Transformations in pregnancy

[Pregnancy has changed my] self-image probably so that now I really need to grow up. I have to think that I am responsible for someone else and I can’t play around, I have to really think how to arrange the everyday and what to do and where the money comes from and how to act. I have been kind of an eternal adolescent before, but if now I would start being [an adult]. But it has come from the fact that I am going to be a mum.

(Pregnant woman 2, age 30, 20 weeks of gestation, first pregnancy)^{60 61}

The quote above from an interview with a pregnant woman suggests that becoming a mother implies the need to become an adult who is responsible for others and not just herself. Furthermore, part of growing up is devoting one’s time to thinking about the arrangements, financial and otherwise, of everyday life. Adulthood is evoked by the forthcoming motherhood in which one is responsible for more than oneself.

In all of my interviews and in many of the discussions I had with pregnant women, it became obvious that pregnancy is a process and period of many transformations. In pregnancy selves are transformed – or to use the term common to recent literature and healthcare work knowledge on parenthood, they are in a transition to something (parenthood, motherhood and so on) (e.g. Family counselling Files 2008) – and selves are born. Transformation is the common denominator that organises the themes and sequencing in my material. All of the transformations involve a lot of doings and work, among which are growing into adulthood, doing responsible deeds and so on.

60 The quotations from the interviews and talks with the pregnant women, as well as with the nurses and the ethnographic descriptions of interchanges between the pregnant women, their partners and the nurses at the appointments and other situations at the clinics have been translated by me. I have tried to translate all the accounts as plainly as possible and to find expressions that match the Finnish ones as closely as possible.

However I am aware that non-native translations that omit any dialect or accent, as well as tidying up some of the awkwardnesses of spoken language, can potentially produce impressions of class positions not found in the original transcription.

61 I have decided not to use pseudonyms in this study but, instead, to identify research participants only by their location in the institutional process being discussed: e.g. public health nurse, pregnant woman, partner and so on. This is in line with IE attempts to avoid individualising the line of writing (and analysis) by maintaining a focus on the institutional processes (DeVault & McCoy 2006, 41).

Simultaneously, the selves enacted, selves that work, are repositioned in a network of social relations, big and small (kinship, various divisions of labour, the gender system, etc.).

Transforming the woman in the body

What happens to women in their bodies in the processes of (narrating) experience and work in pregnancy? I took the title of Emily Martin’s classic book The Woman in the body: a cultural analysis of reproduction (1987) and twisted it into the subtitle Transforming the woman in the body, because I think that, in a way, and some 20 years after that book, the answer is to be found in a project quite similar to Emily Martin’s. That is, in a project that aims to tease out ‘women’s alternative vision[s] of modern existence [… ], refractions of women’s many different places in the social order [… ] as women talk about major physical events they experience [… ], whether women are aware of scientific ideas as well as other ideas about gender in society’ (ibid., 22–23). Times have changed as have conceptualisations regarding knowledge production and the role of medical technoscience and healthcare institutions in women’s lives. Yet the task remains the same.

Pregnancy and giving birth are, without a doubt, major physical events in women’s lives.

Better yet, pregnancy is a life-altering process within which the physical, the social and the cultural/institutional are procedurally rearticulated (into a multiple). It seems to me that pregnancy as a life-rendering process sometimes starts even before the positive pregnancy test or the onset of pregnancy symptoms. Women talked to me about changing their lifestyle according to the healthcare instructions available, and, most of all, they talked about the process of hoping and trying to get pregnant:

It is like, something that I have, in a way, thought about since I was little that I am going to have a family and all that, although I couldn’t be sure whether it would happen for me. But this [pregnancy] has been a kind of a continuum for that which I have thought and hoped for [in life]

since I was young. And particularly procreation [of kin], well, it does seem important to me.

(Pregnant woman 5, age 33, 14+2⁶² weeks of gestation, first pregnancy)

62 The phrase ‘number+number’ refers to weeks of gestation + additional days of gestation. The phrase is commonly used at the clinics.

Pregnancy and children may be something that has been planned for from one’s own childhood. In the quotation, the pregnant woman describes her life as an autobiographical project where procreation seems a natural and self-evident end in itself. It is as though a model of ‘ideal’ life course is being realised in the quotation. Simultaneously, the woman situates pregnancy within the whole trajectory of life. On other occasions, even ‘biological deadlines’ were discussed. For example, later in the same interview, when I asked the woman to tell me about the moment when she found out she was pregnant, she told me mostly about trying to get pregnant and the experiences involved:

It was in that way anticipated that we knew that it [getting pregnant] might happen and hoped for it, of course. I only missed one period and then we took the test. It sounds a bit like a mundane thing, but, of course, when you wait for it to happen and know that it can happen, it is not really a surprise. Of course, it was a really positive thing, because it didn’t happen the first time, and we were already a bit alarmed. Even though we did know that at this age, when one starts to try and hope, on might not get lucky right away, but luckily we didn’t have to wait longer than this. So, really positive information but not as a surprise because we knew what to do. This is why I always wonder about surprise pregnancies. Of course if one is on the pill or something, so it really is a surprise but people know what they do, reasonable people.

