This hearing was called to develop a better understanding of the damage to women and their babies resulting from substance abuse during pregnancy. The hearing transcript addresses prevalence and trends, impacts on mothers and children, impacts on health care costs, impacts on the child welfare system, legal and health policy issues, intervention strategies, and policy recommendations. The document contains statements, letters, and supplemental materials from: (1) Congressional Representatives Thomas Bliley, Jr., Ronald Machtley, George Miller, Nancy Pelosi, Charles Rangel, and Curt Weldon; (2) nurses, doctors, child development specialists, health educators, hospital directors, and substance abuse specialists; (3) attorneys; and (4) a representative of the National Council of Juvenile and Family Court Judges. Included are the findings from a telephone survey of 14 public and 4 private hospitals in 15 cities, and article reprints from a newsletter and two medical journals. (JDD)