Dead Baby Research Articles

The prevalence and challenges of abandoned dead neonates in an African referral center

Background Dead neonates are often preserved in the mortuary pending until parents/caregivers’ collect them for formal burial. This study reports the prevalence and challenges of abandoned dead neonates in an African referral center. Materials and methods The clinical and mortuary records of all dead neonates at the University of Benin Teaching Hospital between January 2006 and December 2010 were retrospectively reviewed to determine the prevalence, influencing factors, and challenges of abandoned dead neonates. Results A total of 1093 (22.9%) mortalities were recorded among 4781 neonates. The prevalence of abandoned dead neonates was 77.2% as 844 of the 1093 dead neonates were abandoned to the hospital and given mass burial by an assigned government agency after at least 3 months of abandonment. This was challenging as an average of 85 dead neonates were given mass burial every 6 months to decongest the mortuary. Of 618 illiterate parents/caregivers of low socioeconomic class, 520 (84.1%) abandoned their dead babies. This was extremely significant statistically when compared with 324 (68.2%) bodies abandoned by 475 literate parents/caregivers in upper/middle class (P < 0.0001). Surgical neonates, neonates with obvious congenital anomalies, and babies from the third birth positions onward were mostly abandoned. Conclusion We advocate the need for public enlightenment campaign to modify present parents/caregivers’ attitudes toward dead neonates. Hospital-based postbereavement programs should be organized to help parents/caregivers adjust appropriately to neonatal deaths. Those with dead neonates should be exempted from paying hospital bills. Keywords : abandonment, challenges, dead neonates, prevalence

A Plea for Doubt in the Subjectivity of Method

A Plea for Doubt in the Subjectivity of Method

"Sadly and with a Bitter Heart": What the Caesarean Section Meant in the Middle Ages

One sunny spring day, a Resurrectionist priest sips tea and speaks of his time as a Bolivian missionary in the 1960s and ’70s. His recollection of the local ‘Indians’ is obscured by more than three decades’ distance. China cup in hand, he recalls vaguely their mud huts, flocks of sheep, herds of llamas, and the beautiful, rugged terrain of the altiplano. With greater precision, he speaks about the local belief system, especially attitudes towards stillbirths. This left a strong impression upon him. The priest emphasizes how deeply fearful the locals were of stillborn babies, and he flavours his recollections with two sad anecdotes. One day, he says, some villagers brought him a small blue corpse. The baby’s father insisted that the missionary baptize it. Since this was canonically impossible, the priest performed an impromptu blessing. It effectively banished the evil spirit conjured by the unfortunate birth. Satisfied with the blessing, the villagers relaxed and returned to their normal lives. On another occasion, one of the priest’s confrères was less delicate. A mother presented him with her dead baby, pleading for a postmortem baptism. At last the cleric told her, “The Church will only permit me to baptize your child if it draws milk from your breast.” Since this was impossible, the mother went away frustrated and ill at ease, having been unsuccessful in her bid to exorcise the unlucky spirit.

A dead baby and a scar, but [] no genitalia in sight. Is Bieito's Jenfa really a Bieito?

Catalan director Calixto Bieito is seen by many as the enfant terrible of opera, and his productions are known for their strong sexual content, onstage violence and radical updating of seminal works. This article, within the framework of Regietheater (director's theatre), examines this director's signature style through the analysis of the Stuttgart State Opera's 2007 Jenfa by Janek, one of Bieito's least controversial productions. Through the analysis of recurrent dramaturgical and directorial choices and the production's relationship with the libretto, this article questions the value of audience, media and theorists' expectations as identifiers of a director's output and contextualizes this production within Bieito's oeuvre.

