Egg and Sperm: Scientific Fairy Tales Gender stereotypes [are]
hidden within the scientific language of biology. We learn about
more than just the natural world in high school biology class; we
() learn about cultural beliefs and practices as if they were part
of nature(Martin, 1991: 485 486) First, a wastefully huge swarm of
sperm weakly flops along, its members bumping into walls and
flailing aimlessly through thick strands of mucus. Eventually,
through sheer odds of pinball-like bouncing more than anything
else, a few sperm end up close to an egg. As they mill around, the
egg selects one and reels it in, pinning it down in spite of its
efforts to escape. Its no contest, really. The gigantic, hardy egg
yanks this tiny sperm inside, distills out the chromosomes, and
sets out to become an embryo (Freedman, 1992) Freedman, David H.
(1992) New Theory on how the Aggressive Egg Attracts Sperm,
Discover, June, Available online:
http://discovermagazine.com/1992/jun/theaggressiveegg55 Martin,
Emily (1991) The Egg and the Sperm: How Science Has Constructed a
Romance Based on Stereotypical Male-Female Roles, Signs, Vol. 16,
No. 3, pp. 485-501 Moore, Lisa Jean (2007) Sperm Counts: Overcome
by Mans Most Precious Fluid, New York: New York University
Press
Slide 5
The Gestation of a Lecture 1. The Medicalisation of Pregnancy:
Dos and Donts and Antenatal screening and testing 2. Gender, risk,
responsibility and decision-making 3. Ultrasound in a visual
society: a Light and Sound Show'
Slide 6
Medicalisation the expansion of medical rationality and
jurisdiction into the realms of previously non-medically defined
phenomena central feature of history of western societies since 17
th century (Oakley, 1980, 1984). Has led to the establishment of
medicine as the dominant discursive and institutional framework for
the surveillance and management of (both healthy and ill) bodies
Has led to a reconfiguration of the conceptualisation and
experiences of reproduction pregnancy becomes defined and treated
as inherently risky medical conditions, necessitating active
medical and technological monitoring and intervention Technological
development played central role can be understood both as a cause
and result of growing medicalisation The Medicalisation of
Experience
Slide 7
According to Oakley (1980), the framework for conceptualisation
and management of pregnancy in Western societies has 5 major
features: the definition of reproduction as a specialist subject in
which only doctors are experts in the symptomatology of
childbearing the associated definition of reproduction as a medical
subject, analogous to other pathological processes as topics of
medical knowledge and intervention (so birth (re)defined as
inherently risky, non-experts discredited) the selection of limited
criteria of reproductive success the divorce of reproduction from
its social context (so subject to complex technologies, bypassing
womens experiences, eg. technological quickening) the restriction
of women to maternity and their typification as naturally maternal
(so happily pregnant, yet we know many women experience medicalized
pregnancy as an anxious time, full of risk and uncertainty) The
Medicalisation of Pregnancy
Slide 8
The Dos and Donts of Pregnancy Eat fish, but not more than 2
portions oily fish/week and no shark, swordfish, marlin Drink
plenty of water Avoid mould ripened soft cheese (brie, camembert)
and blue-veined cheese (stilton) Avoid pate, avoid soft eggs, avoid
liver Avoid unpasteurised milk Cook all meat thoroughly and wash
all fruit and veg Heat ready meals and leftovers to maximum before
eating Wear gloves if gardening, dont change cat litter, avoid
sheep during the lambing season Consider not dying your hair in
first 12 weeks of pregnancy Avoid saunas, jacuzzis, hot tubs, steam
rooms Avoid using solvent-based paints and stripping old paintwork
Take a folic acid supplement, make sure you get enough iron Avoid
supplements containing vitamin A, including cod liver oil, fish
oils No more than 2 cups coffee per day, less if drinking cola
Avoid alcohol, avoid smoking, avoid recreational drugs Avoid people
with chicken-pox Avoid X-raysSource: Adapted from BBC Dont try to
lose weight while pregnant Health website
Slide 9
Slide 10
Antenatal Testing Screening = calculation of the statistical
risk that a condition is present Diagnosis = confirmation of a
condition (tests are invasive and involve a risk of miscarriage) A
positive screening result leads to the choice of undergoing
diagnostic tests All tests are voluntary but how easy is it to
decline?
Slide 11
Common Screening Tests Blood tests for genetic conditions
(Huntington disease; sickle cell anaemia; thalassemia; cystic
fibrosis) Blood tests for probability of chromosomal abnormalities
(Downs syndrome) - Screen negative : less than 1 in 250 chance -
Screen positive: more than 1 in 250 chance Blood tests for
multifactorial disorders (Spina bifida; Anencephaly) 12 week
ultrasound scans (foetal viability, dating pregnancy) - Crown rump
length indicates length of pregnancy - 10 weeks = 3cm; 12 weeks =
5-6cm; 13 weeks = 7cm Nuchal Translucency (Downs syndrome) - False
positive rate of 5%
Slide 12
Diagnostic Tests Chorionic Villus Sampling (CVS): Testing a
sample of placental tissue (Downs syndrome; sickle cell anaemia;
thalassemia; cystic fibrosis) 10-15 weeks, 2% risk of miscarriage
Amniocentesis (all the above plus spina bifida; anencephaly) 18
weeks, 0.5% risk of miscarriage Ultrasound scans (Spina bifida;
Anencephaly)
Slide 13
Understanding and Assessing Risk Understanding risk information
is difficult: - Relies on knowledge/ communication skills of health
professional - False positives cause unnecessary anxiety - Benefits
of screening vs. the anxiety it may cause Screening/diagnostic
tests do not simply reduce anxiety and risk; they also contribute
to them. During the testing period, women experience their
pregnancies as tentative (Rothman, 1988): - Nancy, interviewed in
Rothmans study of experiences of amniocentesis, describes 3 week
wait for results as : a period of suspended animation because I was
trying to deny the reality of the pregnancy to myself because of
the fear of bad results. It was very difficult especially as the
baby had started to move (1988: 103).
