Prospective mothers with the Rh-negative blood factor must make sure that their doctor has taken the necessary steps to avoid Bb-factor incompatibility disease in any future children. Today this is done by the administration of a vaccine following every Rh-positive birth and every miscarriage and abortion if the mother has not been immunized. Rh defects once killed or brain damaged more than 10,000 babies born in the United States every year. With the appropriate precautions, virtually all of these defects can be prevented.

During pregnancy, good prenatal care from an up-to-date physician, including regular checkups throughout the term of pregnancy, is essential. The pregnant woman should keep herself in excellent health throughout the pregnancy and avoid all contagious diseases-especially during the first three months! A nourishing diet is important, high in proteins, vitamins, and minerals, with an adequate caloric intake. (The ideal weight gain over the course of a pregnancy is somewhere between twenty and twenty-five pounds.)

No drugs or medications o f any kind should be taken without the direct and express prescription of a doctor who is aware of the pregnancy. This warning includes pills of every kind, aspirin, sleeping pills, tranquilizers, laxatives, douches, or even being near insecticides. Many of these substances can be trans¬mitted to the fetus during the very fragile prenatal period, irreparably damaging its growth and development. Undercooked red meat should be avoided, as well as contact with unfamiliar cats (danger of toxoplasmosis). No X ray should be allowed except in absolutely essential emergencies. Every caution should be taken to avoid prematurity, which includes extra protection against illness. Low birth weight 396 increases the likelihood of almost all the major birth defects.

At birth, good obstetrical care in a modern, well-equipped hospital is of prime importance. Many serious defects are caused by, or associated with, prolonged and dif¬ficult labor, complicated delivery, or delay in breathing after birth. The best in modem equipment and professional care are necessary to reduce the chances of any birth-related defects, which include cerebral palsy, mental retardation, and neurological abnormalities.

Outlook: Tremendous progress has been made in the last decade, and continues to be made, in the prevention and treatment of birth defects. Advances in pediatric surgery, the detection and control of chemical and metabolic disorders, the development of vaccines and amniocentesis (the extraction of small amounts of fluid from the uterus that enables the detection of certain defects early in the pregnancy), and on¬going research have all contributed to a steadily improving outlook.

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