Is cocaine safe during pregnancy?
Answered by MotherToBaby’s teratology specialists, quoted in full — including the questions most pages skip, like whether a father’s exposure matters.
The questions people actually ask about cocaine in pregnancy
Answered by MotherToBaby, the fact sheets written by the Organization of Teratology Information Specialists and published through the NIH. Quoted in full — we do not condense them.
I use cocaine. Can it make it harder for me to get pregnant?
It is not known if using cocaine can make it harder to get pregnant.
Does using cocaine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Using cocaine can increase the chance of miscarriage, especially when tobacco is also used.
Does using cocaine increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like cocaine, might increase the chance of birth defects in a pregnancy.
It is not known if cocaine can increase the chance of birth defects. Birth defects that have been reported with cocaine use in pregnancy include abnormalities of the brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract. However, most babies exposed to cocaine during pregnancy do not have a birth defect.
Does using cocaine in pregnancy increase the chance of other pregnancy-related problems?
Babies exposed to cocaine during pregnancy tend to weigh less, are born shorter in length, and have smaller heads than babies who were not exposed to cocaine during pregnancy. Cocaine can also increase the chance for preterm delivery (birth before week 37).
Cocaine use can cause the placenta to pull away from the wall of the uterus before labor starts (placental abruption). This can lead to heavy bleeding and can be fatal for the person who is pregnant and/or for the pregnancy.
If I use cocaine throughout my entire pregnancy, will it cause symptoms in my baby after birth?
The use of cocaine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms reported in newborns with exposure to cocaine late in pregnancy include irritability, tremors, muscle stiffness, poor feeding, trouble with sleeping, and hyperactivity at birth. Less commonly, vomiting, diarrhea, and seizures have also been reported. Symptoms usually start 1 to 2 days after birth. Some of these problems might last for weeks after birth, and sometimes longer. Not all babies exposed to cocaine will have symptoms. It is important that your healthcare providers know you are taking cocaine so that if symptoms occur your baby can get the care that is best for them.
Does using cocaine in pregnancy affect future behavior or learning for the child?
Cocaine exposure in pregnancy can cause significant central nervous system problems that might not be seen until the child is older. This can include problems with attention and self-control, delays in learning, trouble processing emotions, language difficulties, and increased need for special education in school.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to watch the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
If a man uses cocaine, could it affect fertility or increase the chance of birth defects?
It has been suggested to avoid cocaine and other substance use before conception. Using cocaine might affect sperm shape and movement, which could affect men’s fertility (ability to get a partner pregnant). No birth defects have been reported as a direct result of a man’s exposure to cocaine. For more general information on paternal exposures, please see the MotherToBaby paternal exposures fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/ .
Quoted from MotherToBaby Fact Sheets — Cocaine, published January 2025. MotherToBaby states its fact sheets should not take the place of medical care and advice from your healthcare providers.
Breastfeeding is a separate question — what LactMed says about cocaine
This is general reference information, not medical advice. Whether to take any medication in pregnancy is a decision for you and your prescriber; do not start or stop a drug on your own, because an untreated condition can also carry risk.