Before formulating my exact research questions, I will take a detour into prior academic discussion on pregnancy and the unborn as constitutive of social relations in order to find a space as well as conceptual framework for my own research. The unborn/foetus has been an explicit focus in (feminist) social and cultural studies at least since the 1980s. It first appeared in Anglo-American academic discussions that aimed to develop universal frameworks for conceptualising the unborn. However, research on it soon spread both in terms of empirical approaches and national contexts. Since the 1980s Rosalind Petchecky (1987), Barbara Katz Rothman (1989ab), Emily Martin (1987), Faye Ginsburg and Rayna Rapp (1995), Marilyn Strathern (1992), Ann Rubinow Saetnam (2005), Charis Thompson (2005) and many others have produced critical analysis on the multiple character and social relations of the unborn that are crucial to feminist work on the (politics of) foetal personhood, agency and subjectivity. They have shown how women can be granted full reproductive freedom without reducing the unborn to neutral biological matter.
4The fact that there is less social science and gender studies research on the (whole) process of care practices with other support on their agenda than just the medical (health promotion and psychological parental support) can be explained by differences in national healthcare and social welfare systems. In Anglo-America, where most of the research on pregnancy, the unborn and maternity healthcare is conducted, maternity healthcare is run by doctors (and to some extent midwives) in hospital environments and centred around a medical screening of health that in Finland falls beyond the scope of preventive healthcare. Further, additional services, such as health visitors’ home visits in the UK, are in most cases targeted at families already classified as ‘problem families’ (e.g. Kearney & York & Deatrick 2000).
5 Rather than just medical care for previously diagnosed illness that is provided by hospitals and doctors.
Notwithstanding this, feminists have been accused of a reluctance to engage in reflexive discussion on foetuses despite the increasing social and moral value granted to foetuses (Michaels & Morgan 1999; Morgan 1996, 48). To me this seems a somewhat harsh overstatement. It would be more correct to say that in the early eras of consciousness-raising in the 1970s and in 1980s feminists tended to ‘work around the foetus’ (see also Michaels & Morgan 1999; Addelson 1999). This is understandable to the extent that inherent in the early theories of patriarchy and pro-choice politics are concepts of human personhood and individual agency apparent in their emphasis on individual choice and rights (e.g. Hartouni 1999, 297). Within such conceptualisations refocusing attention from the unborn with rights as a (semi-)autonomous person to the woman as an individual with full reproductive freedom reduces the unborn to culturally neutral biological matter.
The unborn addressed in these scholarly formulations emerged along with the development and growing use of reproductive technologies. The unborn that once was somatically experienced and mediated became transformed into the pre-human form of human life that we now recognise as the ‘foetus’. Parallel to the technological development, in a variety of social practices the technologically constituted foetus is granted value as human life, personhood, autonomy and civil rights. For instance the foetal unborn has acquired the leading role in publicly defined problems concerning women’s reproductive rights, such as abortion. The modern technology-driven medical practice and science is commonly understood in theory and research on pregnancy and foetuses as enabling the separation of the unborn and its mother. This, then, serves the advocates of foetal personhood, such as pro-life activists, and provides a means to shift pregnancy, maternity, gender identity and childbirth into the hands of other actors, potentially stripping women of their reproductive agency in decisions concerning their unborn. (e.g.
Oakley 1984; Rothman 1989ab; Leppo 2012, 62-63; cf. Firestone 1971.)
Conceptualising pregnancy in terms of individual agency and personhood, or lack thereof, has not proved very useful in solving the contradiction between the unborn and pregnant women: the debate is ultimately reduced to arguments for and against foetal autonomy.
