New research has shown that children exposed to cocaine before birth are at risk of learning and behavioral problems. Such problems have broad implications for education, social welfare, and criminal justice in the United States. However, there are numerous opportunities to minimize prenatal cocaine exposure and its impacts and thus to enhance the well-being of women and their children. This report, a collaborative effort of the RAND Drug Policy Research Center and the New York Academy of Sciences, presents an overview of the current state of knowledge regarding the effects of cocaine on the developing brain and offers policy considerations for addressing the issues that arise from cocaine use by pregnant women. The report discusses three prevention strategies: primary prevention (preventing substance use before and during pregnancy); secondary prevention (identifying pregnant women who use drugs and minimizing their drug use); and tertiary prevention (reducing the adverse consequences of substance exposure in children who were exposed in utero). In addition, the report presents a number of areas where more research is needed and offers a rationale for making more resources available for women and children affected by cocaine. (JD)