(Pregnant woman 5, age 33, 14+2 weeks of gestation, first pregnancy)

Here, as in many discussions and also in other interviews, the pregnant woman comments on her age, which according to her and to medical definitions puts her close to the biological category of an advanced maternal age. She does not, however, comment on the suitability of a woman ‘of advanced maternal age’ for childbearing or rearing. Rather, she and her partner were just worried about the possible fertility issues that are considered to become more prevalent as a woman gets older (see also Homanen 2007).

Women who are hoping and trying, of an advanced maternal age or not, are ‘reasonable people’ who at this time and age know what to do and what to expect. They also know when to get pregnant. It was not just age that was a matter of concern in the timing of pregnancy, but also the conditions of life. Sometimes pregnancy was planned well ahead, as for the informant just discussed, and sometimes ‘it just felt natural given the life

circumstances,’ which are usually linked to relationship status, financial situation and/or point in one’s career.

Although the (idea of) pregnancy seems to transform selves even before one gets pregnant, getting pregnant – or, more precisely, finding out by taking a pregnancy test, probably the most commonly used antenatal diagnostic technology today – is in my view a turning point in itself in transforming selves. This is because confirming pregnancy has immediate implications for women’s lifestyles and their experiences of embodiment, self and other.

I discussed the issues of lifestyle, taking care of oneself and the effects of pregnancy on one’s everyday activities both with women expecting their first child and with mothers expecting the second or the subsequent child(ren). In a nutshell, the difference between being pregnant for the first time and being pregnant for the second time or more seems to be linked to familiarity drawn from earlier pregnancy or pregnancies, and to practical everyday matters concerning caring for often quite young children while pregnant. Women talked about being more ‘relaxed’ and having more ‘realistic’ expectations concerning the pregnant body, family life and themselves as mothers. Being pregnant and giving birth for the first time was the life- and self-altering experience that is reflected upon when pregnant for the second time:

Q: I’d like to go back to the story now [earlier I handed the pregnant woman a piece of paper where I had written instructions to tell a story], and I would like you to tell me in your own words about your pregnancy. In your story you may connect it [your pregnancy] to your life as a whole.

You may, for example, include all the feelings and experiences that you have found meaningful. You can start from wherever you like, go back to whatever topic you please whenever you please, and use as much time as you like. I will make a few notes to go back to later on.

A: [… ] With the birth of the first child it felt like it drastically changed my life and whole way of thinking. It was quite clear that we wanted a friend for the first child and wanted this great experience for the second time. Now, if one compares this pregnancy to the first pregnancy one can easily notice that now one concentrates notably less probably because one already has the first child there on the side. So, one concentrates on the first child and the belly is just carried along. Of course, it doesn’t lessen the feelings I have for this baby[-to-be], but maybe it is born to a different

kind of family than the first child was born into. That is something that comes to my mind first off. It feels wonderful that the first child has swept us into this children’s world and into children’s way of thinking and all that. So, with this second one, one already looks at the world differently.

(Pregnant woman 6, age 33, second pregnancy, 31–32 weeks of gestation)

Even though I tried not to specify what in particular women could or should relate their pregnancies to in the whole trajectory of their life, this woman, as well as others, told her story with reference to her first pregnancy. It is implied in the quotation that while getting pregnant for the second time is a great experience, the (needed) transformations into parenthood are already for the most part done, and besides, there is not really time to concentrate on one’s own bodily condition and activities. ‘One concentrates on the first child and the belly is just carried along,’ as the pregnant woman puts it.

Nevertheless, pregnancy, and the first pregnancy in particular, launches a range of new and altered activities in the everyday lives of pregnant women. At first one may act

‘automatically’ for the quite obvious reason that there are no bodily sensations to match the two red lines or dots in the pregnancy test. Women told me about quitting or considerably reducing their smoking and drinking, choosing less intensive forms of exercise, paying attention to their diet, resting more and perhaps working a bit less. Yet it does not seem common for women to fully realise pregnancy in the early stages. Rather, giving up things sometimes feels bad, although no one ever fully questioned the importance of doing so, or at least not in front of me. Thus, even though ‘the baby’ did not seem ‘real’, she/he or the pregnancy was given some priority in life, as is implied in the quotations below:

Sometimes pregnancy is wonderful, but on the other hand it is really boring as well or like the beginning really, you fell [...] In the end [it’s different] when the baby, hey, is coming soon, and you feel the movements and everything then. But in the beginning it’s a bit like, you can’t do this and that, I can’t do this and that, but there is nothing concrete yet and all that. You can’t eat this or that, or drink that, but yes, nothing there yet. They are [a part of] pregnancy. The best thing, however, is when you get to the end. You are excited about when it’s time to go. And then of course the baby. That’s the reason one is there [in pregnancy, doing things in pregnancy], to get a baby.

