Professor Richard Worthington Smithells

James Spence Medallist

Date of death: 13 June 2002

Year James Spence Medal awarded: 1992

Professor Smithells’ interests lay in neural tube defects, congenital abnormality registers, genetic counselling, and rubella in pregnancy. He established a congenital abnormality register in Liverpool and, after the discovery of the effects of thalidomide, wrote extensively on the effects of drugs on the developing embryo. He served for many years on the Thalidomide Trust. He also created a genetic counselling service in Liverpool, which was a novelty at the time.

In 1962, Smithells was writing about rubella in pregnancy, which continued to be an interest to him. He helped set up the Congenital Rubella Surveillance Programme and was responsible for the Northern Registry.

After being appointed Professor of Paediatric and Child Health at the University of Leeds, his inaugural lecture stated there are three hazards to a newborn baby: being born too soon, being born too dangerously, and being imperfectly formed. He argued that as infant mortality was falling, prevention and diagnosis should be addressed, or as he described it, "making better babies". He suggested collecting fetal cells and making diagnoses, and direct examination of the fetus by photography using ultrasonography.

He considered the introduction of the 1967 Abortion Act to be a poor substitute for prevention; he aimed to prevent the development of congenital abnormalities. He set up a laboratory to study the effects of drugs and nutrition on the early development of the embryo and fetus, and he and his colleagues found an association between vitamins and neural tube defects. In 1991, the report of the Medical Research Council study recommended that the diet of women who bear children should contains an adequate amount of folic acid.

Professor Smithells was also interested in the world babies were born into. In his inaugural lecture he highlighted premature birth and infants of low birth weight are strongly related to social disadvantage. He served on the Executive Committee of the NSPCC, was an honorary member of its council, and was medical adviser to the Family Fund.