We are now into the era of fetal medicine.* Most of the handicapping disorders of infants and children that we care for today are the consequence of problems in prenatal development. Though the majority of these problems appear to have a genetic basis, it is extremely important to recognize those which have an environmental etiology since they are more readily preventable. When a chemical agent becomes recognized as causing problems in fetal development, ie, as being teratogenic, every attempt should be made to prevent the exposure of the fetus to dangerous levels of that chemical agent. This information should reach all women of reproductive age who are receiving the teratogen or who are liable to receive it after conception. Mothering before birth is direct mothering. It is direct in the sense that most chemical agents that the mother takes during pregnancy are also "taken" by the fetus. This is graphically portrayed in Fig 1. If we can simply foster the concept of mothering from conception, this will be a major philosophic advance toward prenatal preventive medicine. For example, every woman needs to know that her cigarette smoking or alcohol ingestion is cigarette smoking or alcohol ingestion by the fetus. Just as she would not wish her infant to smoke or drink after birth, it is even more important that the fetus not be exposed before birth, by her own smoking or drinking.