Anencephalic on parade

Perhaps excessive concern for fetuses is a luxury reserved for countries where medical care is sufficiently advanced that few women die of complications of pregnancy anymore. When there is a realistic chance that your wife will die due to complications, worrying about a fetus seems pretty silly by comparison.

Am I just being really paranoid, or does that fetus look really fake?

JE: I had the same thought. The head looks fairly classic ancephalic, though. Ancephalic babies often don't look very real. Maybe there's some sort of mental defence mechanism that makes people think "ick...that's not real" when confronted with severe malformations. On the other hand, the size bothers me: the baby is described as weighing 2 kg (about five pounds) but looks larger in the picture.

The pictures did look like they could have been Photoshop jobs, but still, my strongest reaction can only be characterized as:

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Well, according to one source, the mass of a newborn's brain is ~350-400 grams. So that's almost a pound less than a baby the same size with a brain would weigh. Given the lower picture, and the size of the hand holding the bowl, it could be about the size of what would normally be a 6-lb baby .

Good point, raven. It's probably the right size then.

I think it's disturbing that they held a parade.

Well, I guess that would depend somewhat on how far along in development it was. I really don't see any important differences between a 30-week-old baby and a full-term baby.

I'm glad the mother is ok, though.

PZ:

That's an excellent point of view, I think

I'm not sure it's as much a point of view as simply keeping a stiff upper lip about the whole thing. Actually, it is natural to be concerned first with his wife's well-being and relieved that the situation wasn't a lot worse, but I doubt he's completed unaffected by the anencephalic baby.

This has got to be a gut-wrenching experience for both of them, not because of any particular beliefs about the moral significance of the event, but because pregnancy is invested with so much hope (usually). You cannot have a really "pragmatic" attitude about miscarriage, still birth, etc. without acknowledging that in practice, these things hurt and do require some grieving.

Man, that is one weird looking baby.

Maybe God let Jim Henson design one for a change.

*rimshot!*

My browser burped and half-froze for a second as I scrolled down, making it look as if you were quoting something saying about Tom Delay being a neckless baby with extraordinary large eyeballs . . .

Poor thing. I don't want to believe it's real - I can feel that proposed mental defense mechanism kicking in. Putting it on a tray and displaying it to the crowd seems rather odd, though? I'm dubious.

Oh god, GWW, it does look like a muppet! Why did you have to say that?! Now I'm imagining it dancing and singing. : ( (Although that does say something about the way we design puppets and such)

Anyway, get ready to see a couple more of them in South Dakota - though I assume that they won't have a parade and be featured in the paper . . .

: (

So which is it? An embryo, a fetus or a baby? It seems alright for you clowns to use the terms interchangeably, so why do you get all up in arms when pro-lifers do it?

And is a baby born 7 months after conception more human and/or more of a person than a baby still in the womb at 8 months? Does the former have more worth than the latter?

Embryo, Fetus, Baby - You Just Hate Them All

what a lame troll... let's starve it to death ! ;-)

I can't come up with a good reason for thinking so, but I too think it's a little creepy that they put it in a washtub and paraded it around town. Then again, I clicked the link to see the freaky baby, so who am I to judge?

What is with all the freaky births coming out of that section of the world lately? Wasn't that infant born with two inside her from over there too?

Is it the water?

;)

How common is this abnormality, because it reminds of the headless peopel from the far East that I think were described in "The Travels of John Mandeville" maybe somewhere in the realm of Prester John.

I can't come up with a good reason for thinking so, but I too think it's a little creepy that they put it in a washtub and paraded it around town.

Am I the only one to think a parade is an excellent response? People often feel shame about events they have absolutely no control over. When something like this happens, the impulse would be to cover up all the evidence and never talk about it again. Provided that the parents were comfortable with the attention, it may have done them a lot of good to have the community attach significance to this birth rather than sweep it all under the carpet.

Count me among those who think the parade is upsetting. Not from the point of view of "it's awful for people to want to see such a thing," but from the point of view of "although obviously severely deformed, we are talking about a newborn here." Presumably an anacephalatic infant wouldn't be cognizant of discomfort during the thing, but even so, it's upsetting. Call me culturally insensitive, but the proper response to such a birth is sadness, I think.

What is with all the freaky births coming out of that section of the world lately?

