Case Study: Crack Babies

1. As a group, discuss what you know about this topic (if anything) before turning the page. Note some points made in the discussion. What questions do you still have?

2. Examine the citations and excerpts or abstracts attached. Do you have any new information to add to what you already knew? Are there some surprises?

3. As you examined each citation, what "markers" helped you decide whether a source would be useful for understanding this issue or not? Make a list of markers you used to evaluate each source. Which are the most difficult of these markers for non-specialists to understand and apply?

4. Who are some of the apparent claims-makers in the formation of this social issue; what groups might benefit from it being defined as an important issue and how? Who might have an interest in discrediting the concept?

5. A loaded question: Some of the excerpts attached are from scholarly sources and others are from the popular press or the Web. If students were told to use only scholarly sources, would that mean they would be limiting their search to sources that were reliable and based entirely on objective research? Why or why not?

Citations and Excerpts

Cheryl Sullivan. "US Health-Care Crisis in the Making." Christian Science Monitor 15 Feb. 1989: 1.
Staggering numbers of drug-addicted infants - born in tandem with the rise of cheap, accessible crack cocaine - are causing a crisis in hospital nurseries across the country. But even as physicians strive to help these babies, they warn that America's struggle to care for these children is only beginning. . . .

Experts say the children are likely to need costly services - from postnatal intensive care at a hospital to special-education programs in school. While much more research on the problem needs to be done, one thing is clear: The existing medical and social-service system is likely to be overwhelmed by the surging numbers of crack babies.

Chasnoff, D.E. Lewis, D.R. Girffith, and S. Wiley. "Cocaine and Pregnancy: Clinical and Toxicological Implications for the Neonate." Clin Chem 35 (1989): 1276-8.
Abstract: Recent studies show that the rate of cocaine use by pregnant women in the United States is much higher than realized hitherto, and an increasing number of infants are being born to cocaine-using mothers. In an ongoing research project to study the effects of cocaine on pregnancy outcome, we studied 70 infants born to cocaine-using women. . . . Cocaine-exposed infants had lower birth weight, shorter gestation, and a smaller head circumference than control infants. Cocaine-exposed infants also had neurobehavioral abnormalities at initial evaluation and a higher rate of perinatal complications. . . .

Susan Chira. "Children of Crack: Are the Schools Ready? A Special Report: Crack Babies Turn 5 and Schools Brace." The New York Times 25 May 1990: A1.
The nation's inner-city schools, already strained by the collapse of families and the wounds of poverty, will face another onslaught this fall -the first big wave of children prenatally exposed to crack.

With the use of crack having reached epidemic proportions in the mid-1980's, the children born to pregnant users then are now turning 5 and will enter kindergarten in the fall. Researchers agree these children's neurological, emotional and learning problems will severely test teachers and schools, and many fear this is a test schools are doomed to fail. . . .

Dr. Judy Howard, professor of clinical pediatrics at the University of California at Los Angeles's medical school, is a leading researcher on cocaine-exposed babies. He predicts that in some inner-city schools such children will make up 40 percent to 60 percent of classrooms within a few years. The March of Dimes says the number of crack-exposed children by the year 2000 could range from half a million to four million.

Katharine Greider. "Crackpot Ideas." Mother Jones. 7 July/Aug. 1995: 52.
DURING THE LATE '80S, AMERICANS SHOOK THEIR heads in disgust at reports that poor black mothers were sacrificing the little ones resting in their wombs for the pleasures of crack cocaine, callously dooming a new generation to "a life of certain suffering, of probable deviance, of permanent inferiority," to quote columnist Charles Krauthammer.

Seizing on early studies that raised alarm over fetal damage from cocaine, scientists cited the same inconclusive data again and again. Local news organs spun their own versions of the crack-baby story, taking for granted the accuracy of its premise. Social workers, foster parents, doctors, teachers, and journalists put forward unsettling anecdotes about the "crack babies" they had seen . . . Reporters went into hospital nurseries and special schools and borrowed the images of premature babies or bawling African-American preschoolers to illustrate their crack-baby stories. Carol Cole, who taught at the Salvin Special Education School in Los Angeles, remembers reporters asking if they could get pictures of the children trembling. . . .

