The inner-city crack epidemic is now giving birth to the newest horror: a bio-underclass, a generation of physically damaged cocaine babies whose biological inferiority is stamped at birth. "This is not stuff that Head Start can fix," explains Douglas Besharov, the former director of the National Center on Child Abuse, who first coined the term bio-underclass. "This is permanent brain damage. Whether it is 5 percent or 15 percent of the black community, it is there. And for those children it is irrevocable." Five percent is the estimate of New York City infants exposed to cocaine in the womb. Fifteen 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 1 to 2 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 expects 120. It is crack that accounts for the astonishing jump in infant mortality rates in places such as the District of Columbia. Cocaine babies, for example, 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 piercing cries of withdrawing babies intolerable. "Never in my medical career have I seen so much suffering as cocaine has brought," says the director of the nursery at D.C. General Hospital (quoted in 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. 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 maternal drinking during pregnancy. 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 is producing damaged babies throughout society. A 1985 survey by the National Institute on Drug Abuse found that at least one in 10 of all American women of child-bearing age had used cocaine in the previous year. The problem does exist among the middle class, where it is better hidden for being widespread. But middle-class values and middle-class money can at least help protect these children after birth. Moreover, when the problem is widespread 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. What to do? Indeed can we really do anything about women so controlled by cocaine that they risk horrible damage to their babies by doing crack during pregnancy? A new burden for inner-city hospitals is cocaine babies abandoned by mothers who simply leave the hospital after delivery and never come back. Cocaine may be the most effective destroyer of the maternal instinct ever found. And repairing the maternal instinct is a problem beyond politics. The other voice of despair says that until the government solves the drug problem as a whole, it cannot hope to solve the problem of cocaine babies. This too may be true, but it is irresponsible, as well as cruel, not to try to save some babies pending solution of the larger drug problem. But how? (1) Punishment. Several jurisdictions have tried criminal prosecution. Three weeks ago a judge in Florida found a 23-year-old mother guilty of criminally conveying cocaine to her unborn child. This case followed a string of legal failures, the most prominent of which occurred in Winnebago County, Ill., where a grand jury refused to indict a Melanie Green of involuntary manslaughter for killing her fetus with cocaine. The jury was probably right. Current legislation, never intended for the contingency of cocaine babies, is too vague to sustain such a conviction. Moreover, criminal sanctions probably won't work. If concern for the child is no deterrent to a pregnant crack addict, concern for the justice system is hardly a better one. One rationale for not prosecuting cocaine mothers is entirely fatuous, however. Leave it to the local ACLU legal director (who represented Green) to offer it. He praised the Green jury for refusing "to criminalize and punish a pregnant woman who was herself a victim and who had already lost her child." The sang-froid of middle-class whites so addicted to rights and so enamored of victimhood is shocking. It is one thing to let the homeless mentally ill die with their rights on in the streets of America. You might, if you stretch it, say that these adults are destroying themselves: the state has no business interfering in people's privacy. But how can you maintain the fiction that a woman who does crack during pregnancy is protected from state intrusion because she, too, is engaged in a self-regarding act? The hospital wards filled with these broken, tormented infants utterly refute the proposition. (2) Treatment. The liberal answer, of course, is not to punish these women but to treat them. But that assumes that they will accept treatment. In the District of Columbia, prenatal care is not only free, the city has made a large effort to bring pregnant woman in for help. Yet, reports The Post, at Greater Southeast Community Hospital 25 to 30 drug-abusing women show up every month for delivery. "A person who is addicted to drugs has another priority," explains Pamela Robinson, a social worker at the hospital. "The unborn child is not a priority." Care for these mothers, says Robinson, "is available, and they are aware of it, but they are not seeking care." The other problem with treatment is that we do not have the slightest idea how to go about it for crack addiction. Besharov, a scholar at the American Enterprise Institute who has studied the problem for 20 years, concludes that "there is almost no evidence of our ability to deliver a successful drug treatment program to people." The heroin successes are due either to the development of blocking drugs (such as methadone) or to programs with a charismatic leader who uniquely engages the participants. Otherwise? "There ain't no proof that this stuff makes a difference," concludes Besharov. (3) Custody. Jeaneen Grey Eagle, who runs an alcohol treatment program at the Pine Ridge reservation in South Dakota, tells The New York Times that her tribe once locked up a pregnant woman who could not stop drinking. She supports such action. So do I. The choice is simple. We can either do nothing, or we can pass laws saying that any pregnant woman who takes cocaine during pregnancy will be sent until delivery to some not uncomfortable, secure location (boot camp, county jail, house arrest -- the details are a purely technical matter) where she will be allowed everything except the liberty to leave or to take drugs. We should do this not as punishment, nor as vengeance, nor even for deterrence, but purely for the protection of the soon-to-be-born child. Taking custody of the child unfortunately but necessarily means taking custody of the mother. This is no solution to mother's drug problem. But it is a solution to baby's. There might be a better solution fairer to both, but no one can find it. And until we do, the bio-underclass grows.