Ellis-Van Creveld Syndrome: Prenatal Diagnosis, Molecular Analysis and Genetic Counseling

To present the perinatal findings and molecular genetic analysis of two siblings with Ellis-van Creveld (EvC) syndrome. A 33-year-old woman, gravida 3, para 1, was referred for genetic counseling at 18 gestational weeks because of recurrent fetal skeletal dysplasia. Two years previously, she had delivered a 1,316-g dead male baby at 28 gestational weeks with a karyotype of 46,XY, postaxial polydactyly of the hands, thoracic narrowness, endocardial cushion defects, transposition of the great arteries, shortening of the long bones, malposition of the toes, and hypoplastic nails. During this pregnancy, prenatal ultrasound at 18 gestational weeks revealed shortening of the long bones (equivalent to 15 weeks), postaxial polydactyly of both hands, thoracic narrowness, and endocardial cushion defects. The pregnancy was subsequently terminated, and a 236-g female fetus was delivered with a karyotype of 46,XX, postaxial polydactyly of the hands, thoracic dysplasia, endocardial cushion defects, shortening of the long bones, and malposition of the toes and hypoplastic nails. The phenotype of each of the two siblings was consistent with EVC syndrome. Molecular analysis of the EVC and EVC2 genes revealed heterozygous mutations in the EVC2 gene. A heterozygous deletion mutation of a 26-bp deletion of c.871-2_894del26 encompassing the junction between intron 7 and exon 8 of the EVC2 gene was found in the mother and two siblings, and a heterozygous nonsense mutation of c.1195C >T, p.R399X in exon 10 of the EVC2 gene was found in the father and two siblings. Prenatal sonographic identification of endocardial cushion defects in association with shortening of the long bones should alert clinicians to the possibility of EvC syndrome and prompt a careful search of hexadactyly of the hands. Molecular analysis of the EVC and EVC2 genes is helpful in genetic counseling in cases with prenatally detected postaxial polydactyly, thoracic narrowness, short limbs and endocardial cushion defects.

Ascertaining year of birth/age at death in forensic cases: A review of conventional methods and methods allowing for absolute chronology

Based on an actual case, where we were able to ascertain the year of birth of three dead babies found in a deep-freezer to within 1–2 years (1986, 1988 and 2004, respectively), we review the current state of forensic age determination/year of birth determination. The age of an individual (year of birth) is often a fundamental piece of data in connection with forensic identification of unidentified bodies. The methods most often used are based on determining various morphological, age-related, changes on the skeleton (or teeth, although odontological methods are not reviewed in this paper). As such, these methods are all relative, i.e. they do not furnish calendar ages or years, but an estimate of the age at death, with a rather large range, i.e. the methods rely on biological aging following the chronological aging. More recently, methods have been proposed using more direct ascertainment of age at death, e.g. protein racemisation, or, as in our case, radiocarbon methods. Especially the latter method may in fact yield absolute ages (years of birth), because 14C activity, as measured in specific proteins in specific cells or tissues in the body, were in equilibrium with the so-called bomb-pulse, when these proteins were formed (at birth). The bomb pulse reflects a dramatic change in atmospheric 14C content due to nuclear bomb testing, and these dramatic changes can be rather tightly related to single calendar years.

