Today, a number of medical technologies with varying degrees of accuracy are available for pregnant women. The most widely used prenatal diagnostic technology is ultrasound. Until the mid 1980s ultrasound was selectively offered to women with a high-risk pregnancy, but it is now considered a regular feature of prenatal care that can benefit all pregnant women. The psychological effects of ultrasound on the pregnancy experience have been widely explored and researchers found, that they are predominantly positive. However, little has yet been said about sociological aspects of the influence of ultrasound on women’s pregnancy experiences. Therefore, this essay seeks to explore this topic in a sociological dimension, in order to answer the question, whether ultrasound is a benefit or a burden in regards to the pregnancy experiences of women. The essay sheds light on how ultrasound can be used for ‘prenatal’ family building as it allows the woman to involve her partner and members of the extended family in her pregnancy experience. The essay goes on to argue, that besides the empowerment of women’s monopoly in family building strategies by ultrasound, the increased level of medicalisation of pregnancy has disempowering characteristics. After examining the influences of ultrasound at the women’s status, it will be argued that also foetal images that have been influenced by ultrasound impact on women’s pregnancy experiences. I will therefore discuss the ‘prenatal paradox’ of the construction of foetal personhood versus the image of the foetus as a consumer commodity. The last part of the essay shows how ultrasound influences the medical and societal view of having a disabled child in a time in which disability can be prevented by induced selective abortion.
The routinised use of ultrasound:
Blessing or burden in women’s pregnancy experiences?
Introduction
Today, a number of medical technologies with varying degrees of accuracy are available for pregnant women: amniocentesis, alpha fetoprotein blood screening (AFP) and chorionic villus sampling (CVS). The single most widely used prenatal diagnostic technology, however, is ultrasound (Harpel 2003). Over the last decades, the use of ultrasound (or sonography) has undergone a shift from a risk-based to a population-based application (Donovan 2006, Press and Browner 1995). In most countries, at least one ultrasound examination is scheduled for pregnant women (one in the United Kingdom, two in Austria Switzerland, three in France, Germany, Italy and Spain) and even more are available by request (Clementi and Stoll 2001).
Until the mid 1980s ultrasound was selectively offered to women with a high-risk pregnancy (i.e. women over a certain age or with a history of miscarriages), but it is now considered a regular feature of prenatal care that can benefit all pregnant women. The sonographer or obstetrician who undertakes the ultrasound is able to confirm or “date” a pregnancy, monitors the foetal position, development and growth and can offer the pregnant woman an opportunity to discover the foetal sex. After an ultrasound, the expectant mother is often offered an image of her foetus to take home.
The psychological effects of ultrasound on the pregnancy experience have been widely explored and researchers found, that they are predominantly positive: Ultrasound helps women to feel reassured, that the foetus is healthy, increases the foetal-maternal bonding and therefore helps women to adjust to the idea of motherhood (Harpel 2003, Mitchell 2001, Taylor 1998).
However, little has yet been said about sociological aspects of the influence of ultrasound on women’s pregnancy experiences. Therefore, I seek to explore this topic in a sociological dimension, in order to answer the question, whether ultrasound is a benefit or a burden in regards to the pregnancy experiences of women.
Although ultrasound also influences the pregnancy experience of women who did not choose to become pregnant (i.e. sustained by Harpel’s qualitative research in 2003), I will only argue from the view of women who experience a wanted pregnancy. Parts of the essay will also address problems that are discussed or closely related to the right-to-life-debate such as the discourse around foetal human rights, sex selection and eugenics. However, I will refrain from discussing the indubitable interesting influences of ultrasound on the right-to-life debate in this essay and will focus on the question, in which way ultrasound influences the female pregnancy experience.
In its opening section, the essay will shed light on how ultrasound can be used for ‘prenatal’ family building as it allows the woman to involve her partner and members of the extended family in her pregnancy experience. The essay will go on to argue, that besides the empowerment of women’s monopoly in family building strategies by ultrasound, the increased level of medicalisation of pregnancy has disempowering characteristics. After examining the influences of ultrasound at the women’s status, I will argue that also foetal images that have been influenced by ultrasound impact on women’s pregnancy experiences. I will therefore discuss the ‘prenatal paradox’ of the construction of foetal personhood versus the image of the foetus as a consumer commodity. The last part of the essay will show how ultrasound influences the medical and societal view of having a disabled child in a time, where “this” could have been prevented and in what manner this development influences women’s pregnancy experiences.
Reconsidering family structures – the foetus as a family member
When a child joins the relationship of two individuals, family structures and relationships change. Existing bonds between partners or members of their extended families may become emotionally strained and new bonds evolve. Studying the sociological influences of ultrasound on women’s pregnancy experience, I seek to answer the question how this technology can potentially influence the adjustment to the new family life.
Psychologically, the picture of the foetus on the ultrasound screen increases maternal-foetal bonding (Mitchell 2001, Harpel 2003). Besides the increased attachment between the mother and the foetus, ultrasound has also evolved to be a female strategy in family building. Although men still tend to view reproduction as a female domain, women engaged in heightening their partner’s involvement in the pregnancy by taking them along to the ultrasound examinations or showing them ultrasound videos or pictures (Rapp 1999, Mitchell 2001). Mitchell found, that seeing the foetus on the screen contributed to changes in male behaviour like working shorter hours to stay with the woman or, in contrast, working harder to save up more money for the additional family member. In this sense, ultrasound can be perceived as an important step towards fatherhood (Harpel 2003, 19). This is also shown by Johnsons’s and Puddifoot’s findings, that expectant fathers who had seen an ultrasound picture of the foetus experienced more intense grief compared to men who lacked this experience (ibid. 17).
The ultrasound picture introduces the foetus not only to the man but also to other family members. Even when women have partners, they often like to include other family members like their parents or previous children in the ultrasound experience. Women who could not bring family members to the ultrasound examination often tried to involve the family by informing them about the latest news the ultrasound had revealed such as size, appearance and sex of the foetus (Harpel 2003). Some women gave copies of the ultrasound pictures to their parents and parents-in-law or showed the ultrasound video they were given (Mitchell 2001). They used the pictures to announce the pregnancy or introduce the foetus in the family, even by sending the pictures over the internet to involve family members abroad (Harpel 2003, 117).
Especially the opportunity to learn the sex of the foetus contributed to the family building. By revealing whether the child is going to be a “him” or “her” and inducing name-picking, ultrasound contributed to the creation of a social identity of the foetus. In addition, knowing the sex of the foetus also proved to be valuable information in women’s efforts to introduce the foetus as a family member (Harpel 2003, 132). Harpel also found, that women often believed that building relationships between family members was a part of their maternal role. When women engaged in creating a social and emotional place for the foetus in their family, they experienced knowing its sex as helpful. When the women had no children, they concentrated on preparing their relationship for a new parental role. If they had children, they started to prepare them for the addition of a new sibling (ibid. 134-135).
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