Date: July 2011, Version 1.2

What is cocaine?

Cocaine (coke, crack) is a recreational drug that causes changes in mood and behaviour by affecting the balance of certain chemicals in the brain.

Is it safe to use cocaine during pregnancy?

When a pregnant woman uses cocaine, it enters her bloodstream and crosses the placenta to the baby. Cocaine also collects in the fluid around the baby and is absorbed through the baby’s skin.  Because unborn babies continually swallow this fluid they also swallow the cocaine. Cocaine in the baby’s bloodstream reaches the baby’s heart, brain, and other organs.

Studies suggest that using cocaine during pregnancy may increase the risk of stillbirth, or of having a premature and/or low birth weight baby. Cocaine should therefore not be used in pregnancy.

What if I have already used cocaine during pregnancy?

If you are pregnant and use cocaine, you should speak to your doctor or midwife about this. They will be able to get you help and support to safely stop using cocaine. Regular cocaine users, or people who feel as if they are dependent upon cocaine should not stop or reduce the amount of cocaine taken without a doctor’s guidance as this could cause withdrawal symptoms that may be dangerous to both mother and baby.

Can using cocaine during pregnancy cause birth defects?

Cocaine affects the blood vessels, reducing blood flow. There have therefore been concerns that use of cocaine in pregnancy may cause birth defects that are due to abnormal blood flow in the developing baby in the womb.

There are some isolated reports of babies with these types of birth defects being born to mothers who used cocaine during pregnancy.

One large study that analysed information from 16 smaller studies showed that babies born to women who used cocaine during pregnancy were more likely to have a birth defect than babies born to mothers who had not used drugs. However, birth defects were also more common in babies of women who had used other types of recreational drugs. This suggests that the birth defects observed in this study may not have been specifically caused by cocaine, but may have been caused by certain lifestyle factors in pregnant women who use recreational drugs (e.g. smoking, alcohol use, poor nutrition, ill health).

More research is required to determine whether cocaine use in pregnancy can cause birth defects in the baby.

Can using cocaine in pregnancy cause miscarriage?

Some studies have shown a link between cocaine use in pregnancy and an increased risk of miscarriage. However, other studies have not agreed with this and it is currently unclear whether using cocaine in pregnancy increases the chance of a miscarriage. 

Can using cocaine in pregnancy cause stillbirth?

An increased risk of stillbirth has been linked to cocaine use in pregnancy. It has also been shown that placental abruption (where the placenta detaches from the womb before the baby is born) is more likely to occur in women who use cocaine whilst pregnant. Placental abruption can be very serious and can result in the death of both mother and baby.

Can using cocaine in pregnancy cause premature delivery and low birth weight?

Current scientific evidence suggests that cocaine use during pregnancy is linked to giving birth too early (<37 weeks of pregnancy) and to having a low birth weight baby (<2500g). Use of cocaine during pregnancy appears to reduce the rate at which a baby grows in the womb, possibly due to reduced blood flow through the placenta. Poor growth in the womb has been linked to health problems later on in life.

Can using cocaine in pregnancy cause other health problems in the child?

Withdrawal symptoms at birth (neonatal withdrawal)
Withdrawal symptoms are thought to occur as the newborn baby’s body has to adapt to no longer getting addictive substances through the placenta.

Studies have shown that cocaine use during pregnancy can cause withdrawal symptoms in the baby at birth. Therefore, if you have used cocaine in the weeks before delivery your baby may require close monitoring and/or supportive treatment for a few days after birth. It is important that you tell your doctor or midwife if you have been using cocaine so that they can arrange for your baby to be born at a unit that can monitor and treat your baby for withdrawal symptoms if necessary.

Growth in childhood
One study has shown that children who were exposed to cocaine in the womb during early pregnancy were smaller on average at seven and ten years of age than children who were not exposed to cocaine. This suggests that cocaine has lasting effects on a child who was exposed in the womb.

Learning or behavioural problems
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that exposure to certain substances at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

Cocaine affects the balance of ‘mood chemicals’ in the brain. There are therefore concerns that using cocaine during pregnancy could also affect an unborn baby’s developing brain.

Several studies have shown that children whose mothers used cocaine during pregnancy were more likely to have problems with thinking, learning, and behaviour than children whose mothers did not use cocaine. One study has shown that the more cocaine that a mother used in pregnancy, the more likely a child was to have problems. However, other studies have not identified problems in children exposed to cocaine in the womb.

It is often difficult to compare different scientific studies of learning and behavioural problems in children who have been exposed to a particular substance in the womb. Studies often investigate different learning or behavioural issues, or use different scoring systems to identify a problem. The results can therefore not always be compared directly. Additionally, some studies only investigate children when they are young. We therefore do not know whether these children ‘grow out’ of any problems that are observed, or show more problems with their learning or behaviour as they get older.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care, most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

If you have used cocaine during pregnancy it is best for you and your baby that you tell your doctor or midwife as soon as possible. They will then be able to make sure that you and your baby receive extra monitoring or support if necessary.

Are there any risks to my baby if the father uses cocaine?

No studies have specifically investigated whether cocaine used by the father can harm the baby through affects on the sperm, however most experts agree that this is very unlikely. More research on the effects of drug and medicine use in men around the time of conception is needed.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from  

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.