Using cocaine during pregnancy can have serious, and even fatal, consequences for babies. It may be very difficult for pregnant women who are addicted to cocaine to read this post but it is intended to educate, not to judge. We urge you to seek rehab treatment sooner rather than later for the best outcomes for you and your baby.

Drug and alcohol use during pregnancy can affect the development of the baby in a number of ways. In this blog we will take an in-depth look at the ways in which the illegal stimulant drug cocaine can affect an unborn foetus and a newborn baby. We will also look at the long-term impact on children exposed to cocaine in the womb.

According to the American non-profit organisation March of Dimes, it also takes longer for cocaine to leave the systems of unborn babies and newborns compared to adults.

The extent of the negative consequences on the baby is dependent on the dosage, the timing and the duration of cocaine use by the mother.

Read on to learn more about the risks associated with cocaine abuse and addiction while pregnant.

In this blog

  1. What is cocaine and how common is it in SA?
  2. Cocaine and pregnancy: Short-term impact
  3. Withdrawal or NAS
  4. Cocaine and pregnancy: Long-term impact

What is cocaine and how common is it in SA?

Cocaine is a powerful and addictive stimulant derived from the Coca plant native to South America that causes a user to feel euphoria and heightened energy. Cocaine powder is usually snorted and crack cocaine, which comes in the form of rocks or chunks, is smoked. Cocaine can also be dissolved in water and injected into the blood stream.

According to the United Nations, approximately 1% of South Africans use cocaine. However, almost one in 10 people in addiction treatment centres report cocaine or crack cocaine as their primary substance of abuse, according to data from 2011. According to more recent data for 2020 published by the South African Community Epidemiology Network on Drug Use cocaine use varies widely from province to province. About 6% of people in treatment in the Western Cape reported cocaine as their primary or secondary drug of use compared to 27% in KwaZulu Natal.

Cocaine and pregnancy: Short-term impact

Cocaine use in pregnancy has been found to harm the developing foetus in a number of ways.

This drug can affect the baby because it is able to easily cross the placenta and enter the body of the unborn baby. This can disrupt development at crucial times and deprive a baby of oxygen.

As cocaine crosses the placenta, it “constricts the blood vessels reducing blood flow to the [foetus]”. Because oxygen is transported by blood, this reduced blood flow results in a reduced oxygen supply to the foetus which can slow the growth of bones and the intestine.

Most babies exposed to cocaine do not have birth defects but they do have a higher risk of birth defects related to the urinary tract or heart than nonexposed infants. The drug may cause a stroke in the unborn baby which can result in brain damage or death.

Cocaine use can also cause other complications during pregnancy.

For example, 31% of women who use cocaine throughout their pregnancy experience preterm delivery i.e., their babies are born prematurely – before 37 weeks of pregnancy. Premature babies are at risk of a number of complicated medical and developmental problems although there are many preterm babies who do not experience complications. Short-term complications include breathing, heart, brain, temperature control, and immune system problems. Long-term complications include learning, vision, hearing, behavioural and psychological problems as well as cerebral palsy and other chronic health issues.

Additionally, 15% of women who use cocaine throughout their pregnancy have premature detachment of the placenta which can deprive the baby of oxygen and nutrients (which are carried via the placenta) as well as cause heavy bleeding in the mother. It can be “deadly for both mother and baby”.

There is also a higher risk of an infant being born underweight if the mother abused cocaine while pregnant. A baby is considered underweight if they weigh less than 2.5kg. One study on almost 8000 newborn babies found that 16.7% of babies with a low birth rate were exposed to cocaine while only 6.7% of normal-weight babies were exposed to the drug.

Babies with a low birth weight can be healthy but many are not. They are 20 times more likely to develop complications and die compared to babies of normal weight.

Moderate exposure to cocaine in the womb has been linked to a higher risk of babies having a smaller head circumference than normal which has been reported to be linked to having a lower IQ later in life.

There is also a higher risk of experiencing a miscarriage, which is when a baby dies before 20 weeks, earlier on in pregnancy if a woman uses cocaine.

Withdrawal or NAS

Neonatal abstinence syndrome (NAS) refers to a group of conditions a newborn can experience if his or her mother is addicted to drugs during pregnancy. NAS occurs when the baby is physically addicted to a drug and experiences withdrawal after birth. Cocaine has been reported to cause NAS in some babies.

Cocaine and pregnancy: Long-term impact

While the impact of cocaine is immediate, long-term consequences have also been documented in children exposed to cocaine in the womb as they age.

Studies show babies born to active cocaine users are more at risk of developing a learning disability. A study on cocaine-exposed children in America estimated that they were 2.8 times more likely to have a learning disability at age seven when compared to their nonexposed counterparts. According to another study, prenatal cocaine exposure accounted for an estimated extra cost of 26 million dollars annually to the American economy in services related to special education.

Other problems related to impulsivity and attention have been reported.

Higher doses of cocaine use in pregnancy has been shown to increase the risk that the baby will abuse substances later in life.

Areas in the brain involved with regulating attention, impulsivity and the stress response are thought to be particularly vulnerable to exposure to cocaine in the womb.

Studies have shown that, compared to nonexposed babies, those exposed to cocaine during pregnancy have a slower growth rate which is associated with “a negative impact on later motor development, cognitive functioning, metabolic processes, physical activity and social outcomes in diverse populations”.

An example of this negative impact is that these children have a higher risk of developing obesity later in life, even when they aren’t born prematurely.


Cocaine use during pregnancy can cause a range of short and long-term physical and mental health consequences as well as developmental problems to exposed babies. It is important to help, instead of punish, mothers addicted to cocaine. These women should be assisted with accessing treatment as soon as possible to limit this risk.

Are you in need of treatment for cocaine addiction? Contact us today!