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In 1939, Levine, Newark, and Stetson [24] published in less than two pages in the Journal of the American Medical Association their landmark article, a case report describing hemolytic disease of the newborn (HDN) and the discovery of the blood group that later became known as the Rh system. A woman who delivered a stillborn infant received a transfusion of red cells from her husband because of intrapartum and postpartum hemorrhage. Following the transfusion, she had a severe reaction but did not react to subsequent transfusions from other donors. The woman’s serum reacted against her husband’s red cells, but not against the cells of the other donors. Levine, Newark, and Stetson postulated that the mother had become immunized by the fetus, who had inherited a trait from the father that the mother lacked. In a later report, they postulated that the antibody found in the mother and subsequently in many other patients was the same as the antibody Landsteiner and Wiener prepared by immunizing Rhesus monkeys [25]. This also began a long debate over credit for discovery of the Rh system.

During the early 1900s, immunologic studies had established that active immunization could be prevented by the presence of passive antibody. This strategy was applied to the prevention of Rh immunization in the early 1960s in New York and England at about the same time [26, 27]. Subjects were protected from Rh immunization if they were given either Rh‐positive red cells coated with anti‐Rh or anti‐Rh followed by Rh‐positive red cells. Subsequent studies established that administration of anti‐Rh in the form of Rh immune globulin could prevent Rh immunization, and thus almost eliminate HDN. Currently, control of HDN is a public health measure similar to ensuring proper immunization programs for susceptible persons.