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addicted.pregnant.poor
Kelly Ray Knight
Duke University Press, 2015
For the addicted, pregnant, and poor women living in daily-rent hotels in San Francisco's Mission district, life is marked by battles against drug cravings, housing debt, and potential violence. In this stunning ethnography Kelly Ray Knight presents these women in all their complex humanity and asks what kinds of futures are possible for them given their seemingly hopeless situation. During her four years of fieldwork Knight documented women’s struggles as they traveled from the street to the clinic, jail, and family court, and back to the hotels. She approaches addicted pregnancy as an everyday phenomenon in these women's lives and describes how they must navigate the tension between pregnancy's demands to stay clean and the pull of addiction and poverty toward drug use and sex work. By creating the space for addicted women's own narratives and examining addicted pregnancy from medical, policy, and social science perspectives, Knight forces us to confront and reconsider the ways we think about addiction, trauma, health, criminality, and responsibility. 
 
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At Women’s Expense
State Power and the Politics of Fetal Rights
Cynthia Daniels
Harvard University Press, 1993

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.

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Disembodying Women
Perspectives on Pregnancy and the Unborn
Barbara Duden
Harvard University Press, 1993

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.

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Embodying Culture
Pregnancy in Japan and Israel
Ivry, Tsipy
Rutgers University Press, 2009
Embodying Culture is an ethnographically grounded exploration of pregnancy in two different cultures—Japan and Israel—both of which medicalize pregnancy. Tsipy Ivry focuses on "low-risk" or "normal" pregnancies, using cultural comparison to explore the complex relations among ethnic ideas about procreation, local reproductive politics, medical models of pregnancy care, and local modes of maternal agency.

The ethnography pieces together the voices of pregnant Japanese and Israeli women, their doctors, their partners, the literature they read, and depicts various clinical encounters such as ultrasound scans, explanatory classes for amniocentesis, birthing classes, and special pregnancy events.

The emergent pictures suggest that although experiences of pregnancy in Japan and Israel differ, pregnancy in both cultures is an energy-consuming project of meaning-making— suggesting that the sense of biomedical technologies are not only in the technologies themselves but are assigned by those who practice and experience them.

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Fetal Rights, Women's Rights
Gender Equality in the Workplace
Suzanne U. Samuels
University of Wisconsin Press, 1995

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.

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Medication in Maternity
Infant Exposure and Maternal Information
Yvonne Brackbill, Karen McManus, and Lynn Woodward
University of Michigan Press, 1985
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.
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Misconceiving Mothers
Legislators, Prosecutors, and the Politics of Prenatal Drug Exposure
Laura Gomez
Temple University Press, 1997
A tiny African-American baby lies in a hospital incubator, tubes protruding from his nostrils, head, and limbs. "He couldn't take the hit," the caption warns. "If you're pregnant, don't take drugs." Ten years earlier, this billboard would have been largely unintelligible to many of us. But when it appeared in 1991, it immediately conjured up several powerful images: the helpless infant himself; his unseen environment, a newborn intensive care unit filled with babies crying inconsolably; and the mother who did this -- crack-addicted and unrepentant.

Misconceiving Mothers is a case study of how public policy about reproduction and crime is made. Laura E. Gomez uses secondary research and first-hand interviews with legislators and prosecutors to examine attitudes toward the criminalization and/or medicalization of drug use during pregnancy by the legislature and criminal justice systems in California. She traces how an initial tendency toward criminalization gave way to a trend toward seeing the problem of "crack babies" as an issue of social welfare and public health.

It  is no surprise that in an atmosphere of mother-blaming, particularly targeted at poor women and women of color, "crack babies" so easily captured the American popular imagination in the late 1980s. What is surprising is the was prenatal drug exposure came to be institutionalized in the state apparatus. Gomez attributes this circumstance to four interrelated cause: the gendered nature of the social problem; the recasting of the problem as fundamentally "medical" rather than "criminal"; the dynamic nature of t he process of institutionalization; and the specific feature of the legal institutions -- that is, the legislature and prosecutors' offices -- the became prominent in the case.

At one level Misconceiving Mothers tells the story of a particular problem at a particular time and place -- how the California legislature and district attorneys grappled with pregnant women's  drug use in the late 1980s and early 1990s. At another level, the book tells a more general story about the political nature of contemporary social problems. The story it tells is political not just because it deals with the character of political institutions but because the process itself and the nature of the claims-making concern the power to control the allocation of state resources.

A number of studies have looked at how the initial criminalization of social problems takes place. Misconceiving Mothers looks at the process by which a criminalized social problem is institutionalized through the attitudes and policies of elite decision-makers.
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Mothers On The Job
Maternity Policy in the U.S. Workplace
Vogel, Lise
Rutgers University Press, 1993

Women's increasing demands for protection and benefits in the workplace, especially with regard to maternity leave, have sparked more than a century of controversy among feminists on how best to serve the needs of working women. This debate continues to divide the feminist community. One side believes women are better served by emphasizing equality with men--pregnancy should be treated like any other "disability." The other side wants to recognize difference--special provisions should apply only to pregnant women. Lise Vogel examines the evolution of this debate on pregnant women in the workplace, looking at theoretical as well as practical implications.

Vogel begins by assessing the history of the contemporary debate on pregnancy policy in the U.S. Since the middle of the nineteenth-century, American women have been torn by the contradictory demands of motherhood and the workplace. Pregnancy was grounds for dismissal from work and few employers took action to protect pregnant workers. To counter this, early twentieth-century feminists and reformers emphasized female specificity and women's special role.