I don't know about fetus in fetu, but anencephaly and other neural tube defects are thought to be related to lack of folate in the maternal diet. So I'd guess that it's a combination of poor diet and selection bias: lots of babies are born, only a few of them are abnormal but they are the ones we hear about. The headline "Perfectly normal baby born to parents in India" would get pretty boring after a while.

Presumably an anacephalatic infant wouldn't be cognizant of discomfort during the thing, but even so, it's upsetting.

I'm almost certain that the poor thing was dead already. It is described as having died half an hour after birth and being brought to the hospital already dead. It probably died in its parents' arms, which is probably the best one could hope for it.

Anencephaly is pretty rare, but does occur in the U.S. However, in most countries with good prenatal care they are often diagnosed early in the pregnancy by ultrasound and I imagine that most parents choose to terminate the pregnancy (as this is a fatal defect). If the pregnancy goes to term, physicians usually do a c-section as delivery can cause a lot of damage to the infant unless it is a breech birth--I could go into a lot more detail, but will respect people's sensitivities.

Neural tube defects (spina bifida is the old term most people know) are related to a lack of folate in the diet but I haven't heard of anencephaly being related to it also (and I may have missed the information).

Depending on the severity of the defect and mode of delivery, the picture may be completely accurate...I'll admit that I have not looked at the picture...I've seen anencephalic babies in my OB career and don't really want to look at this one.

So I'd guess that it's a combination of poor diet and selection bias: lots of babies are born, only a few of them are abnormal but they are the ones we hear about.

I'm not convinced that you need anything besides selection bias. You'd be a lot less likely to hear about an anencephalic baby born in the US or Europe because it's a known (if rare) phenomenon and the parents would have no desire to publicize it. Anyway, neural tube defects would be likely to be caught long before birth (triple screen or ultrasound). Many parents will choose to have an abortion when it's clear that there is no chance that the baby could possibly survive.

Assuming that part of the reason is simply the share of the human population in "that section of the world", it might be a little surprising that such stories aren't coming out of China. I suspect there might just be a cultural difference that makes it less likely that we'd hear about it.

There isn't enough information in the story to know why the body was treated the way it was. I don't much is gained by praising or criticizing the behavior without that information.

bitchphd:

Call me culturally insensitive, but the proper response to such a birth is sadness, I think.

I'm not keen on calling you anything, but in my view the only proper response is one that respects the parent's wishes. I'm not sure if that's the case in this instance (and I am too squeamish to look at the pictures) but I don't see anything intrinsically wrong with making the birth into a public event.

I have the whole 'ick' factor over the parade too, however the culture is very different there and as the article reported, police had to be called in to stop the crowd from invading the hospital. Please remember we are talking about a small town (compared to where most of us live) and in that area they tend to either know one another personally or via family connections. It is a 'village' in the most community minded sense of the word.

Not to mention there is that curiousity factor (which as far as I am concerned is a good thing, science started as curiousity) The child was dead before they reached the hosptial; he felt no pain, shame or horror. My first concern would have been for his mother Suntali, between the heartache of losing a child and the hormone fluctuations I hope that she will get through this with as little pain and complications as possible.

As an aside, I think the article mistranslated the father's response. I am reasonably sure that he felt loss and saddness over the lost of his son, however he has his wife and two daughters who are all alive and well and he takes comfort in them. And remember he may also be in shock, they were more than likely expecting a normal, healthy child only to be faced with this. Numbness is a coping mechanism, much like the above suggested "it looks fake" mental protection system.

I don't [think] much is gained by praising or criticizing the behavior without that information.

I agree with that and will offer no further comments.

Neural tube defects (spina bifida is the old term most people know) are related to a lack of folate in the diet but I haven't heard of anencephaly being related to it also (and I may have missed the information).

Now you got me interested, Dawn. I found 44 PubMed hits on "anencephaly AND folate"; the upshot seems to be that:

1) anencephaly, meningomyelocele and encephalocele, and spina bifida are classified together as open neural tube defects (NTDs);

2) any of these NTDs can be prevented for the most part with appropriate prenatal use of folic acid, although not all NTDs respond to this treatment;

3) even in this country, where access and information is much easier than for that poor Nepali baby, lots of women aren't following the recommendation;

4) there are NTD mouse models, where they are studying the pathways involved in NTDs, and how folic acid acts to prevent the defects.

