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Presents a conceptual framework that can be used to estimate the costs of prenatal exposure to tobacco, alcohol, and illegal drugs. Cost estimates that have been made are presented. It is obvious that preventing drug use or smoking should be a first priority of public policymakers. (SLD)

Explores sources of societal disapproval of drug-abusing pregnant women, and examines the relationship between society's moral judgments and public policies. A pregnant woman's fundamental moral obligations to the fetus are comparable to a parent's obligations to a child already born. Society has an obligation to provide needed health care. (SLD)

Discusses the problem of drug-exposed infants from the perspective of a county attorney's office, focusing on a new Minnesota law that responds to the problem through early identification and provision of services. The approach calls for mandated reporting by medical providers and includes the possibility of civil commitment. (SLD)

Addresses the issue of drug-exposed infants from the perspective of a reproductive rights attorney. States genuinely interested in promoting healthy children will stop ignoring women or treating them as potential child abusers and will change the current punitive legal focus to a focus on treatment. (SLD)

Discusses drug-exposed infants from the perspective of a juvenile court judge. Experience in Los Angeles County (California) illustrates the following common problems in the juvenile courts: (1) high court caseload; (2) lack of legal representation and overloaded case workers; and (3) lack of resources mandated by law. (SLD)

Reviews recent actions by state legislatures and courts in response to the problems of drug-exposed newborns. Also discusses civil and criminal court decisions regarding women who use drugs during pregnancy. State policy responses cannot be developed without a detailed assessment of the state's resources. (SLD)

Discusses treatment modalities for drug-abusing women. The following are barriers that prevent women, particularly pregnant women, from getting treatment they need: (1) lack of programs admitting women; (2) lack of programs tailored to women; and (3) fear and isolation experienced by drug-abusing women. (SLD)

Drug-exposed infants are having a profound impact on the child welfare system. When community resources are not available to meet the needs of these children and families, requirements of current child welfare laws cannot be met. The range of services necessary for effective child welfare responses is discussed. (SLD)

Estimates the number of infants exposed to legal and illegal substances before birth, drawing on 27 published reports and National Institute on Drug Abuse data. The following are estimated exposure levels: (1) cocaine, 2-3 percent; (2) marijuana, 3-12 percent; (3) cigarettes, 38 percent; and (4) alcohol, 73 percent. (SLD)

Reviews studies of the effects of prenatal drug exposure on child development, and reviews ideal early intervention programs. Researchers agree that prenatal drug exposure is only one of many factors that can influence a child's development. Specialized treatment programs and family support can ameliorate prenatal drug exposure effects. (SLD)

Reviews the effects of prenatal exposure to the following: (1) cigarettes; (2) alcohol; (3) heroin; (4) narcotics; (5) marijuana; and (6) cocaine. Also discussed are the effects of exposure to multiple drugs and research issues in assessing drug effects. The importance of environment in long-term outcome is emphasized. (SLD)

Summarizes and analyzes the following issues in developing policy to address the problems of drug-exposed infants: (1) degree of harm; (2) identification; (3) interventions; (4) needs assessment; (5) child protection; and (6) drug treatment. Significant interventions, including expanded prenatal care and drug treatment programs, are proposed. (SLD)