When a pregnant woman takes cocaine it can affect her unborn child, causing a range of possible problems from minor deformities to life-threatening conditions. Your daughter (and her unborn child) will need the advice and care of a team specialised in dealing with this sort of problem.

Talk to GP

If possible, try to encourage her to talk to her GP as soon as possible to get booked in with the appropriate local maternity service. Ideally she should be trying to stop or cut down her cocaine habit as far as she can while she's pregnant. But, in reality this is often asking the impossible.

This may also be a good time to try to build bridges with your daughter. Most women tend to become closer to their parents once they too become a parent - suddenly they have a new understanding of what their parents were going on about all those years, and parents are a great source of experience and help too.

Having a child also sometimes gives an addict a new goal in life and the motivation to kick their habit (although by no means always). So this could be a good time to remind your daughter that you're there and as long as she doesn't abuse the relationship, you'd like to be involved. Whether or not your daughter takes up this offer, your grandchild will benefit from your involvement.

The harm of cocaine to an unborn child

Cocaine can harm the unborn child in many ways.

1. When taken early in pregnancy there's an increased risk of miscarriage, while later on it may trigger premature labour. Cocaine doubles the risk of a premature baby. As well as being born early, the baby may be 'small for dates' and with a smaller head (suggesting a smaller brain) because the drug restricts the blood supply (and so nutrition) to the baby. Small babies like this are much more vulnerable, especially in the first few weeks of life, and are at greatly increased risk of cerebral palsy, developmental problems, visual and hearing disabilities. These problems may be avoided if the woman stops using the drug in the first trimester or third of pregnancy.

2. There may be a risk of malformations, especially of the genito-urinary system, when cocaine is used early in pregnancy while the baby is still forming.

3. Cocaine can also cause death of the baby in the womb, or a stroke so that the baby is born with brain damage. It also increases the risk of placental abruption and ante-partum haemorrhage, where the placenta comes away from the inside of the womb leading to potentially fatal bleeding.

Problems after delivery

There may also be problems once the baby is born. For example, at first they may seem less responsive to sounds and faces, and be rather floppy.

If cocaine is taken late in the pregnancy, the baby will be used to having the drug in its system and so will go through 'withdrawal' once born. The baby may seem very irritable, crying or starting at any sound or sensation, and very difficult to settle or soothe, while some simply withdraw into hours of sleep all day. This can last days and interfere with bonding.

And of course the erratic lifestyle that many addicts lead, especially when getting their fix, may be a greater priority than caring for another, can interfere with parenting and cause havoc to the routine that a small child needs. This may be where your role could be vital to help provide stability to both your daughter and her child.

This article was last medically reviewed by Dr Trisha Macnair in August 2008