Advances in obstetrics and gynecology in the past 25 years have strikingly reduced the dangers to mother and baby during the birth process. Parent education is the most important part of modern prenatal care. Like other aspects of modern maternity care it can no longer be provided by the mother's physician alone but calls for the help of professional colleagues. During a period of 27 years at Chicago Lying-in Hospital it has been possible to maintain a rate of about 5 % for abdominal deliveries without sacrificing the best interests of mother and baby. In certain patients the operation should logically be extended to complete cesarean hysterectomy, and a series of 400 such operations has been performed without mortality. The incidence of birth trauma resulting in perinatal mortality has decreased markedly, but breech presentation still poses a problem. Discovery of the cause of preeclampsia and eclampsia and reduction of the incidence of cerebral palsy and mental retardation still challenge the investigator.