Thirteen states require doctors to report drug use in pregnancy or positive drug tests in newborns. Nine states specifically define drug use during pregnancy as child abuse or neglect, triggering a range of responses from treatment and other services to an investigation and the possible removal of the child. The bulk of these policies were put in place between 1988 and 1991, as the crack-baby scare peaked.

J. Litt and M. McNeil. "Biological Markers and Social Differentiation: Crack Babies and the Construction of the Dangerous Mother." Health Care Women Int. 18 (1997): 31-41.
Abstract: Crack mothers - particularly African American and Latina women - have been constructed as maternal villains who actively and permanently damage their offspring. Many women have been arrested or lost parental rights to their children because of child neglect charges. Despite this panic, recent medical and legal research indicates that reports of damage to the fetus have been greatly exaggerated. This article examines the ongoing questions in medical publications about crack babies. The authors connect the search for biological markers of cocaine use during pregnancy to a new cultural conception of a bio-underclass. The conclusion considers medical developments and controversies in the broader context of class and racial divisions and reproductive politics in the United States.

Christopher S. Wren. "For Crack Babies, a Future Less Bleak." New York Times 22 Sept. 1998: D4.
When the first babies were born to crack addicts in the mid-1980's, images of trembling infants with tubes up their noses led to fears that such children were irreversibly damaged and doomed to grow into violent misfits.

The dire predictions failed to materialize by the early 1990's, prompting a different conclusion: that cocaine causes no lingering effects on children born to drug-addicted mothers. Instead, it was asserted, whatever problems the children had could be attributed to poverty and other environmental factors.

Now many pediatricians and other child development specialists who work with these children believe that the complex truth lies in between. . . .

Office of National Drug Control Policy. "Cocaine." ONDCP Drug Policy Information Clearinghouse Fact Sheet Nov. 2003. (retrieved 20 Dec. 2004).
. . . Although the effects of prenatal cocaine exposure are not completely understood, scientific studies have shown that such afflicted babies are often born prematurely, have low birth weights and smaller head circumferences, and are shorter in length. Originally thought to suffer irreversible neurological damage, these "crack babies" now appear to recover from the drug exposure. This is not to underestimate the many subtle but significant effects such babies later experience because of their exposure to cocaine, including impairment in behaviors that are crucial to concentrating in school. . . .

Ken Kobré. Crack Babies in Infancy. (photostory) (retrieved 20 Dec. 2004).
. . . [caption for a photograph of a crying infant] Exposed to the drug in the womb and born addicted to crack cocaine, this child experiences severe withdrawal symptoms. Conservative estimates suggest that at least 11 percent of all newborns in the United States today were exposed in the womb to one or more illicit drugs. The number is even higher in urban areas. Birth and hospitalization of a normal newborn cost approximately $2,000. Birth and hospital care of a crack exposed neonate, with round-the-clock nursing, monitors, blood and urine tests, high-tech equipment and social service evaluations, costs $11,000. Who pays the bill? The government, since crack-addicted mothers are unlikely to carry insurance. . . . [though there is no date on this page, the rood directory is for an Elsevier-owned publisher of books on media technology, dated 2004.]

L. T. Singer et al. "Cognitive Outcomes of Preschool Children with Prenatal Cocaine Exposure." JAMA 292 (2004): 1021.
Abstract: CONTEXT: Because of methodological limitations, the results of the few prospective studies assessing long-term cognitive effects of prenatal cocaine exposure are inconsistent. OBJECTIVE: To assess effects of prenatal cocaine exposure and quality of caregiving environment on 4-year cognitive outcomes. . . . Prenatal cocaine exposure was not associated with lower full-scale, verbal, or performance IQ scores but was associated with an increased risk for specific cognitive impairments and lower likelihood of IQ above the normative mean at 4 years. A better home environment was associated with IQ scores for cocaine-exposed children that are similar to scores in nonexposed children.

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