Near-Dead Pearl

DANIELLE PAFUNDA Near-Dead Pearl H H heytellitI wasbornina plateofclamsina dinerinnorthFlormm ida.A perfectly roundpeacock-shaded pearl,a rarity Idiots.I all butdied in an oyster s gulletand was buriedin thatplateofclamsby a fatfuckofa shortordercook.Myrotten corpselayer, mybruiseofa bodybag,turned everyone on. I wasborn ,ifyoucancallitthat, centuries ago.A grainofsandwornoffa slickpieceofsea glass.Thatseaglass, an ocean-smoothed shardfrom thepirateQueen Granuaileselegantlittle prophylactics case. Drifting lonelyacrosstheoceanfloor, I fellinlovewithan oyster, an ambisexual iconoclast, a hundred yearsold. Ze was mybeloved,and I worshipped at thechipseparating hirsplish-splash. Fornearly a decade ,ze remainedtight-lipped. Then one dayze opened.Whetherin surprise orwelcome,I didn'tgivea shit.I rakedmywayinandbeganto inflame. ButI'm notthevillaininthisscene.Ze wascruel.Ze heldmetoo tightly, washedmewithputrid acids,ranhirbacterial swagoftongue over me.Some nightsI thought Id be erased.Butevery timeze tookitout on me,I grewthicker skinned, and eventually nothing ze saidbothered me."Youslutsliver," ze taunted, "youformer whoreandpermanent nuisance .Yousea-bottomed prostitute." Ze wasn'twrong, perse. I'd fallen quitefarfrom mydayswiththeQueen. I'd beenina lotofcrevices, and takena lotofknocks on thecoralreef. Whatcan I sayaboutit?Ze wouldrollmeover, and I'dforget myself .Forget, smallas I was,thatI wasoncea gift from onegreat queento another. Queen Granuailesdirty whisper in Queen Elizabeth's earas I slippedfromcoldwhitehandto pocket.Neitherhaghadan eggleftto guard. Itwasn't politics; thatlittle exchange sealedthemarriage ofqueens. Theydied,Granuaileand Elizabeth, yearslater, landsapart,at thevery samehour.The verysameminute, thespooks.And somewhere in the 142 shuffle, thosehenchmen inserviceto theQueen dumpedtheglassbox overboard. Whatdid theycare?In thosedays,ifa fellahadn'tcomein oroutofa queens body, thenherpersonaleffects, thefurred robesand handwritten notes,thedevicesand potions,all werejettisoned.Only actualgoldwas worthitsweightin gold,and whatwas thelittleglass box butsentimental clutter? What was I buta puked-upshardin the making? Oh,howmybelovedsoothedallthat.Memory slippedoff intothe scuzzybasement ofmyoyster s shell.Ze wasnasty, ze washome. AJJfc So howdid I endup so near-dead?Ze killedme.Slowly, one layer ata time,shellacked meto deathwithhirownparticular stain.I heard less,I sawless,I neverwentout,andone day, near-dead, light spilledin on me.Out thecrackI rolled.Ze hirself wasfully dead,as itturned out. A hundred-some yearsbeyondhirexpiration date.None too fresh by thetimea porkfacedcracker orderedup theseafoodspecial.Ze wentin thetrash, and I shotintoa plateofshellfish andfries. Its Honeywhofoundme.Haltingatthekitchen door,shetucked me deep in hercleavage.Then she swungthrough to thedinerside, plunkeddowntheplate,gavea curtnod to one oftheregular lechers, andhotfooteditto theladies.There,shetippedmeoutwithone long coral-painted nail.Inherway, Honeywasa classact.Sherolledmeinher palm,rinsed meinthesink, andsuckedmebetweenherlips.Itwassalty, warm, pinkly dark.Then shespatme,rolledmeina thinsheetofrough paper, andtuckedmebackinherrack. I dozed there. I hunkered very deepinsidemyownglossy remains, betweenHoneys neatlytrussedtits.At theend of hershift, she collaredStrung Out Barb,theotherwaitress. "Hey, bitch," Barbprotested, shanks ofredhairescapinga plasticclawclip. "Youwanttoseethis." Honeywhisked. Barbdouble-timed. Inthe T-topinthebackofthebacklot,justbeforegravel becameswamp, the coralnailcamebackforme,slidmeoutofmysleazywrap,andheldme upto Barbs slowfocus. 143 "Real?" A swampbirdcalled. "I think so.Founditintheclams." "Theycomeingreen?" "Thisone does." An enginerevved, gravel crackle. Somemoments. "Theycomefrom clams?I thought itwasoysters." I shivered. Whatwerethey passingovermygrave? InmytimewithQueen Granuaile, I sawmyshareofstrung pearls, andsawherfoamforthem. Aye, they like to beworn ,now, dont they >Shedscoop themoutofthechest,butI knewwhattheyreally were.Just whatthe skeletons weretohermen.Nothing, everything, a threat anda promise. Theywere,ultimately, bones.And Queen Granuailewas right, a bone likestobeworn. $ In thea.m.,Honeylocatedme betweengelcutletand underwire chasm.All night,I rode it out in herhamper.She'dbrought home a friend, Rick,whowas tucking hisbusinessbackin hisshorts whenshe hauledmeintotheir funk. I thought she'dhandmeover, butinsteadshe gripped tight andslugged backunderthecovers. "Hot filly," he hackedagainsthersateen-wrapped thigh. "Youcan ridemeanytime. I mean,rideyou.Aw,shit." He pinchedherandwinked hisgoodbye. Itsmelledlikehomeinthebed,littoral. I thought ofhir, mydearly departed hissy fit oyster, andI wondered ifI didn'tfeela little something likelonging.Butthen,no.Just Honeydroppingme in thedampspot, wipingmeon thehemofthesheet.She shotbackoutofbed.Clickety. Shesearched, thegreatscreenhumming withbluelinks, withnumbers. Clickety. "How much, howmuch, howmuch," shewhisper-chanted. "Dumb shit," shesays. And thistimesheswallowedmewhole. 144 Once swallowed,I snaggedin Honeys gut,wherethingswere rather crowded.Therewas a LiveBaby, whomI couldsee through the walls.Therewasa Dead Baby, a littlesalt-looking lumpofa child.And therewas the Cancer. My gutmatesweren'tthe cheeriestlot. Dead Babyharangued mewiththetaleofhowhehadpersevered, waiting for hismoment, whileotherbabiesswamout in greatbreezes.Live Baby chewedherdeveloping fingers, and Cancerhuddledinthecorner waitingforDead Babytosleep. Fuckinfuck. Honeys tonestrickled downon us. Speaking? Thinking ?I couldn'ttell.Fuckingfuck ofanidiot. Give the first piece ofassthat looks at you your piece of ass ,and what doyou expect >This ones not gonna give. And thenshe burst intointerior sobs. "Is shealways thisloud?"I askedDead Baby. "Iswho?" "Honey Honey." "Who?" "Honey, we'rein her."I couldsee therewas littleframe ofreferenceforthislot . "You'renewhere," hesaid...