Slide 14
Experiences of Risk and Responsibility Testimonies posted on
BabyCentre webforum about ante-natal tests: I had my ultrasound and
amniocentesis done two days ago and now I have to wait 2 weeks for
the results. I am so worried and I can't stop thinking about it. I
am so worried that I am giving myself anxiety attacks (Shani). Like
most of you, for the past four days I've been living on a roller
coaster of fear, feeling like every ounce of joy has been sucked
from this pregnancy (Erin). This has been the longest week and a
half on earth. Its so scary. I don't think I've cried this much in
my whole life (Michelle). See also:
http://www.healthtalk.org/peoples-experiences/pregnancy-
children/antenatal-screening/topicshttp://www.healthtalk.org/peoples-experiences/pregnancy-
children/antenatal-screening/topics Focus on individualised risk
management in risk society, decisions about prenatal testing and
potential termination constructed as personal choices, bringing
responsibilities: If the mother doesnt know about it [foetal
abnormality] she cant be blamed for going through with it
[pregnancy] If you dont have it [amniocentesis] and you have a
Mongol [baby with Downs] you blame yourself, and if you have it and
lose the baby you blame yourself (interviewee in Farrant, 1985, p.
118)
Slide 15
Decision-Making: Further Tests? Following a screen positive,
pregnant women have to decide whether to have further diagnostic
tests. Markens, S., C. H. Browner et al. (1999) Because of the
risks: how US pregnant women account for refusing prenatal
screening, Social Science and Medicine, Vol. 49, No. 3, pp. 359-369
Is choice always really a choice? Whose choice is it?
Slide 16
Decision-Making : After Diagnosis Following a diagnosis,
parents are faced with several choices: Foetal surgery or similar
treatment Continuing with the pregnancy without intervention
Termination of the pregnancy Is non-directiveness by medical
professionals fair? Is choice always really a choice? Whose choice
is it?
Slide 17
Testing and acting on test results creates new norms for foetal
health, growth and development Quality control becomes central to
medical surveillance and management of pregnancy Aim is clearly the
perfect child, normal, healthy By cloaking prenatal screening in
language of choice and autonomy, women are encouraged to
participate in the workings of this powerful apparatus, to measure
and identify anomalies so they can be reported and extinguished
(Vanstone et al, 2014, p. 65) Prenatal screening [puts] the onus on
women to detect and abort foetuses with disabilities or to provide
care for children with disabilities, obscuring the responsibility
of society to help all people live to their full potential
(Vanstone et al, 2014, pp. 66-67) Disability Rights
Perspective
Slide 18
The Politics of Foetal Representation 20 weeks 7 weeks
Slide 19
Based on the assumption that what we see must be true
Ultrasound passes soundwaves through the body which produce echoes,
from which distance, size and shape of objects inside can be guaged
Its routinisation and centrality in pregnancy has created an
alternative epistemology of pregnancy where womens haptic hexis
(embodied knowledge) is displaced by the optic hexis (visual
knowledge of pregnancy) It has significant effects on how we
conceptualise the status of the foetus (personhood, autonomy, who
is the patient), and has thus played a central role in debates on
abortion Changes mens experiences of pregnancy (seeing the baby as
real, and feeling like a father, bonding) Visual Medical
Knowledge
Slide 20
Individual and Collective Bonding Ultrasound enables both
individual and collective bonding, whereby social birth comes to
precede biological birth 20 weeks 12 weeks
Slide 21
3D/4D Ultrasound Technologies Why wait till the end of your
pregnancy before you can meet your baby? At Meet Your Baby, we can
scan and show you your baby live in 2D, 3D or 4D dimensions on our
large flat screen monitors. During your baby bonding ultrasound
scan, we can even determine the sex of your baby. Our highly
qualified and experienced Ultrasound Sonographers, only operate the
latest GE Voluson Ultrasound Scanning machines in our state of the
art baby bonding scanning suites, to give you the best opportunity
to see some really remarkable and magical images.
(www.meetyourbaby.co.uk)www.meetyourbaby.co.uk
Slide 22
3D/4D scanning is an amazing three dimensional picture of your
baby on the screen. Your baby can be seen moving, yawning, sucking
its thumb and even smiling. A truly magical experience! () You will
receive a CD of your scan which you can then use to reproduce the
pictures and e-mail them to friends. Depending on the package you
choose we can also save the scan onto DVD to be played time and
time again. PLEASE NOTE: We consider all our scans to be diagnostic
and never scan just for entertainment. The health of you and your
baby is our primary concern so our sonographers will be checking
that your baby is developing normally. Package 1. 95.00: 30 minute
appointment with CD, 10 thermal images, baby sexing if requested
and pregnancy progress report Package 2. 150.00: 45 minute
appointment with CD and DVD of 2D, 3D and 4D images, 10 thermal
images, 4 printed 3D pictures, baby sexing if requested and
pregnancy progress report
(www.ultrasoundnow.co.uk)www.ultrasoundnow.co.uk 3D/4D Ultrasound
Technologies
Slide 23
What is sociologically interesting about womens and mens
experiences of the medicalised pregnancy is that it is an
experience both of alienation and elation (Petchesky, 1987).
Screening and foetal imaging technologies are both empowering and
disempowering, distressing and reassuring, sources of anxiety and
comfort, forms of controlling pregnant women and of helping them
feel in control of their pregnancies. Thus, we must recognise the
complexity and ambivalence that characterise embodied experiences
of pregnancy in a technological age. Medicalised Pregnancy as
Ambivalence