The thesis will be structured as follows. In Chapter 2 I will discuss my theoretical and methodological choices in more detail. My conceptual orientation combines institutional ethnography as theorised by Dorothy E. Smith with certain insights from particular science and technology studies (STS) that discuss how different entities, such as the unborn, are enacted in a material-semiotic (or socio-material) and procedural manner (Mol 2002;
2008a; Haraway 1991a; 1996; 1997). The concept material-semiotic refers to the way realities and representations are simultaneously performed, as discussed in the case of the analytical concept of enactment. In the rest of the chapter I will draft a preliminary picture of the ethnographic field I am about to enter. I will provide a brief description of the ways in which the history of the organisation and current guidelines and policies coordinate maternity healthcare work, and give contextual information on the field clinics that participated in this study, i.e. the ethnographic setting. I will also discuss my interference in that field, and my method of bringing together different research materials in a multi-sited and dialogical institutional ethnography of multiple pregnancies and the unborn.
Chapter 3, Pregnancy as an embodied experience, the first analytical section of the research, inquires into experience-based knowledge in pregnancy that is, pregnancy as it is
lived and experienced. The description of interviews I had with pregnant women and field observations form an outlining framework for the ethnographic analysis of institutional practices and orders that will follow in the subsequent chapters, both in the sense of controversy and complement. I will show that pregnancy is accounted for as a set of transformations within which selves are born and selves shift. Overall I will address the social relations that coordinate pregnant lives and selves in and outside the clinics but that are also constituted by the women themselves.
The second analytical section of the research, Chapter 4, Pregnant selves and unborn relations in the paths of maternity healthcare, begins the actual inquiry into the practical and specific realities of everyday work at the clinics. I ask how the logics of transformation and teamwork in making babies, children, mothers, kin relations and so on are actually realised in care work as documented in video recordings of the appointments, observational and documentary material, and interviews with the nurses. In the chapter, I will trace the temporal rationale of doing care and pregnancy in the institution i.e. go about my inquiry as pregnant women do and follow the paths from the first appointment onwards, in line with the progression of pregnancy. I will argue that the temporal movements in the processes of care for pregnancies follow a logic, albeit it is somewhat incoherent, whereby mental and socio-material transformations of family life are provoked to move from nurturing and caring for a foetus, a human life and a baby in itself, to attending to one’s own particular baby and a child with at least potential personality traits, gender and social identity, and kin ties. In the practices of evoking bonding in maternity healthcare, these ties and social relations to one’s unborn are enacted, above all, as emotional affection and preparation, early interaction and, possibly, over-attentiveness that coincide with psychosocial knowledge on and approach to the abstract issues of parenthood. The institutional stir to bonding, however, leaves scope for vague agency to make homes and maternal selves through social and material arrangements within one’s own social networks.
The final analytical chapter, Chapter 5, Multiple ruling relations in making the unborn–
woman relations, attends to thematic logics of care that cannot be linked to any specific
phase or point in the temporal trajectory of care. The themes in making unborn relations that, in effect, set spaces and limits for women’s agency are technoscience-in-the-making, politics/citizens-in-the-making, divergence/class-in-the-making and consumers/product-fetishes-in-the-making. These logics of making relate to the temporality of care and have been touched upon earlier in the thesis: they make and break the temporal logic of transforming foetuses, human life and babies in general to particular babies and children with identities and social bonds. This chapter is more abstract and theoretical, because of my commitment to (institutional) ethnography: staying responsive to the dialogue between myself and the research participants and the knowledge produced in dialogue. At the point of writing up my thesis, this means that I must not succumb to the singular voice of scholarly theory that shares with other abstract institutional discourses a tendency to marginalise the intentions and perspectives of the original speakers and actors (Smith 1998, 67; see also Van Maanen 1988, 73–100). My structural response has been to offer first ethnographic description that remains at a more descriptive analytical level and is, thus, also accessible to a wider variety of readers. Finally, I will bring in theory and the more abstract power relations coordinating care. In this way, I attempt to maintain a multiplicity of voices and knowledges-in-the-making (which are open to the reader).
In Chapter 6, the concluding chapter, I will explicitly answer my research questions and reflect on my research as a whole. Further, I will discuss the potential implications for maternity healthcare, especially regarding care directed at the maternal–unborn relationship. This also involves thinking through what it means to grant or not to grant the unborn agency from a feminist perspective in the light of my research and its conceptual applications.