In parts of West Africa, some babies and toddlers are considered spirit children-nonhumans sent from the forest to cause misfortune and destroy the family. These are usually deformed or ailing infants, the very young whose births coincide with tragic events, or children who display unusual abilities. In some of these cases, families seek a solution in infanticide. Many others do not. Refusing to generalize or oversimplify, Aaron R. Denham offers an ethnographic study of the spirit child phenomenon in Northern Ghana that considers medical, economic, religious, and political realities. He examines both the motivations of the families and the structural factors that lead to infanticide, framing these within the context of global public health. At the same time, he turns the lens on Western societies and the misunderstandings that prevail in discourse about this controversial practice. Engaging the complexity of the context, local meanings, and moral worlds of those confronting a spirit child, Denham offers visceral accounts of families' life and death decisions.