Nancy Scheper-Hughes, a professor of anthropology at UC–Berkeley, conducted much research in the northern area of Brazil, constituting roughly the same area as twice the state of Texas. This area has been plagued by economic hardship for decades, and at the time of this essay, uncountable numbers of children were dying before age five due to various diseases and simply from starvation. In this essay, Scheper-Hughes examines a peculiar effect that all this death had on mothers in this region.

At the time of her research, children in northeast Brazil were at very high risk of death. Because of this, the life expectancy was only around forty years at the time. Children were often born to mothers who could not or would not breastfeed and often to mothers with no partners or support system. Needing to work, often these impoverished mothers would simply lock their babies inside as they returned to sugar fields or other domestic and low-paying jobs during the day.

Scheper-Hughes lived in this area of Brazil while conducting research on these children and their mothers. She found that children who were perceived as "ill-fated" or "better off dead" were often written off by their mothers, who were willing to simply allow them to die. These mothers often came to view living (weaker) children as angels, instead of sons or daughters, because of their high expectancies of impending death. In fact, they viewed some of their babies as "wanting" to die. Babies who were born with more vigor and strength were nurtured; those who were born small, pale, or weak were often stigmatized and died of neglect.

Scheper-Hughes recalls the story of Zezinho, a little boy whom she discovered while assisting his mother in a delivery of another child. Only thirteen months old, his mother had written him off as suffering from "failure to thrive," and he lay curled in a fetal position in his own urine and feces. Scheper-Hughes took little Ze with her and force-fed him, much to the chagrin of the other local caretakers who agreed with Ze's mother that he didn't stand "a ghost of a chance." He gained strength and quickly learned to sit up. Scheper-Hughes later returned him to his mother but wondered what she had really accomplished by giving his mother one more mouth to feed in such an already-impoverished state. When Scheper-Hughes returned a couple of decades later, Ze praised his mother as being the best friend in his life. In this culture, there is no guilt weighing on the consciences of the mothers and no resentment from the children who are written off as already dead.

Because many of the mothers did not expect their children to live, they had a delayed sense of attachment to their children. These mothers had learned to emotionally detach themselves from their young children because of the statistics which faced them: the average Alto woman experienced 9.5 pregnancies, 3.5 child deaths, and 1.5 stillbirths. Seventy percent of child deaths occurred in the first six months of life. Forty-five percent of all deaths in the community each year happened to children under five years of age.

Even local midwives and traditional healers advised women to let some babies die based on whether "a baby was born unfortuitously." They instructed mothers not to even care for such infants and just allow nature to take its course. Babies who died were often taken to the local cemetery, whose little plots are used over and over again, without prayers or ceremony.

Scheper-Hughes cautions that she has not published her research as a condemnation of these mothers; rather,...