Nurses attack guidance on parents holding dead babies

Nurses attack guidance on parents holding dead babies

After a stillbirth – offering choices, creating memories

The death of a baby around the time of birth is a major catastrophe for parents. Their grief is likely to be profound and long lasting. Many parents welcome the opportunity to create memories of their dead baby and treasure the brief time during which they were able to see or hold him or her. NICE guidance consists of four documents which make different statements about parents seeing and holding their baby. Lack of consistency about an important aspect of practical care and the potential for choice to be removed, is unhelpful to parents and to the professionals caring for them. Informed choice must remain the overriding principle of care.

Predictors of stillbirth among HIV‐infected Tanzanian women

To determine maternal risk factors for stillbirth among pregnant HIV-infected women in sub-Saharan Africa. Prospective cohort study nested within a micronutrient trial. At enrollment, maternal sociodemographic, obstetric, immunologic, clinical, and nutritional variables were measured. Women were followed through monthly clinic visits until delivery. Multivariate predictors of stillbirth were identified in Poisson regression models. Antenatal clinic in a tertiary care hospital in urban Dar es Salaam, Tanzania. N=1,078 women enrolled between 12 and 27 weeks of gestation. Stillbirth (delivery of dead baby > or = 28 weeks' gestation), fresh stillbirth, and macerated stillbirth. Among 1,017 singleton pregnancies, there were 49 stillbirths, yielding a stillbirth risk of 50.0 per 1,000 deliveries (95% Confidence Interval(CI) = 37.2, 65.6). Of stillbirths with known type, 53.7% were fresh and 46.3% macerated. In multivariate analyses, baseline measures of late (> or = 21 weeks' gestation) study entry (Relative Risk (RR) = 2.13, 95% CI = 1.17, 3.87), CD3 count > or = 1,179 cells/ml (RR = 2.15, 95% CI = 1.16, 4.01), stillbirth history (RR = 3.53, 95% CI = 1.30, 9.59), primiparity (RR = 3.65, 95% CI = 1.83, 7.29), and syphilis infection (RR = 2.06, 95% CI = 1.09, 3.88) predicted increased stillbirth risk. Late study entry, illiteracy, stillbirth history, primiparity, CD3 count > or = 1,179 cells/ml, gonorrhea infection, and previous hospitalization predicted increased risk of fresh stillbirth, while living alone and syphilis infection predicted increased risk of macerated stillbirth. Applying antenatal screening and preventive tools for the socioeconomic, obstetric, immunologic, and clinical risk factors identified may assist in reducing the high incidence of stillbirth among HIV-infected women in urban sub-Saharan Africa.

