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CRACK for birth control

BMJ 2004; 328 doi: https://doi.org/10.1136/sbmj.0403124 (Published 01 March 2004) Cite this as: BMJ 2004;328:0403124
  1. Vittal Katikireddi, Clegg scholar1
  1. 1BMJ

After adopting several children of a drug addicted mother, Barbara Harris devised a radical programme to reduce the number of drug affected pregnancies. Vittal Katikireddi investigates

I wish you had come to me with your birth control offer years ago so I wouldn't have had 14 babies," Sharon says. She has experienced a new approach to dealing with children of drug addicts that is sweeping across the United States--prevent their birth.

The programme, known as Children Requiring a Caring Kommunity (CRACK), aims to “offer preventive measures to reduce the tragedy of numerous drug affected pregnancies” by paying drug and alcohol addicts--both men and women--to use birth control or be sterilised, in the hope of preventing them from reproducing. The organisation, which now has 23 branches across the United States, believes that not only are developmental and health problems prevented, but also the difficulties of raising a child in the environment of drug misuse is avoided. Studies suggest that babies born to mothers who use cocaine are at an increased risk of intrauterine growth retardation, congenital abnormalities (including central nervous system defects, urinary and genital conditions), impaired behaviour and learning development, prematurity, and fetal death.1

Conceived in California

In 1990, a Californian couple decided to become foster parents. They took care of an 8 month old baby girl, who they learned was the fifth baby born to an addict from Los Angeles. Four months later, a phone call from a social worker offered them the baby's younger sibling, only recently born. They agreed. This second arrival needed hours of care to help him withdraw from …

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