Interesting!

Anencephaly is associated with high maternal fever at the stage of neural tube formation (around 40 days, I think). There have been clusters in the US when the flu is going around.

PZ -

first the centipede, then the stomach worms, and now this.

why is pharyngula turning into a freak/geek show?

you're going to lose readers - and that would be a shame.

please rethink your editorial strategy.

Dawn

ah, in some of the articles PubMed just returned, I learned that one of the genes they are looking at in the molecular pathways is the thermolabile (heat-sensitive) mutation of methylene tetrahydrofolate reductase. I had not previously understood how folate can address heat-related NTDs, but that possible explanation makes sense.

I do highly recommend the Walter Reed Pathology Museum for anyone out there who is "interested" in bizarre stuff like this baby.

Remember: really freaky hideously or beautifully deformed babies and fetuses are produced EVERY DAY by the truckload all over the world.

We just don't hear about them, much less get a chance to see them.

But go to the Walter Reed Pathology Museum. There's all kinds of cool stuff there. In bottles.

first the centipede, then the stomach worms, and now this.

why is pharyngula turning into a freak/geek show?

you're going to lose readers

I'm sure the author of this comment meant to say "gain" instead of "lose."

On planet earth, most humans are attracted by the weird and freaky. Scientists tend to be even more interested than most.

By the way, PZ, the other day I went to the bathroom and my feces was shaped exactly like a question mark! I almost took a picture. Next time I won't be so lazy.

That photo, or the dead baby's body, has been faked. It's far too large for a woman to have given birth to it. It looks like very very bad special effects, such as those seen on that old chestnut,"ET."
Come on, people. Take a good look at it! Ridiculous.
As for the parade, maybe the people there don't have access to cable TV, so they have to provide entertainment in person.
Just a literal form of our supermarket tabloids.

GWW - too much information!

One more comment: the fact that I have to add HTML tags to each paragraph in a selected portion of text is a irritating. If there is a way to change this, I beg the Star Chamber to take such action.

I've decided that when I die I want my body to be paraded through town.

I can't explain why, it just feels right to me.

We have different traditions for such birth events here in the U.S.:
http://seattlepi.nwsource.com/local/217156_janedoe23.html

I don't know, Isabelita, my second baby weighed eleven damn pounds. In the second photo you can see more size perspective when he is surrounded by adults, and he looks about the same size as my own baby.

I agree with Bitch Ph.D., too, and I wish the article had gotten the mother's feelings on the treatment of her dead baby. I have a difficult time wrapping my mind around the idea that she'd say, "A parade, you say? Why sure!"

Dan S. (stop stealing my name!):

My browser burped and half-froze for a second as I scrolled down, making it look as if you were quoting something saying about Tom Delay being a neckless baby with extraordinary large eyeballs . . .

He's not?

PaulC:

Am I the only one to think a parade is an excellent response?

No. It's like a New Orleans funeral.

Those photos aren't fake. I've got some medical embryology texts here with photos of anencephalics that have exactly the same pop-eyed muppet look.

A Google image search for "anencephaly" will also turn up similar photos, although I don't recommend it for the weak of stomach.

Personally, I enjoy the "geek/freak show" aspect of this blog-- and that's just the creationists I'm talking about! Seriously, though, post whatever the hell you want, PZ-- I'll certainly keep visiting the site.

Eeek. You weren't kidding Edgyspice.

In all seriousness, that link alone is enough to debunk the existence of an all-loving god.

Yikes.

I thought it looked more like a village-wide funeral procession than a "parade" - note that PZ used the term parade, not the original article. For all I know, this is the standard way of beginning the grieving process for a stillbirth/infant death. Certainly, none of the people in the picture looked jovial. American culture is one of the strangest with regard to death in that we try to completely ignore it. After reading The American Way of Death, (and Stiff, for that matter), I'd take being paraded through the streets as a much more dignified way to go.

About the baby being too large)
I think it's an illusion produced by some accident of photography -- a wide-angle lens, maybe?. Look closely at the second image: you can see that it's in a bowl which is being held aloft on the palm of one hand. The bowl looks to be size of a small serving dish -- maybe 8" diameter -- and the baby fits comfortably in it. That's not a big kid.