In the 1960s activists adopted a strategy framed on equality, which moved away from the earlier emphasis on differences. The use of equality strategies to cover the female-specific phenomenon of pregnancy turned out to have problems. Now women's special needs were denied and ignored. These difficulties and a series of court cases in the 1980s triggered debates in the feminist legal community. Vogel looks at the litigation and debates, which pitted advocates of gender-neutral strategies against critics who called for female-specific policies.

Vogel argues that, in terms of practical benefits, women will be served best by a gender-neutral approach to pregnancy policy. She encourages equality advocates to recognize the inherent diversity of individuals, and points out the need to be sensitive to individual factors of race and class, as well as sex.

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front cover of Mothers On The Job
Mothers On The Job
Maternity Policy in the U.S. Workplace
Vogel, Lise
Rutgers University Press, 1993

Women's increasing demands for protection and benefits in the workplace, especially with regard to maternity leave, have sparked more than a century of controversy among feminists on how best to serve the needs of working women. This debate continues to divide the feminist community. One side believes women are better served by emphasizing equality with men--pregnancy should be treated like any other "disability." The other side wants to recognize difference--special provisions should apply only to pregnant women. Lise Vogel examines the evolution of this debate on pregnant women in the workplace, looking at theoretical as well as practical implications.

Vogel begins by assessing the history of the contemporary debate on pregnancy policy in the U.S. Since the middle of the nineteenth-century, American women have been torn by the contradictory demands of motherhood and the workplace. Pregnancy was grounds for dismissal from work and few employers took action to protect pregnant workers. To counter this, early twentieth-century feminists and reformers emphasized female specificity and women's special role.

In the 1960s activists adopted a strategy framed on equality, which moved away from the earlier emphasis on differences. The use of equality strategies to cover the female-specific phenomenon of pregnancy turned out to have problems. Now women's special needs were denied and ignored. These difficulties and a series of court cases in the 1980s triggered debates in the feminist legal community. Vogel looks at the litigation and debates, which pitted advocates of gender-neutral strategies against critics who called for female-specific policies.

Vogel argues that, in terms of practical benefits, women will be served best by a gender-neutral approach to pregnancy policy. She encourages equality advocates to recognize the inherent diversity of individuals, and points out the need to be sensitive to individual factors of race and class, as well as sex.

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Pregnancy, Motherhood, and Choice in Twentieth-Century Arizona
Mary S. Melcher
University of Arizona Press, 2012

Early twentieth-century Arizona was a life-threatening place for new and expectant mothers. Towns were small and very far apart, and the weather and harsh landscape often delayed midwives. It was not uncommon for a woman to give birth without medical care and with the aid of only family members. By the 1920s, Arizona was at the top of the list for the highest number of infant deaths.

Mary Melcher’s Pregnancy, Motherhood, and Choice in Twentieth-Century Arizona provides a deep and diverse history of the dramatic changes in childbirth, birth control, infant mortality, and abortion over the course of the last century. Using oral histories, memoirs, newspaper accounts, government documents, letters, photos, and biographical collections, this fine-grained study of women’s reproductive health places the voices of real women at the forefront of the narrative, providing a personal view into some of the most intense experiences of their lives.

Tackling difficult issues such as disparities in reproductive health care based on race and class, abortion, and birth control, this book seeks to change the way the world looks at women’s health. An essential read for both historians and public health officials, this book reveals that many of the choices and challenges that women once faced remain even today.

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Pregnant Women on Drugs
Combating Stereotypes and Stigma
Rosenbaum, Marsha
Rutgers University Press, 1998
From Library Journal
Sociologists Murphy and Rosenbaum interviewed over 120 women who had children while using drugs. Their interviews reveal how the women became addicted, how they may or may not have modified their behavior to protect their children, and how they have dealt with having children and losing them as a result of their addiction. Not all the women interviewed were from abusive or poor families; there is extensive information on how the study population was selected. Also included are suggestions on how to deal with the problem, including women-centered drug treatment and training programs to help women learn trades as well as parenting skills. Though the interviews are enlightening, readers may wish for more answers to the question of how to deal with the root problem and less about the problems drug-addicted mothers face. For academic libraries, especially those with women's studies and sociology collections.?Danna C. Bell-Russel, Natl. Equal Justice Lib., Washington, DC

Review
A powerful refuation of the media-hype stereotypes of pregnant drug users as selfish and unfeeling, Pregnant Women on Drugs shows the extent to which many drug-using women develop the motivation to achieve their dual goals of improving their children's health and maintaining maternal custody. -- Steven R. Kandall, M.D., F.A.A.P., and author Substance and Shadow: Women and Addiction in the United States

Research-based but intensely personal. . . You will be touched by the poignant descriptions about the real lives of pregnant women on drugs. . . Pertinent reading for researchers, clinicians, and all Americans. -- Loretta P. Finnegan, M.D., researcher and perinatal addiction specialist

Touching and informative. . . Drug-addicted women who have either been ignored or reviled are finally given voice to tell their own stories. Their sad, true, and quintessentially human experiences provide persuasive arguments for compassion and supportive approaches to the problems of substance abuse and pregnancy. -- Lynn Paltrow, civil liberties and reproductive freedom attorney
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Preventing Prenatal Harm
Should the State Intervene? Second Edition
Deborah Mathieu
Georgetown University Press, 1996

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.

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Smoking and Pregnancy
The Politics of Fetal Protection
Oaks, Laury
Rutgers University Press, 2001

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.

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Surrogates and Other Mothers
The Debates over Assisted Reproduction
Ruth Macklin
Temple University Press, 1994

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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