Some say the fetus is the “tiniest citizen.” If so, then the bodies of women themselves have become political arenas—or, recent cases suggest, battlefields. A cocaine-addicted mother is convicted of drug trafficking through the umbilical cord. Women employees at a battery plant must prove infertility to keep their jobs. A terminally ill woman is forced to undergo a cesarean section. No longer concerned with conception or motherhood, the new politics of fetal rights focuses on fertility and pregnancy itself, on a woman’s relationship with the fetus. How exactly, Cynthia Daniels asks, does this affect a woman’s rights? Are they different from a man’s? And how has the state helped determine the difference? The answers, rigorously pursued throughout this book, give us a clear look into the state’s paradoxical role in gender politics—as both a challenger of injustice and an agent of social control.
In benchmark legal cases concerned with forced medical treatment, fetal protectionism in the workplace, and drug and alcohol use and abuse, Daniels shows us state power at work in the struggle between fetal rights and women’s rights. These cases raise critical questions about the impact of gender on women’s standing as citizens, and about the relationship between state power and gender inequality. Fully appreciating the difficulties of each case, the author probes the subtleties of various positions and their implications for a deeper understanding of how a woman’s reproductive capability affects her relationship to state power. In her analysis, the need to defend women’s right to self-sovereignty becomes clear, but so does the need to define further the very concepts of self-sovereignty and privacy.
The intensity of the debate over fetal rights suggests the depth of the current gender crisis and the force of the feelings of social dislocation generated by reproductive politics. Breaking through the public mythology that clouds these debates, At Women’s Expense makes a hopeful beginning toward liberating woman’s body within the body politic.
Information on prenatal testing abounds, but few books are addressed to prospective parents in need of practical guidance. In this comprehensive and sensitive account, Elena Nightingale and Melissa Goodman offer remarkably clear answers to the set of bewildering questions generated by the concerns of parenthood.
Prospective parents are given the guidance needed to make informed choices about whether or not to undergo testing and, if they elect to do so, how best to use the results. As humans, we are recipients of a rich genetic heritage. Each human cell contains 46 chromosomes with a total of 50,000 to 100,000 genes distributed among them. Such richness carries immense possibilities for error when gene replication occurs; it is therefore not surprising that gene disorders such as Down syndrome, Huntington's disease, and neural tube defects pose a major public health problem. Rapid development of sophisticated new techniques has vastly increased our ability to diagnose genetic disorders during the prenatal period. For example, the amniotic fluid sampled in the middle trimester can be tested for such biochemical abnormalities as Tay-Sachs disease. The advent of more recent techniques, such as sampling the cells of the villi of the chorion (a procedure that can be carried out in the first trimester), employing gene probes, and using ultrasonographic detection, has advanced the diagnosis of genetic disorders faster than most researchers would have thought possible.
Nightingale and Goodman carefully explain the practicalities of this potentially confusing array of prenatal tests: how they are performed, what they reveal, and what their limitations are. The book concludes with a thoughtful consideration of the economic, ethical, and legal issues related to prenatal screening. Although primarily intended to assist prospective parents, this volume is also of interest to health care providers, public health officials, and policymakers who struggle with these difficult decisions.
In earlier times, a woman knew she was pregnant when she experienced “quickening”—she felt movement within her. Today a woman relies on what she sees in a test result or a digital sonogram image to confirm her pregnancy. A private experience once mediated by women themselves has become a public experience interpreted and controlled by medical professionals. In Disembodying Women, Barbara Duden takes a closer look at this contemporary transformation of women’s experience of pregnancy. She suggests that advances in technology and parallel changes in public discourse have refrained pregnancy as a managed process, the mother as an ecosystem, and the fetus as an endangered species.
Drawing on extensive historical research, Duden traces the graphic techniques-from anatomists’ drawings to woodcuts to X-rays and ultrasound-used to “flay” the female body and turn it inside out. Emphasizing the iconic power of the visual within twentieth-century culture, Duden follows the process by which the pregnant woman’s flesh has been peeled away to uncover scientific data. Lennart Nilsson’s now-famous photographs of the embryo published in Life magazine in the mid-1960s stand in stark contrast to representations of the invisible unborn in medieval iconography or sixteenth-century painting. Illumination has given way to illustration, ideogram to facsimile, the contemplative intuition of the body to a scientific analysis of its component parts.
New ways of seeing the body produce new ways of experiencing the body. Because technology allows us to penetrate that once secret enclosure of the womb, the image of the fetus, exposed to public gaze, has eclipsed that of woman in the public mind. Society, anxious about the health of the global environment, has focused on protecting “life” in the maternal ecosystem, in effect, pitting fetus against mother.
Duden’s reading of the body lends a unique historical and philosophical perspective to contemporary debate over fetal rights, reproductive technologies, abortion, and the right to privacy. This provocative work should reinvigorate that debate by calling into question contemporary certainties and the policies and programs they serve to justify.