De gustibus and all that, Dawn, but stomach worms etc. are a big part of why I come here. (I should note that, by an amazing coincidence, I am playing a Stereolab playlist in the background, and the song 'Stomach Worm' just came on! Hmm... coincidence, or evidence for the strong anthropic principle?)

On a more serious note, were I to have an anencephalic child, I'd be shattered that the child had the condition; but, given the presence of that condition, I would not be at all sad (indeed would probably think it a mercy) that the child died (in any event a foregone conclusion in anencephaly). Death itself would be no misfortune here, no cause for mourning.

Anencephaly and Johnny Hart within a couple of posts of each other. Coincidence? I think not.

"He's not?"

We resent that remark!

I am much happier with the idea that the second picture is of a funeral procession and/or that the baby is already dead. And I wasn't trying to say "oh look at those awful people and their horrible traditions," though I can see how my comment led to that interpretation. Sorry about that.

Dear PZ,

Please think of all of the random people on the internet who choose to read your blog, even though you never asked them to, and instead of treating your personal blog as your personal space to, say, blog, instead cater your content directly to what the vocal minority wants to and doesn't want to see.

[/sarcasm]

Sorry about the run-on sentence, guys. :D

On Topic: I've only seen drawn diagrams of anencephaly and it is nothing like seeing it in the flesh (though that should have been obvious to me before seeing it). We actually just finished a brief segment on neurulation in my Devo course a couple weeks ago so this is sort of filing into my brain as supplemental material. Yea for learning!

In the article linked to in Bruce's comment above (about enlisted mens' wives w/anencephalic pregnancies who want the military insurance provider to pay for abortions), one such wife said:

'What many people don't realize, she said, "is that an anencephalic pregnancy could be over a year in gestation. One of the nasty things not many know is that because the brain is not developed, the fetus doesn't send a signal that it is ready to come out."'

Is this true? And would the mother's medical team allow the pregnancy to continue that long? Could they not induce delivery?

Maybe the dead, deformed baby will get snatched up by a Creationist museum.

You don't believe me, then how do you explain PYGMIES + ANENCEPHALICS!

There isn't enough information in the story to know why the body was treated the way it was. I don't much is gained by praising or criticizing the behavior without that information.

I've read plenty of stories in Fortean Times about Indians treating children with birth defects as "miraculous babies", even building shrines for people to leave offerings at.

I thought that the eyes grew out of the brain proper, so how does something without a brain get eyes? Or is it that anencephalia means no cerebral cortex? I've forgotten this stuff. (I guess it might have to be the latter, because one needs a brainstem to breathe, no?)

Cyclopean kittens 'n' stomach worms 'n' centipedes 'n' anencephalic stillborn babies are major reasons for visiting this site! Nature ain't always pretty! (And reading this site on a daily basis has converted me from a wishy-washy agnostic to an out-and-proud atheist)!

"On the other hand, the size bothers me: the baby is described as weighing 2 kg (about five pounds) but looks larger in the picture."

"The" picture? Did you only look at the top picture, which is visually misleading because of foreshortening, and not the bottom picture?

I delivered a full term anencephalic baby about 8 months ago, this baby looks like he has anencephaly just looks way too big to be a newborn. The occurance of anencephaly is about 1 in 1000. Now if you take a daily dose of folic acid (400 mcg) that will cut your chances of having a baby with an NTD by about 70%. So ladies even if you dont plan on becoming pregnant please take folic acid. About 50% of pregnancies are unplanned.
I am aware that if you do a google search on anencephaly some pretty scary pictures will pop up. You have to remember that these babies are dead & have more than likley been sitting in a jar somewhere preserved. I think you would look pretty scary too if you were dead & pickled in a jar somewhere. If you would like to see a picture of a live, breathing, pink, beautiful anencephalic baby visit my website or email me & I can send you a picture. There is nothing about my son that is freaky or scary, you dont have to have a strong stomach to look at his picture. With a cap covering his head he looks like any other newborn baby. He lived for 33 hours after birth & acted like any other "normal baby". I feel for this little boys parents, they were probably in shock & didnt know what to do. The doctors have more than likley never even seen a baby with anencephaly. www.geocities.com/valleyhillnicole/InMemoryofLogan