(Pregnant woman 1, age 24, 39+ weeks of gestation, second child, third pregnancy)

By eating and exercising [taking care of oneself in pregnancy]. I have always walked a lot, but now I always try to walk to work and back home, to get the exercise and so that I would not gain weight and that kind of thing. Surely it is good for joints and for everything if you exercise. I went swimming there for a while but now I haven’t gone for certain reasons [… ] because I have a swimming buddy and she had surgery and because she got ill she has not been able to come swimming, and I haven’t gone by myself. But that [swimming] was one of those things that I started because I am pregnant, because it is a good form of exercise [for pregnant women]. [… ] Sometimes it annoys me that you can’t do any of these unhealthy things. You’re not allowed to smoke or use alcohol or feast on treats or anything else. I do eat sweets and other stuff sometimes, I think that this is such a little sin that one is allowed to feast more sometimes when one knows that one is not going to have a cigarette or have a drink. I haven’t had a drop of alcohol even though it is said that a little dosage wouldn’t hurt, but I haven’t had even that. I can’t think of anything else off the top of my head that has changed.

(Pregnant woman 3, age 28, 27 weeks of gestation, first pregnancy)

Sometimes this taking care of oneself in pregnancy annoys women, especially in the early stages when the pregnancy itself and the unborn seem ‘unreal’ or ‘not concrete’. Yet they take care of their health anyway by consuming healthy food and avoiding unhealthy food or drink, and by staying in shape and resting. All this taking care of one’s health is mainly done for the sake of something or someone else.

The valued object is often implied to be ‘a healthy baby’. Hence what is assumed to be doing ‘good’ for the unborn, turning it into a healthy newborn, is not necessarily doing

‘good’ for the pregnant woman. However, since the unborn by definition develops within the woman (e.g. Bordo 1993, 86–88), nurturing, nourishing or doing anything to/for the unborn is doing it to the pregnant woman. This is not to say that choosing healthy lifestyles that are usually in line with medical and healthcare instructions is somehow

‘bad’ for pregnant women. In fact women regard new lifestyles as good for their own health as well (see also Markens & Browner & Press 1997, 360–366); furthermore, pregnancy as a site for altering one’s bodily activities, being and appearance is also perceived as liberating.

Pregnancy signs in the body and even the sometimes unpleasant symptoms fascinate

women, and women become much more aware of the materiality of the body. One is not able to do everything, such as working, cleaning and carrying things, as one did before pregnancy, and one has to ask for help from other people. The new-found materiality of the body is realised, first of all, in its laboriousness. The body that changes its boundaries, and eventually the big belly, are in the way and make moving and doing more challenging.

One also has to learn to move and do things differently, and the body keeps surprising pregnant women by being new and strange. The sensation is described in terms of ambivalence: the body is a stranger and yet one’s own, and as soon as one finally ‘gets used to it’ or ‘accepts it’ it changes again:

Q: If you think specifically about how pregnancy has altered […] or what bodily changes and symptoms have felt like? What kind of thoughts have they evoked during either one of your pregnancies?

A: In principle, in this second pregnancy, I have enjoyed it when the belly came and all that. And one knows that one can get rid of the extra weight if one wants to, and I haven’t even cared even though I got some [extra weight]. Actually I have gained just as much as in the first pregnancy. So I don’t think I have had any problems at any stage. In the first pregnancy, I had a little bit of an identity crisis, because of the bodily changes. Of course it changes quickly as the pregnancy proceeds and like that, it becomes all different. But even then when I went to the swimming pool and everything, well, I did all kinds of things, so I didn’t not go to the swimming pool or anything like that because I had a bit of a belly and some extra fat. But I do remember that I rebelled a bit more [in the first pregnancy] and that when I started to accept it [the body] at the end then I gave birth. I said that it is funny that suddenly the body changes again just when I have accepted it. Though this belly is here now and it is like this and it is huge […].

Q: What is it that is so great about the belly?

A: I think that the thing that is great it that there is this beginning of a life inside. Maybe it is just great or great, but amazing. Yes that, when you know that it is there underneath the belly skin, that it is somehow real. And when one knows that as the belly grows, the child grows too and then when one feels the first kicks and everything, it is great. It is something in itself. And surely there is a purpose for the fact that it lasts nine months in that you get used to the idea that the child is coming from there. And on the other hand the clumsiness and everything that is part of the last stages [of pregnancy], when you are not able to do anything, that is something that in a way eases the fear of giving birth in a way, that you start hoping that the birth should start now. When at first you’re a

little scared that terrible, what’s going to happen at birth. But at the end you are so clumsy and you can’t do anything that then it is just lovely when the labour starts, a good thing. Then you can put dishes in the dishwasher and take them out and the belly is not in the way.

(Pregnant woman 4, age 39, second child born one month before interview)

It is implied in the quotations that pregnancy is a process in which the self is attuned both to human life and a baby growing within oneself and to the new awkwardness, clumsiness and size of the body. Sometimes the changes in the body that come with pregnancy may forge ‘identity crises’ like negative experiences of the self, but it seems that unless there are some major complications in one’s pregnancy, these experiences are regarded as

It is implied in the quotations that pregnancy is a process in which the self is attuned both to human life and a baby growing within oneself and to the new awkwardness, clumsiness and size of the body. Sometimes the changes in the body that come with pregnancy may forge ‘identity crises’ like negative experiences of the self, but it seems that unless there are some major complications in one’s pregnancy, these experiences are regarded as