Nor do such concepts appear to be useful tools for making sense of the empirical world,
since for pregnant women themselves pregnancy is not just about conflicting interests between them and their unborn but also about collaborative interests that affect how bodies are lived and actions taken (see also Oaks 2000; Sevón 2009, 73). At some times women experience the unborn as separate from themselves, and at others as part of themselves (Markens & Browner & Press 1997, 386). The status of the unborn as its own person, an individual or legal subject, is, at best, partial. In other words, the individualist and dichotomous model, in which women’s lifestyle and right to choose are perceived as limits to the rights of the unborn, is quite ambivalent in regards to women’s experience and everyday lives. There have been a few interrelated theoretical-political/philosophical approaches and concepts that go beyond the individualistic dogma in exploring reproduction, including concepts such as relationality (e.g. Whitbeck 1984; Sherwin 1992;
Shildrick 2004), collective action (e.g. Morgan 1996; Casper 1994; Addelson 1999), material semiotics (Haraway 1997; Barad 1998) and agential realism (Barad 1998).
In general, to be able to conceptualise pregnancy as a (set of) social relationship(s), adjustments to the ‘conventional’ understandings of the body, subject, personhood, agency and social relations are required – not just in relation to the unborn within but also in relation to the pregnant woman’s sense of self. This is because in a phenomenological as well as in a social sense the pregnant woman is herself and not quite herself simultaneously (e.g. Homanen 2007; Piensoho 2001; Young 1998; Rothman 1989ab;
Kristeva 1982; 1993). While the pregnant body may be experienced as a stranger at times it cannot be identified with an ill body, because it rarely appears alienating in the same sense. Julia Kristeva6 (1993, 180) has suggested that pregnancy could be explored via subjectivity that is constitutive of another within. In a similar vein Barbara Katz Rothman (1989a) renders concepts of individuality and possession questionable in pregnancy by pointing out how the body of a pregnant woman in social practice seems not to be her own as it was before pregnancy. Her sense of self-determination is transformed when all kinds
6 Kristeva as well as other French psychoanalytic theorists such as Hélène Cixous (e.g. 1976) and Luce Irigaray (e.g. 2001) have discussed pregnancy in wider terms than the common psychoanalytic concept of fulfillment of lack. Rather, they seem to conceptualise pregnancy as a condition of simultaneously having and not having a relationship with the Other, and bodily being simultaneously oneself and not oneself. My theoretical approach does not apply psychoanalysis or the work of writers in that tradition per se but obviously the conceptualisations of Kristeva, Cixous and Irigaray can also be authenticated in more sociological terms.
of actors, people and apparatuses are claiming ownership of and a custodian role towards the foetus and (thus) the woman’s body. Further, Rothman reminds us that pregnancy is not just a physical relationship between the pregnant woman and the unborn but a social relationship as well: pregnant women respond socially to the unborn and its ‘activities’ as do other people around her (ibid.).
The efforts to conceptualise pregnancy as social relations in a way that do not push aside either the personification and morality of the foetus or women-centred, pro-choice politics (e.g. Bordo 1993, 95) have involved the mobilisation of notions of relational agency. The logic of the relational modelling can be summarised thus: if persons are conceived not as autonomous but as relationally enacted and socially situated beings, then the relationship between the woman and the unborn is no longer modelled as a conflict between two persons or on the basis of making either participant disappear (Morgan 1996 on Whitbeck, Sherwin and Petchecky).
Lynn M. Morgan (1996) takes issue with such (mostly) theoretical and philosophical attempts written in the 1980s and early 1990s (e.g. Whitbeck 1984; Sherwin 1992;
Petchecky 1987; Strathern 1992; Duden 1993). She concludes that, despite these theoretical efforts, by replacing ‘the individualistic’ with the feminist antidote of the day,
‘the relational’, the texts under her review fail to escape culturally specific Western biases.
Morgan (ibid.) argues that the problem with the particular writers she takes up is not the concept of relationality per se, but the concepts of agency and inherent embodiment that imply that embodiment and embodied subjectivity somehow precede their cultural inscription (ibid.; see also Michaels 1999, 133 on Duden). According to her, this is apparent in the ‘early’ philosophical accounts, where relationality or sociability is located in the cognitive and corporeal attributes of the foetus/infant, in the pregnant woman’s sentience and/or in a larger social network. A person is, accordingly, someone who has come to possess certain biological attributes that enable relationship-making, her mother’s consciousness of an existing relationship and/or a social network’s realisation of the full self-awareness needed for social interaction. (Morgan 1996, 52-55.) What is assumed, then, is relationality of the personhood but not of the body or better yet the physical
(including the mind), although (and partly because) such assumptions are made in the name of granting women self-sovereignty.
