This chapter presents a review of the literature related to the topic of: perceptions of mothers with positive urine drug screens for cocaine regarding their infants and their relationships with their infants. The significance of cocaine abuse and its consequences, behaviors exhibited by cocaine abusing mothers, factors leading to these behaviors, and findings regarding mother-infant interactions are presented. This is followed by a summary and conclusion.
Cocaine is a central nervous system stimulant which produces an euphoric effect that is immediate but short-lived. The euphoria is followed by depression and irritability. Physical effects include a rise in heart rate and temperature, hypertension, and tachycardia and peripheral vasoconstriction. Severe doses may lead to seizure, stroke, hyperthermia, myocardial infarction, acute toxicity, and sudden death. The route of administration may lead to less serious complications such as rhinitis, sinusitis, erosion, or perforation of the nasal septum due to snorting. Freebasing can lead to bronchitis or other problems. Intravenous use may lead to viral and bacterial infections. Behaviors such as the use of sex to barter for cocaine may take place. Psychological effects may include lethargy, cocaine, craving, irritability, and anhedonia with withdrawal efforts. Psychotic episodes and paranoia are sometimes found in heavy users (Sullivan, 1990).
The use of cocaine in pregnancy may affect both the mother and the fetus. Placental abruption may follow cocaine use, vasoconstrictive effects on intrauterine blood flow are thought to result in intrauterine growth retardation, the duration of pregnancy may be affected (less than 37 weeks is common), and spontaneous abortion is increased with cocaine use. Neonatal effects include poor intrauterine growth, teratogenesis possibility, and neurobehavioral effects that are measurable at birth and have a long-lasting effect. Sudden in...