Defining preventable birth defects: The March of Dimes' new program of publicity, research fundraising, and advice for pregnant women (1953-1973).

This article uses archival material to trace rising rhetoric about prenatal prevention of birth defects. I argue that the new philanthropic framing of "birth defects," aimed to create a coherent category and scientifically prevent a complex array of intractable anatomical and functional disorders seen in infants and young children, with repercussions for women. Emphasis on scientific prevention of birth defects was built on networks of volunteers, fundraising activities, and philanthropic marketing models that had been developed for a crippling epidemic disease, polio. The National Foundation's (NF) expansion to congenital malformations fit uneasily within the prior infectious disease eradication model, assuming that elimination of birth defects was a worthy and achievable goal. Scientific research fundraising, advice, and advocacy aims became entangled. Marketing of birth defects as a vast problem and looming undesirable outcome for all potentially pregnant women was shaped by philanthropic and professional domain expansion. The NF initially promised that funding scientific research innovation would yield a return on investment, with scientific research on pregnancy leading inevitably to elimination or repair of congenital malformations or medical rehabilitation. However, definitions of prenatal prevention were unstable, and prioritizing research and medical aid funds for the vast array of chronic conditions defined as their new target became a challenge. Framing birth defects as a public health crisis, such advocacy leveraged parents' hopes and aspirations for their children's future well-being towards fundraising for medical research and technologically mediated gatekeeping of bodily and functional differences.