The Silent Birth: A Feminist Perspective

We grieve all that cannot be spoken, that for which there is no name (Griffin, 1978). The social work profession embraces the idea that social action is necessary as a part of the field's responsibility to society. This includes and social action that seeks to improve the lives of others, particularly the underrepresented and the vulnerable populations (Reamer, 1998). The feminist perspective, a theoretical paradigm often used to examine women's issues and one embraced by many social workers, rests on the concept of the personal is political (Collins, 1986, p. 215). There is, perhaps, no more deeply personal and profound experience for many women than losing a baby to stillbirth (Cacciatore & Bushfield, 2008). Stillbirth, or sudden intrauterine death, occurs 10 times more frequently than Sudden Infant Death Syndrome, yet it has failed to be acknowledged as a public health problem (Racial/Ethnic Trends, 2004). This translates to about one in 110 pregnancies that will end in stillbirth. Despite improvements in prenatal care and advanced medical testing, stillbirth rates over the past 10 years have declined only slightly in the United States (Ananth, Liu, Kinzler, & Kramer, 2005; Goldenberg, Kirby, & Culhave, 2004; Silver, 2007). Many sudden intrauterine deaths occur at or near full-term to otherwise apparently healthy infants. Upon postmortem examination, one-fourth to one-half of stillborn infants die as a result of causes that are indiscernible (Froen et al., 2001). Mothers, and often fathers, are left searching for answers, for any explanation to the questions surrounding the child's death, often left in the turmoil of irrational self-blame (DeFrain, 1986). Although etiological aspects of stillbirth are cloaked in obscurities, the psychosocial dimensions of grief responses to stillbirth, as well as child death in general, are often even more elusive (Froen et al., 2001; Goldenberg et al., 2004). The birthing process is often a traumatic physiological event (Silver, 2007; Slade, 2006; Soet, Brack, & DiIorio, 2003; Smith Armstrong, 2002; Hendrick, Altshuler, & Suri, 1998). Researchers in England discovered that 20% of mothers who have a stillbirth experience prolonged depression, and at least one in five suffer from posttraumatic stress disorder (Walling, 2002). Approximately 20 percent to 30 percent of women who have experienced stillbirth exhibit appreciable psychiatric long term morbidity (Radestad, Steineck, Nordin, & Sjogren, 1996). As a result, it is not unusual to observe significant stressors in families after such a tragedy. These disruptions can result in prolonged dysfunction leading to an erosion of familial relationships and, sometimes, even severances. The emotional effects of giving birth and death simultaneously are often misunderstood (Fletcher, 2002; Malacrida, 1997; Michon, Balkou, Hivon, & Cyr, 2003) and rarely examined beyond the cursory rhetoric of perinatal death (Cacciatore, 2007). Women who give birth to a dead baby may feel disenfranchised from social groups in which babies and children are integral, while their mourning experience is generally decried by society in general (personal communication with R. E. Kubler, Scottsdale, Arizona, 2004; DeFrain, 1986; Fahey-McCarthy, 2003; Fletcher 2002; Saddler, 1987; Worth, 1997). Fathers, too, are often faced with tumult after stillbirth. Both bereaved mothers and fathers demonstrated significantly higher levels of depression from a control group, those effects being longer lasting in mothers up to 30 months after the death (Boyle, Vance, Najman, & Thearle, 1996; Vance & Najman, 1995). Fathers are in a difficult position after a stillbirth for a number of reasons: They are expected to take care of the wife emotionally; they are expected to continue to work and pay the bills; and they need to grieve for their lost baby themselves (DeFrain, Martens, Stork, & Stork, 1990, p. …

