ABSTRACT
Over the past decade, the study of the possible effects of prenatal cocaine exposure on child outcome has become increasingly sophisticated. The field emerged in the midst of a national controversy over “crack babies” and “pregnant addicts.” Popular opinion predicted the emergence of a “biologic underclass” of cocaine-exposed children. In large part, the public’s early apprehensions stemmed from the social associations of illicit drug use with criminality and a variety of gender and racially biased assumptions (Daniels, 1997; Neuspiel, 1996). Throughout the 20th century, cocaine use has not only been illegal, but associated in the public mind with deviancy, violence, and uncontrolled sexuality, particularly among African Americans (Neuspiel, 1996). In the scientific world, these social meanings were reflected in implicit assumptions that any amount of exposure to cocaine in pregnancy would have negative effects on the infant. In contrast, in the early literature on prenatal alcohol exposure, there was sustained controversy as to whether “social use” (i.e., level of use that is socially acceptable in nonpregnant adults) of alcohol in pregnancy-in the absence of maternal alcoholism-had negative effects on child outcomes (Forrest & Florey, 1991). The social associations of illicit drug use have continued to impact scientific research negatively through discriminatory public policies and increasingly punitive judicial law. For example, mothers are less likely to report drug use to researchers and health providers for fear of imprisonment and loss of child custody (Roberts, 1991).