In the late 1970s and throughout the 1980s, many private employers in the United States enacted fetal protection policies that barred fertile women—that is, women who had not been surgically sterilized—from working in jobs that might expose fetuses to toxins. In Fetal Rights, Women’s Rights, Suzanne Samuels analyzes these policies and the ambiguous responses to them by federal and state courts, legislatures, administrative agencies, litigants, and interest groups. She poses provocative questions about the implicit links between social welfare concerns and paternalism in the workplace, including: are women workers or wombs?
Placing the fetal protection controversy within the larger societal debate about gender roles, Samuels argues that governmental decision-makers confuse sex, which is based solely on biological characteristics, with gender, which is based on societal conceptions. She contends that the debate about fetal protection policies brought this ambiguity into stark relief, and that the response of policy-makers was rooted in assumptions about gender roles. Judges, legislators, and regulators used gender as a proxy, she argues, to sidestep the question of whether fetal protection policies could be justified by the biological differences between women and men.
The fetal protection controversy raises a number of concerns about women's role in the workplace. Samuels discusses the effect on governmental policies of the ongoing controversy over abortion rights and the debates between egalitarian and relational feminists about the treatment of women at work. A timely and engrossing study, Fetal Rights, Women's Rights details the pattern of gender politics in the United States and demonstrates the broader ramifications of gender bias in the workplace.
Arguing that the state must meet strict conditions to justify interfering in at-risk pregnancies, Deborah Mathieu examines the legal and ethical concerns that arise when governments mandate the behavior of pregnant women. She explores both the pregnant woman's right to decide what happens to her body and the future child's right to be protected from avoidable damage. Mathieu addresses such topics as reproductive hazards in the workplace, mandated fetal therapy, forced lifestyle changes for pregnant women, and the future child's right to sue for lack of prenatal care. The controversy raises key issues of rights, duties, and the scope of legitimate state action, thus posing fundamental challenges to the fields of medicine, biomedical ethics, law, and public policy.
This edition has been completely updated and expanded. Mathieu presents new arguments for acceptable types of state intervention and provides specific examples. This edition also incorporates recent court decisions, especially cases involving substance abuse. The book includes both an updated bibliography and an updated reference list of relevant court cases.
This book offers much-needed critical awareness of the less easily recognized ways in which ultrasound technology is profoundly social and political in the United States today.
The 1966 edition of the leading medical textbook states that pregnant women can safely smoke half a pack of cigarettes a day. Yet today, women who smoke during pregnancy are among the most vilified figures in public health campaigns. Laury Oaks argues this shift is not due solely to medical findings indicating that cigarette smoking may harm the fetus. Also responsible are a variety of social factors that converged more than a decade ago to construct the demonized category of the “pregnant smoker.”
This book charts the emergence of smoking during pregnancy as a public health concern and social problem. Oaks looks at the emphasis public health educators place on individual responsibility, the current legal and social assertion of fetal personhood, the changing expectations of pregnant and prepregnant women, and the advent of antismoking campaigns. She explores how public health educators discuss “the problem” with one another, how they communicate with pregnant smokers, and how these women themselves understand the “risk” of fetal harm. Finally, Oaks discusses the various meanings of “objective” statistics on the effects of smoking on the fetus, exploring the significance of cultural context in assessing the relative importance of those numbers. She argues that rather than bombarding pregnant women with statistics, health educators should consider the daily lives of these women and their socioeconomic status to understand why some women choose to smoke during pregnancy. Without downplaying the seriousness of the health risks that smoking poses to women and their babies, the book supports new efforts that challenge the moral policing of pregnant smokers.
Developments in new reproductive technologies have confounded public policy and created legal and ethical quandaries for professionals and ordinary citizens alike. Drawing from the most current medical, psychiatric, legal, and bioethical literature, Ruth Macklin, noted author and philosopher, presents the arguments surrounding these advances through the voices of fictional characters. The episodes she narrates are based on real-life situations, both from her personal experience as a hospital ethicist and from the public arena, where such controversial court cases as that of Baby M have sparked a multitude of disparate opinions on surrogacy, in vitro fertilization, and egg and sperm donor program.
Macklin's hypoethical tale centers on Bonnie and Larry, an infertile couple longing for a child. As the couple's quest to become parents begins, they discover that Bonnie is physically incapable of carrying a pregnancy to term. Desperate to explore their options, Bonnie and Larry attempt adoption but are rejected by the agency without explanation. Finally, they contemplate surrogacy as their last chance to have a child. Seeking advice and answers, they consult health professionals, lawyers, pastoral counselors, and a bioethicist. In the course of this complicated and often painful decision-making process, they attend meetings of a government task force on reproduction where they hear both radical and liberal feminist positions.
Their experiences with friends, family members, two surrogates, hospital ethics committees, and special interest groups underscore the difficulty of coming to a consensus on such issues as AIDS, the right to privacy, premenstrual syndrome, the violation of surrogate contracts, and the responsibilities of therapists and physicians to their patients and to the community at large.
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