Radioactive fallout after the March 2011 Fukushima nuclear meltdown entered the U.S. environment within days; levels of radioactivity were particularly elevated in the five western states bordering on the Pacific Ocean. The particular sensitivity of the fetus to radiation exposure, and the ability of radioisotopes to attach to cells, tissues, and DNA raise the question of whether fetuses/newborns with birth defects with the greater exposures suffered elevated harm during the period after the meltdown. We compare rates of five congenital anomalies for 2010 and 2011 births from April-November. The increase of 13.00% in the five western states is significantly greater than the 3.77% decrease for all other U.S. states combined (CI 0.030 - 0.205, p < 0.008). Consistent patterns of elevated increases are observed in the west (20 of 21 comparisons, 6 of which are statistically significant/borderline significant), by state, type of birth defect, month of birth, and month of conception. While these five anomalies are relatively uncommon (about 7500 cases per year in the U.S.), sometimes making statistical significance difficult to achieve, the consistency of the results lend strength to the analysis, and suggest fetal harm from Fukushima may have occurred in western U.S. states.