Visual Delights Two: Exhibition and Reception (review)

Reviewed by: Visual Delights Two: Exhibition and Reception Beth A. Kattelman Visual Delights Two: Exhibition and Reception. Edited by Vanessa Toulmin and Simon Popple. Eastleigh, UK: John Libbey Publishing, 2006; pp. vi + 266. $29.95 paper. This collection of essays, drawn from the second Visual Delights Conference held in 2002 at the University of Sheffield, covers an extensive range of topics from the visual and popular culture of the late Victorian and early Edwardian periods. The result is a sampler that offers glimpses into a wide array of subjects, but not a deep analysis of any particular area. This is not necessarily a fault of the contributors, however, since conference papers, by necessity, are not as in-depth as longer essays written specifically for publication. The volume includes papers on such disparate topics as film censorship, stereoscopic viewing, the life of a traveling photographer, lantern-slide marketing campaigns, a habitat panorama, and the visual iconography of childhood death. While all of the eighteen essays are competently written, a few stand out for their combination of insightful commentary and unique subject matter. Kaveh Askari’s essay on “Trilby’s Community of Sensation,” for example, is a particularly interesting exploration of the commercial circulation of this famous George du Maurier 1894 novel about Svengali and his unfortunate protégé, as well as the visual techniques that were used to promote Maurice Tourneur’s 1915 film adaptation of the same. By examining theatrical productions, tableau vivants, illustrations, posters, and photographs, Askari demonstrates how “mesmerism becomes a catalyst for visual tricks involving translation from one medium into another” (67). William Merrin’s essay, “Skylights Onto Infinity: The World in a Stereoscope,” provides a fascinating look at the role of the stereoscope in Victorian society and how it reflected and reasserted the separation of the public and private spheres. In addition to exploring circulation of the stereoscope in the Victorian home, Merrin also provides an interesting and concise history of stereoscopic viewing, which he traces from the discovery and development of perspective in the early 1400s to the Victorian era. For those interested in the technical aspects of early screen use, there is John Plunkett’s “Optical Recreations, Transparencies, and the Invention of the Screen,” which gives detailed accounts of how screens and transparencies were created and how they were used in such entertainments as the phantasmagoria and the diorama. Peta Tait also continues her fascinating exploration of aerial artists in “Viewing Deadly Targets for Feminine Identity: Alar, the Human Arrow,” which discusses the difficulty of trying to learn about a dynamic aerial performance when the only remaining record consists of textual descriptions and static visual resources. Film historians will also find many interesting essays in this anthology. In “Early Political Film in Britain,” for example, Alan Burton explores the beginnings of British political cinema. Although often thought to be an interwar development, Burton argues that film was being used for propaganda purposes as early as the general elections of 1906 and 1910. Another fascinating essay on film history is Charles Musser’s “The May Irwin Kiss: Performance and the Beginnings of Cinema,” which discusses the interplay between the 1896 film The May Irwin Kiss and the stage play The Widow Jones, exploring the historiographic paradigms that this relationship animates. Helen Walasek’s “Punch and the Lantern Slide Industry” should also be of particular interest to those who study how visual iconography is used in marketing campaigns and the symbiotic effects that can occur between print publications and visual performance. In it, Walasek, former curator of the Punch Archives and Collection, examines how Punch’s proprietors used lantern-slide lectures to entice new subscribers. In anthologies of conference papers, the writing can be very uneven from one essay to another, and this is the case here. Just as the essays mentioned above are of particularly high quality, the book also contains a few that are not so impressive. Ine van Dooren and Amy Sargeant’s “Dead Babies: Representations of Infant Mortality Before the First World War,” for example, is a litany of photographs and drawings showing childhood death, with little accompanying analysis. While this essay deals with a fascinating and unique subject and is accompanied...

