At Women’s Expense
Cynthia R. DANIELS Harvard University Press, 1993 Library of Congress KF481.D36 1993 | Dewey Decimal 342.730878
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.
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.
Winner of the 1998 C. Wright Mills Award from the Society for the Study of Social Problems
The Making of the Unborn Patient: Social Anatomy of Fetal Surgery, Monica J. Casper, It is now possible for physicians to recognize that a pregnant woman's foetus is facing life-threatening problems, perform surgery on the foetus, and if it survives, return it to the woman's uterus to finish gestation. Although foetal surgery has existed in various forms for three decades, it is only just beginning to capture the public's imagination. These still largely experimental procedures raise all types of medical, political and ethical questions. Who is the patient? What are the technical difficulties involved in foetal surgery? How do reproductive politics seep into the operating room, and how do medical definitions and meanings flow out of medicine and into other social spheres? How are ethical issues defined in this practice and who defines them? Is foetal surgery the kind of medicine we want? What is involved in reframing foetal surgery as a women's health issue, rather than simply a paediatric concern? In this ethnographic study of the social, cultural and historical aspects of foetal surgery, Monica Casper addresses these questions. "The Making of the Unborn Patient" examines two important and connected events of the second half of the 20th century: the emergence of foetal surgery as a new medical specialty and the debut of the unborn patient.
Mothers often know very little about the drugs they receive during pregnancy and even less about the drugs they consume during childbirth. The adverse fetal effects of drugs—whether prescription or over-the-counter—and the information mothers receive from the drug and medical communities about those drugs are shown in this International Academy for Research in Learning Disabilities monograph. The research for the study presented in Medication in Maternity included 602 mothers, and as such must be seen as a significant contribution to the field of neonatology in general and to learning disabilities specifically. The authors' findings indicate that many infants are exposed to prenatal and during-birth drugs that could cause learning difficulties or have other toxic effects, and that mothers are rarely told what drugs they are taking or how those drugs could harm their child.
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.
In The Public Life of the Fetal Sonogram, medical anthropologist Janelle S. Taylor analyzes the full sociocultural context of ultrasound technology and imagery. Drawing upon ethnographic research both within and beyond the medical setting, Taylor shows how ultrasound has entered into public consumer culture in the United States. The book documents and critically analyzes societal uses for ultrasound such as nondiagnostic "keepsake" ultrasound businesses that foster a new consumer market for these blurry, monochromatic images of eagerly awaited babies, and anti-abortion clinics that use ultrasound in an attempt to make women bond with the fetuses they carry, inciting a pro-life state of mind.
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.
Since the late nineteenth century, medicine has sought to foster the birth of healthy children by attending to the bodies of pregnant women, through what we have come to call prenatal care. Women, and not their unborn children, were the initial focus of that medical attention, but prenatal diagnosis in its present form, which couples scrutiny of the fetus with the option to terminate pregnancy, came into being in the early 1970s.
Tangled Diagnoses examines the multiple consequences of the widespread diffusion of this medical innovation. Prenatal testing, Ilana Löwy argues, has become mainly a risk-management technology—the goal of which is to prevent inborn impairments, ideally through the development of efficient therapies but in practice mainly through the prevention of the birth of children with such impairments. Using scholarship, interviews, and direct observation in France and Brazil of two groups of professionals who play an especially important role in the production of knowledge about fetal development—fetopathologists and clinical geneticists—to expose the real-life dilemmas prenatal testing creates, this book will be of interest to anyone concerned with the sociopolitical conditions of biomedical innovation, the politics of women’s bodies, disability, and the ethics of modern medicine.