Five percent is the estimate of New York City infants exposed to cocaine in the womb; 15 percent is the estimate for the District of Columbia. Although this catastrophe is particularly acute in the black community, it is obviously not restricted to it. Besharov's estimate (the best that I have seen) is that 0.5 percent of all babies born in the United States have been exposed to cocaine. It is clear, moreover, that throughout the country the problem is exploding. In 1985, two cocaine babies were born in Cincinnati. This year, University Hospital there expects 120.
It is crack that accounts for the astonishing jump in infant-mortality rates in places like the District of Columbia. Cocaine babies have 15 times the risk of sudden infant death syndrome. But the dead babies may be the lucky ones.
For some of the crack babies who survive, the first life experience is the agony of cocaine withdrawal. They suffer terribly. They are so sensitive to touch that they cannot be held or fed properly. Some move their limbs endlessly, looking for relief. Even the hardened veterans of the neonatology intensive-care units find the high-pitched cries of withdrawing babies intolerable. "Never in my medical career have I seen so much suffering as cocaine has brought," the director of the nursery at D.C. General Hospital told the Wall Street Journal.
A mother's use of cocaine during pregnancy can cause appalling damage to the infant: strokes, seizures, paralysis, prematurity, deformed hearts and lungs, abnormal genital and intestinal organs. And, most ominously, permanent brain damage. A cohort of babies is now being born whose future is closed to them from day one. Theirs will be a life of certain suffering, of probable deviance, of permanent inferiority. At best, a menial life of severe deprivation. At worst, early and painful death. And all this is biologically determined from birth.
It is a horror worthy of Aldous Huxley. In Brave New World, the state creates a race of (sub)human "Epsilon" drones by reducing their oxygen as they incubate in government-run fetal "hatcheries." "Nothing like oxygen- shortage for keeping an embryo below par," explains Mr. Foster, a hatchery scientist, rubbing his hands.
Cocaine works the same way. It does its damage in the womb by cutting off the blood supply to the baby, leaving every organ, the brain in particular, screaming for oxygen. Yet life has outdone Huxley. Even he could only imagine a mad (and satirical) utopian state doing this to its children. It is harder to imagine mothers doing it to their own. Yet, says Dependency Court Commissioner Stanley Genser of Los Angeles County, "we are getting women in here now who have given birth to their second or third or fourth drug baby."
It is not just in the inner city that a bio-underclass is emerging. Alcohol is creating a similar bio-underclass among Indians. Studies show that on some reservations 5 to 25 percent of children suffer from fetal alcohol syndrome, physical abnormalities and mental retardation caused by heavy drinking by pregnant women. The children are hyperactive, difficult to raise, harder to educate. They have quite simply been robbed of the capacity for thinking well. The consequence, pediatrician Geoffrey Robinson told the New York Times, is ''a devastation that is worse than smallpox."
No doubt, maternal drug and alcohol abuse are producing damaged babies throughout society. A 1985 survey by the National Institute on Drug Abuse found that at least 10 percent of all American women of childbearing age had used cocaine in the previous year. The problem does exist among the middle class, where it is better hidden for being widely dispersed. But middle-class values and middle-class money can at least help protect these children after birth.
When the problem is widely dispersed, it produces individual tragedies. But only when it becomes concentrated and localized, as in the inner city or on the reservation, does it become a threat to communal life as a whole. In the poorest, most desperate pockets of American society, it has now become a menace to the future.
For the bio-underclass, the biologically determined underclass of the underclass, tomorrow's misery will exceed yesterday's. That has already been decreed today.