What Morgan (1996) is implying is that if the embodied woman in these ways is retrieved as the site of pregnancy she will be essentialised in terms of biology and reproduction.
How, then, to approach pregnancy and the foetus without assuming precursors to personhood or subjectivity, such as already existing biological embodiment? Building on earlier conceptions of relationality, Morgan7 (1996), Meredith W. Michaels (1999, 130), Laury Oaks (2000) and Monica Casper (1994) suggest that any effort to relocate the pregnant woman as the site of pregnancy will have to involve taking into account the contexts within which the embodiment is materially and symbolically constituted. These contexts refer to the specific historical, political, cultural and social sites and matters within which the foetus, its relations and agency are configured and enacted. Within each of these sites there is embedded a specific power matrix that coordinates to whom, or in what agency, it locates itself at any given moment. If there are no a priori presumptions taken for granted about the essence or ontology of anything or anyone, women’s reproductive rights and freedom should be formulated over and over again in response to what appears to matter at any given time and space. (Morgan 1996; Casper 1994; Michaels 1999.)
Basically, what is suggested is that feminist analyses should be sociologically informed and self-reflexive (see also Silius 2010; Porter 1994). At the level of political activity in certain Western local controversies over reproductive freedom, then, individualist argumentation on ‘choices’ and rights may achieve momentary success but in other situations – other nations, cultures, times and so on – such a logic of argumentation could better be replaced by a collective approach to the constitution of the unborn. What one has to be reflexive about is that the approach chosen does not advance dominance over people.
7 Even though Morgan (1996) seems to be mapping theoretical and conceptual limitations of the past few decades of research in her article, what she finally ends up doing is building on the work she critiques. That, at least, is how I prefer to situate her in the history of feminist theory on the unborn/foetus. As Clare Hemmings (2011, 31-57) notes, reproducing (decade-by-decade) progress narratives that represent the past feminist work as essentialist, anachronist and unreflexive cannot explore how new theory adds on to existing theory in a non-linear fashion (see also Anttonen 1997, 51).
For example, locating humanity in larger social networks of relations in a culture that emphasises biological sentience as constitutive of personhood may result in undermining women’s right to early abortion, mandatory HIV testing and medication for women and so on, as noted by Kathryn Pyne Addelson (1999, 33). (In fact this is happening right now in right wing neoconservative parts of the West).
On a more theoretical side, reflexivity and being sociologically informed, in my understanding, means that the unborn needs to be studied as enacted in different practice rather than assumed as some singular entity waiting to be discovered – by medicine, parents or scientific devices. The unborn or the foetus is thus viewed, in this study as well as others (e.g. Casper 1996; 1998; Oaks 2000), as a way of organising social relations.
Thus different practices involving collective/shared activities concerning the unborn and conceptualisations of them are not (merely) different perspectives but multiple enactments of the unborn. (Mol 2002, 32–36, 44; cf. Ruppert 2011, 223–224; Law 2004, 54–57;
2008). I use the term enactment, that has widely been adopted by researchers in science and technology studies (STS), material-semiotics or post-ANT (Actor Network Theory), rather than terms like construction. This is because whereas ‘construction’ implies fixity and completeness, enactment emphasises how realities and representations are simultaneously performed in an endless process (Mol 2002, 44; Law 2008, 635). The unborn, as well as other entities such as bodies, things and people, then, are continually performed a new and maintained in a process of doing. They are empirical matters.
To account for this tentative, historical, emergent and multiple nature of the unborn child, baby and foetus and its relations, I have decided to name it just ‘the unborn’ when I am talking about a subject position that can then be occupied by the foetus, the baby, the child and so on, depending on the context of performing it. The term ‘unborn’ is certainly not a neutral term, but it is less politically charged and value-laden than a prenatal child or a baby. Instead, the term foetus would, in my view, imply that the unborn is always first and foremost the technologically mediated scientific figure. If that is the case, it has to be arrived at empirically and not assumed. Lastly, the term unborn suits the empirical field
under study because the work and the people involved in the activities at the clinic aim at birth.8