Recent research has shown the advantages for children’s welfare of open fetal surgery over postnatal treatment for myelomeningocele. However, a balance must be struck between complications of premature birth risked by prenatal surgery & the long-term advantages for affected children’s health, including mobility & neurological capacity. Risks for women are repeated surgery for intervention & delivery. The research raises legal & ethical questions about how fetal interests should influence women’s choices, & whether women may decline interventions in their pregnancies that offer their children lifelong advantages. Beyond fetal interests & women’s preferences are state interests in fetal life, which have been expressed in judicially authorized cesareans. Underlying issues are the nature of fetal interests, contrasting entitlements to care from their mothers of fetuses & born children, healthcare providers’ responsibilities toward fetuses, & duties to pregnant women.