The effects of social support on maternal anxiety and depression after stillbirth

While most births result in a live baby, stillbirth (the birth of a dead baby) occurs in nearly 1 in 110 pregnancies. This study examined whether levels of maternal anxiety and depression are lower amongst mothers who received social support after stillbirth. Using non-probability sampling, data were collected from 769 mothers residing within the USA who experienced a stillbirth within the past 18 months and for whom we have complete data. The study Maternal Observations and Memories of Stillbirth and the website http://www.momstudy.com containing the questionnaire were open in the period 8 February 2004-15 September 2005. Congruent with the family stress and coping theory, mothers of stillborn babies who perceived family support in the period after stillbirth experienced levels of anxiety and depression that were notably lower than those of their counterparts. Nurses, physicians and support groups also were important sources of support after a stillbirth; however, these sources of support alone were not statistically significant in reducing anxiety and depression in grieving mothers. Community interventions should focus on the grieving mother and her family system, including her partner and surviving children.

Amniocentesis and Motherhood: How Prenatal Testing Shapes Our Cultural Understandings of Pregnancy and Disability

Amniocentesis and Motherhood: How Prenatal Testing Shapes Our Cultural Understandings of Pregnancy and Disability

A technology of care: Caregiver response to perinatal loss

Highly technologized care of pregnancy and childbirth, both lauded and vilified, has also seeded a countermovement of high-touch perinatal care. Employing a feminist symbolic interactionist account, this article examines the relationship between high technology and caregiver response in the high-touch care of dying or dead babies and the grief experienced by their mothers. Recognizing the distancing effects technology has on both caregiver–patient and mother–baby relationships, caregivers engaged in a countermovement of high-touch and thus repositioned themselves closer to women's experiences where they were better able to meet women's needs. When technology brings unfavourable consequences humans can, in their innovation and concern for others, reposition themselves in relation to technology, thereby modifying those unfavourable consequences.

Detached signifiers, dead babies and demon dwarves: Bieito's Dutchman

The Catalan director Calixto Bieito is a successful opera director, critically acclaimed for his often violent and confrontational concepts. He has worked mainly on German stages in the last decade, where audiences have often been scandalized by the explicit imagery and radical re-interpretations in Bieito's work. This reactive review critiques his production of The Flying Dutchman for Stuttgart State Opera (2008), applying mainly semiotic and some phenomenological analysis. It also contextualizes Regietheater (director's theatre) with audience expectation. The context of the production and the impact of using an earlier (1841) version of the opera is examined with reference to direction, scenography and conceptual updating of The Flying Dutchman.

How Few Words Can the Shortest Story Have?

