15 February 1983
Dear Doctor Koop:
I am pleased that you are working to improve maternal health in an effort to reduce infant mortality. The "Healthy Mothers, Healthy Babies" materials will be a most useful adjunct to our Orange County Health Department prenatal classes.
There is, however, a major problem with the posters you have produced. They do not belong in public health departments. The fairy-tale scenes are worlds away from our clients' lifestyles.  Many of our clients are poor, adolescent, unwed mothers who cannot possibly identify with the pregnant or lactating women in the DHHS posters.  They may be colorful, as is stated in the literature we received, but they are far from being informative.
Please, make more realistic posters.  An example of an appropriate poster would be a scenario of a pregnant black woman shopping in a grocery store with nutritious foods in her cart and selecting some fresh vegetables.
In closing, we will not be using the poster you have sent to our health department.  However, I have requested that posters be sent to us in hopes that you will respond to our request for more useful visual aids for our clinic.  Please understand that we support the "Healthy Mothers, Healthy Babies" program.  But, we want to avoid wasting expensive materials that are inappropriate. In this time of economic hardship every dollar spent should be scrutinized for its utility.
Sincerely,
Sharon D. Ammons, R.N., B.S.N.
student, M.S.P.H. program
University of North Carolina School of Public Health