The Natural History Museum Fails Me

It started out innocently enough. We decide to take Natty to the Natural History Museum for the afternoon. There's an exhibit called "Surviving: The Body of Evidence" that's all about how the human body has been shaped by evolution. And that's cool. Bastian explores a giant body laid out.There's a video about how the ankle bends uniquely among us bipeds.
I get him to bend his ankle. He wanders off again.
We explore the giant clear plastic body for awhile. Cuz it's weird.
I spy a lonely little acorn on the floor and pick it up and put it in my pocket (where later I cannot find it).
And then this.
And I start to stare at this and the accompanying video in disbelief, my jaw slack. I say out loud, "What the hell is this?!?!" No one answers.
I point out to my sister how all these little facts,
though not untrue,
when tied together,
become immensely misleading.
I drop everything and head for the front desk in search of someone to complain to. It being very late on a Friday, Front Desk Dude has a hard time scaring up someone from exhibits. He calls everyone there. He asks a passerby who would know if the director of exhibits had left - he had not. He pages him. He calls the lady in charge of marketing. She doesn't answer. I explain my issue to him. I use fancy words like "scientific illiteracy" to get 'em good and shakin' at the knees. He is very kind and very helpful. He sees my point. He gives me direct numbers and the most recent newsletter talking about the exhibit, which has the name of the museum from which it originates.

So I go home and post on my facebook and write the following scathing letter

Hello,

I recently (7/17/09) toured the exhibit Surviving: The Body of Evidence on display through August 30th at the Cleveland Museum of Natural History. When viewing the section titled We Are Not Perfect, But We Are OK, and specifically the portion titled Big Brain Issues, I was heartily disappointed to discover information that I felt was contradictory and highly misleading. First, the display said:

Giving birth has always been - and continues to be - a risky and difficult process because there is such a tight fit between the baby's skull and the width of the mother's pelvis. Sometimes the mother or the child does not survive childbirth.


While this quote is not untrue, it is very misleading. Yes, birth is risky. Yes, it is made more difficult for humans due to our bipedalism and the size of our brains. However, this tight fit is not the primary reason that mothers and children do not survive childbirth, which is actually proven by two other quotes:

Every year, worldwide, four million newborns die: the leading causes are low birth weight and birth trauma. - United Nations Statistics

Low birth weight suggests the opposite of a tight fit, while birth trauma remains decidedly nonspecific.

Every year, worldwide, 529,000 women die from complications of pregnancy and childbirth. For every one of these, twenty more are injured in some way. - World Health Organization

What are the actual causes of maternal mortality and morbidity? This exhibit seems to suggest it has something to do with CPD (cephalopelvic disproportion) and that the solution is cesarean section:

Cesarian [sic] sections (an operation for delivering the baby) avoid the complications of the condition in which the baby's head is too large to fit in the birth canal (cephalo-pelvic disproportion).

In fact, the leading causes of maternal mortality according to the World Health Organization include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour, which may or may not be the result of CPD. Additionally, the leading incidents of maternal morbidity (uterine rupture and uterine scar, infertility, perineal or low abdominal pain, anemia, uterine prolapse, and fecal and urinary incontinence) seem to be primarily resultant from preconditions completely unrelated to cephalopelvic disproportion, namely prolonged labour, haemorrhage, sepsis, and preeclampsia.

The exhibit goes on to include this fascinating factoid:

In 2003, of all the births in the United States, 27.5 percent were by cesarean section. In 2004, the percentage increased to 29.1: the rate has been increasing since 1996. -National Vital Statistics Report,September 22, 2005

In conjunction with the exhibit's other quotes, this seems to suggest that CPD is rampant in the U.S. In conjunction with the entirety of the exhibit, I felt lead to believe that humans are evolving such large brains and heads that 1/3 of all American women have completely lost the ability to give birth. Even if taken as mere fact without making this leap, the inclusion of the American cesarean rate has nothing to do with an evolutionary trend and everything to do with modern medicine. The trends of modern medicine and their causes, however, were not an intended feature of the exhibit as I understood it.

Merely altering some of the quotes to include different terms would improve the clarity of many of the statements. Rather than childbirth being "a risky and difficult process because there is such a tight fit..." perhaps "a risky and difficult process in part because there is such a tight fit" would be more appropriate.

Unfortunately, the inclusion of the final quote regarding the U.S. cesarean rate could not really be clarified with a change in phrasing. It necessitates either much deeper discussion or complete removal. The rate of cesarean in the United States has little to do with head size, pelvic size, cephalopelvic disproportion, or the tremendous rates of maternal and infant mortality, primarily because "Of the estimated total of 536 000 maternal deaths worldwide in 2005, developing countries accounted for 99% (533 000) of these deaths." (from Maternal Mortality in 2005)

If a visitor to the exhibit is intended to understand that sometimes cephalopelvic disproportion does indeed happen and that this is related to our evolutionary legacy, perhaps a statistic about CPD would be more appropriate. See: http://www.ican-online.org/vbac/cephalopelvic-disproportion-cpd Also, "In a series of 1000 consecutive primigravidae, in which an active approach to labour was adopted, the incidence of disproportion was less than 1 per cent and there was notable absence of trauma, especially to the child." From: http://www3.interscience.wiley.com/journal/119703236/abstract

Or perhaps one could provide more accurate information related to the evolutionary legacy of childbirth by doing some reading by anthropologists studying the matter, such as Wenda R. Trevathan, Robbie Davis-Floyd and Carolyn Fishel Sargen, Cecilia Van Hollen, and Sheila Kitzinger.

I'd appreciate any thoughts on this matter.

Sincerely,
Anna Kiss
Ohio

Before leaving in a huff, however, we continued through the rest of the museum and Aleks and Bastian spent some of their money from Baba in the gift shop. Bastian picked a lion mask.
Natty tried on an eagle mask and pecked his wee little head.

Aleks chose a dinosaur painting kit. We still love the museum, even if they make mistakes sometimes (and besides, given the exchanges I've been having with the anthropologist who curated it from UPenn, my outrage is all directed towards Pennsylvania at this point).