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According to Sara Barron, who has worked as a nurse for three decades, a particular birth defect that is extremely fatal appears to be on the rise. Barron, who worked in a small hospital located in rural Washington State, noticed that the neural tube birth defect, anencephaly was becoming more common than usual. Out of concern, Barron called the state Department of Health, who has since started an investigation. Despite the investigation, some people are worried that the health officials have not done enough to get to the bottom of this issue.

In 2012, Barron had witnessed two cases of this defect, which occurs when an infant is born with missing areas of their brain and skull, in 2012. After Barron heard of another case of anencephaly at a hospital 30 miles away, she reported the cases. At the start of the investigation, the epidemiologists looked over several hospital records within the three-county area. They discovered that from Jan 2010 through to Jan 2013, there were a total of 23 cases of anencephaly. The officials calculated the incidence rate at 8.4 cases per 10,000 live births, which is significantly higher than the country's average of 2.1 cases per 10,000 live births.

After the epidemiologists concluded that the rate of anencephaly was indeed abnormally high within these counties, the investigation appeared to have to slow down. Some of the mothers living in the area who had given birth to children with defects expressed their concerns over the investigation. One mother, Andrea Jackman, who gave birth to a daughter with spina bifida, which is another type of neural tube defect, was surprised that the officials had never contacted her to ask her what she might have been exposed to during her pregnancy.

"What are you researching if you haven't physically called the families to find out?" Jackman questioned according to CNN.

The state epidemiologists have reported that they avoided interviewing mothers because the line of questioning could be upsetting. Furthermore, asking mothers to relive their pregnancies could be heart breaking. State epidemiologist, Mandy Stahre, said that for now they have chosen to look at medical records.

"(Medical records) give us a lot of information about all of the known risk factors," Stahre stated.

So far, the medical records have not helped the epidemiologists identify any possible causes of the rise in defects. Other critics, such as Dr. Beate Ritz, who is the vice chair of the epidemiology department at the UCLA (University of California Los Angeles) Fielding School of Public Health, have stated that medical records can be extremely unreliable for research.

"From a research point of view, this is very bad research," Dr. Ritz said. "The data quality on medical records is so low that it's not really research."

The state's Department of Health aims to reveal the total number of neural tube birth defect cases within the next few months. Stahre reported that if the number continues to be higher than average, the officials might start interviewing mothers.