Not ruling out photoshop, but it looks anencephalic.
More often, the head basically stops at the eyebrow level, but they rarely go full-term.
We're seeing more in the south asian (Indian, Bangladeshi & Pakistani) immigrant community, as it's more common in consinguinal marriages (i.e. between 1st cousins).
So I guess Alabama must get quite a few.
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"I started out with nothin' and I still got most of it left" - Seasick Steve