to make a referral to help you to manage your cocaine addiction during pregnancy.

close help
Who am I contacting?

Calls and contact requests are answered by admissions at

UK Addiction Treatment Group.

We look forward to helping you take your first step.

0203 811 7325