Surgery for birth defects helped create the specialty of pediatric surgery during the middle of the last century. Around this time, pioneering operations were successfully performed to allow the survival of babies with, e.g., esophageal atresia or congenital diaphragmatic hernia (CDH). Indeed, along with innovations such as parenteral nutrition, this concentration of surgical, nursing, and anesthetic expertise now allows high survival rates to be achieved for many previously fatal anomalies. Moreover, for certain conditions that retain high mortality and/or morbidity, fetal surgery represents a promising experimental approach to reduce the harm of birth defects further. Given this progress, it would be tempting to imagine that the problem of birth defects was largely solved.