How Few Words Can the Shortest Story Have? Amihud Gilead Of the best shortest story, we have only tales. According to one of them, Ernest Hemingway was proud of being the author of a story written in merely six words: "For sale: baby shoes, never worn." He considered this as his best story.1 Interviewing Gary Paulsen, Lori Atkins Goodson heard another version: Probably the best writing ever done was by Hemingway and several other writers—I think it was in North Africa. During a drunken discussion, somebody said that they should write the best and shortest story they could write. They all had stories. Hemingway came up with six words: "For sale: Baby shoes. Never used." ... Isn't that great? That's all there is. Six words. There's a book, there's a movie, there's a short story, there's a poem—anything you want to do with those six words, you can do it. It's just amazing what you can do with your words.2 I greatly prefer the first version to the second despite its musicality or semi-rhythm. The minor colon is better than the major full stop and the capital letters. The whole story is genuinely minor in tone, and its great power rests upon this tone. "Used" is much less evocative and more commercially practical than "worn." "Used" draws the attention to the shoes, whereas "worn" intimately relates to the dead baby. Yes indeed, these six words can initiate a book, a feature movie, and the like; yet, as you will see below, I prefer to think about a whole world centered around, or arising out of, Hemingway's six words. Whether his six-words story is the shortest ever written is quite a different question, which will not be discussed in this paper. A very short story may comprise more than six words, say, seventeen, [End Page 119] such as the following: "The last man on earth sat alone in a room. There was a knock on the door" ("Knock" by Fredric Brown).3 Which of these two stories is the better? The shorter one, Hemingway's story in the first version. Why? Not only because there is not a single superfluous word or, even, a letter or punctuation mark; each word, each mark must be there, each is necessary for the story. Hemingway's six words create or initiate a whole story, actually a universe, of sorrow, bereavement, mourning, solitude, silence, untimely death, despair, loss, and tragedy.4 Thus, each word in this story gets the utmost meaningfulness or significance that a word may have. Hemingway's story shows us a tragic world of dread "in a handful of" six words, each of which is very simple. In contrast, although Brown's story bears a lot of tension and it is quite enigmatic (Who is knocking on the door? God, the Devil, an alien? Or is it simply a hallucination?), it conveys much less in seventeen words than do Hemingway's six. Brown's seventeen words do not create or reveal a world, let alone a universe. They create some tension, perhaps a thrill, possibly an enigma but not a world. There is certainly some puzzle that the reader may attempt to solve, but not much more. Even in this respect, Hemingway's story is more enigmatic: What is the purpose of the sale of this baby's shoes? Is there some hope that what cannot be used for the lost baby will be useful for another, living baby? Or is it the stinginess of the dead baby's parents or relatives? Or is it their poverty that forces them to sell even these little shoes? Or is it their wish not to possess these shoes any longer despite their great significance? Regarding this last possibility, it is more suitable to sell them than to throw them away. In any of these possibilities, the shoes have some value. And the enigma under discussion is certainly tragic in any of these possibilities. In contrast, Brown's story suggests merely a puzzle, not a tragic enigma. Such a puzzle may be found even in pulp fiction, not in fine writing, whereas...

Colopleural fistula: Case report and review of the literature

We report a 28-year-old woman, pregnant, at 24 weeks, with 3-day history of right-sided chest pain and shortness of breath. Few hours after admission, she delivered a dead baby. She had a history of right partial hepatic lobotomy and cholecystectomy at UK on May 2004 because of multiple pyogenic liver abscesses. Chest examination revealed signs of hydrothorax on the right side. Chest X-ray showed pleural effusion on the right side. Pleural fluid was exudative with high neutrophils. Gram stain and culture showed multiple organisms. CT scan chest and abdomen with contrast, combined with barium enema, revealed right colothorax communication. Colothorax fistula was closed surgically. On the following days, the patient's symptoms resolved, and she was consequently discharged.

Images of stillbirth: memory, mourning and memorial1

When a baby is stillborn, maternity units in the United Kingdom and USA encourage mothers, fathers and other family members to hold the dead baby, take photographs and gather other mementos. The rationale for these activities is that acknowledging the stillborn child helps the grieving process. In the context of conventional family photography, however, stillbirth images are contradictory. The body of the baby in the arms of his or her mother, whilst conventional in terms of pose, is unconventional in terms of content. This article explores the meaning and function of contemporary private and public stillbirth images, arguing that they help create a social identity for the baby, reconstructing the disrupted biography of the family to include the dead child, thereby allowing him or her to be remembered, mourned and memorialized; also that public stillborn images reflect the development of new mourning practices that help parents cope with a hitherto invisible loss.

The loss of a baby and the birth of the next infant: The mother's experience

This paper considers the area of perinatal death by focusing on the mother's experience. An argument is made for questioning whether mothers attempt to replace a dead infant. It is suggested instead that they long to mother their lost baby and as a result their new infant is mothered in the shadow of the dead baby. The term ‘penumbra baby’ is suggested instead of ‘replacement baby’. Literature is considered from an historical perspective. Three clinical cases are discussed: one patient was seen immediately following a late miscarriage, the second soon after an intrauterine death and the third patient during both her pregnancy and the post-natal period, following a neonatal death. Consideration is given to the relationship between the parental couple when there has been a perinatal loss, and the way this may impact on the woman's ability to mourn and regain her emotional well-being.