Here is an excerpt from a medical journal that describes the defect better than I can:
Discover, April 1997 v18 n4 p28(4)
Emergency deliveries: high-risk pregnancies shouldn't show up in the ER. But they do, and they are never simple. (emergency room)(Vital Signs) Pamela Grim.
Full Text: COPYRIGHT 1997 Walt Disney Company
>>>>>High-risk pregnancies shouldn't show up in the ER. But they do, and they are never simple.
. . . .
Six days later I had another delivery.
A woman, 35 years old and six months pregnant with her first baby, was complaining of abdominal pain. The nurse signed her in. Just then, the bag of water that cushions the fetus broke, and amniotic fluid began leaking onto the floor. The nurse rushed to get me.
I still hadn't recovered from the previous week's delivery. I had been dreaming about reaching out and feeling toes, feeling feet. I craved a normal headfirst ER delivery, all panic and chaos, climaxing with the delivery of an irate, squalling, and clearly healthy baby. I wanted the expected unexpected--a healthy woman whose labor has proceeded more quickly than foreseen. You slip your sterile glove within the vagina and feel for the cervix. During most of a woman's life, the cervix is a narrow funnel-like entry to the uterus, but during delivery, as the baby's head presses against it, the cervix becomes wide and flat like a plate and the os--the opening of the cervix into the vagina--dilates enough to let the baby's head through.
I pulled on my gloves and began the ritual. "You're going to feel something cold and wet." I slipped my hand into the vaginal canal.
I didn't know what I felt. There was the cervix and the os, and there was something sticking out from the os. It felt like a piece of wood, like a little tree log extending into the vagina.
"What the hell . . ." I said. There was a rivulet of fluid and then this thing slithered out onto the cart--its head was a great bubble of membranes with a wrinkled, gray, gelatinous mass under it. Two gigantic bulging eyes, like the eyes of an enormous fly, stared blindly at the ceiling. Long gray folds of flesh draped down to the grinning mouth. All this was attached to a normal baby's body.
"Jesus Holy Christ," the nurse said.
"Anencephalic," I said. I could not believe what I was seeing. "It's an anencephalic baby." The gelatinous mass was the brain.
The medical definition of anencephaly is "markedly defective development of the brain, together with the absence of the bones of the cranial vault. The cerebral and cerebellar hemispheres are usually wanting, with only a rudimentary brain stem and some traces of basal ganglia present. Colloquially, individuals with this malformation are sometimes called frog-babies." A number of conditions can increase the risk of anencephaly, including malnutrition, folic acid deficiency, and certain medications.
To me the baby's head looked like the head of a giant housefly. The nurse and I stared down, too stunned to move.
"Is the baby alive?" the mother asked.
I had been too overwhelmed to check for a pulse. I put my hand down on the umbilical cord. There was a slow pulse.
Scenes of the resuscitation procedure flashed before me: intubating the baby so it could breath (it hadn't so much as gasped), IV in the umbilical stump, the drugs, the fluids, a helicopter ride to a neonatal intensive care unit, the days, weeks, even month or two in the unit, the hundreds of thousands of dollars, the grim prognosis, the inevitable, heart-wrenching end. I thought about all this.
"No, dear," I said. "I'm afraid your baby is dead."
"Is it a girl?"
I looked down. I hadn't even noticed. "No, he's a boy."
"Can I see him?"
The nurse and I looked at each other. The nurse shook her head.
"No, dear," I said. "Later, later."
I cut the cord and delivered the placenta. The pulse was gone within a minute or so. There was never even a hint that the baby took a breath.
That night I went home to bed and as usual stared at the ceiling and reviewed what had happened. I didn't worry over the ethics of the life-and-death decision I had made. It somehow didn't bother me, although it should have. What I saw instead was that baby--that inhuman fly-baby. But then I thought about the mother. This woman had tried to conceive for ten years. After the stillbirth, she had wept, saying, "It's all my fault. I'm bad, I'm bad. It's all my fault, and I wanted that baby so much."
I kept going back and forth between the image of the fly-baby and the weeping mother until finally I got out of bed, sat down by the window, and looked out over the city. A few cars passed, a dog barked, a cat picked its way across the street, otherwise nothing. Except, of course, somewhere in this city, someplace I couldn't see from my window, that mother was still crying and still blaming herself.
So much for grace.<<<<<
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