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Embodied Experiences of Pregnancy in a Technological Age ...

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Embodied Experiences of Pregnancy in a Technological Age ... Embodied Experiences of Pregnancy in a Technological Age ... Presentation Transcript

  • Transformations Week 6Embodied Experiences of Pregnancy in a Technological Age
  • The gestation of a lecture
    Part 1
    Dos and Dont’s
    Introduction to
    antenatal testing Part 2
    Gender, risk, responsibility and decision-making
    Part 3
    ‘Ultrasound in a visual society:
    a Light and Sound Show'
  • Dos and Don’ts in Pregnancy
    Eat fish, but not more than 2 portions oily fish/week and no shark, swordfish, marlin
    Drink plenty of water
    Avoid mould ripened soft cheese (brie, camembert) and blue-veined cheese (stilton)
    Avoid pate, avoid soft eggs, avoid liver, consider avoiding peanuts
    Avoid unpasteurised milk
    Cook all meat thoroughly and wash all fruit and veg
    Wear gloves if gardening
    Don’t change cat litter
    Take a folic acid supplement
    Make sure you get enough iron
    No more than 4 cups coffee per day, less if drinking cola
    Avoid alcohol
    Avoid smoking
    Avoid drugs
    Avoid people with chicken-pox
    Don’t try to lose weight while pregnant
    Source: BBC Health website
    View slide
  • Antenatal testing
    Screening = calculation of the statistical risk that a condition is present
    Diagnosis = confirmation of a condition (tests are invasive and include a risk of miscarriage).
    A positive screening result leads to the choice of undergoing diagnostic tests
    All tests are voluntary – but how easy is it to decline?
    View slide
  • Common screening tests
    Blood tests for genetic conditions (sickle cell anaemia; thalassemia; cystic fibrosis)
    Blood tests for chromosomal abnormalities (Down’s syndrome)
    Blood tests for multifactorial disorders (Spina bifida; Anencephaly)
    Ultrasound scans (foetal viability)
    Nuchal fold (Down’s syndrome)
  • Diagnostic tests
    Chorionic Villus Sampling (CVS) (Down’s syndrome; sickle cell anaemia; thalassemia; cystic fibrosis)
    Amniocentesis (all the above plus spina bifida; anencephaly)
    Ultrasound scans (Spina bifida; Anencephaly)
  • Assessing/ understanding risk
    Understanding the meaning of risk information can be difficult:
    • Relies on the knowledge and communication skills of the health professional
    • ‘False positives’ cause unnecessary anxiety
    • Benefits of screening vs. the anxiety it may cause
    How might screening/diagnostic tests make pregnancy a more or less worrying time for parents?
  • Assessing/ understanding risk
    Interviewer: Did you feel that you had an adequate understanding of the risk information you were being given? [1:60 but risk reducing as pregnancy progressed]
    Woman: It was meaningless. It was meaningless, because you never, you don't think about, risk is meaningless. What actually would've been useful would be to, say, compare it to, “Well, what's the risk about, of me having an accident if I get in a car? What's the risk of me, you know, being knocked over as I walk down the street?” And in that context it would've meant more…
    [The couple decided not to have amniocentesis and the baby did not have Down’s].
    Source: http://www.healthtalkonline.org/Pregnancy_children/Antenatal_Screening
  • Assessing/ understanding risk
    One woman was delighted her risk was 1 in 1700 after the nuchal scan, having been 1 in 300 or 400 on the basis of her age alone, but she later had a baby with Down's syndrome. In retrospect discovering she was 'the one' made the figures seem meaningless.
    Source: http://www.healthtalkonline.org/Pregnancy_children/Antenatal_Screening
  • Assessing/ understanding risk
    ‘We got really lucky, I mean the doctor who did the scan, when she came out with our odds, she said that it was the lowest chance that she had seen in years. So we felt really reassured by that, as opposed to what the number would be to actually go and have the next step, something like amniocentesis.’
    Source: http://www.healthtalkonline.org/Pregnancy_children/Antenatal_Screening
  • Decision-making: Further Tests
    Following a screen positive, parents have to decide whether to have further diagnostic tests
    Is ‘choice’ always really a choice?
    Whose choice is it?
    Markens, S., C. H. Browner et al. (1999) ‘“Because of the risks”: how US
    pregnant women account for refusing prenatal screening’, Social Science
    and Medicine, Vol. 49, No. 3, pp. 359-369
  • Decision-making After Diagnosis
    Following a diagnosis, parents are then faced with a number of choices:
    • Foetal surgery or similar treatment
    • Continuing with the pregnancy without intervention
    • Termination of the pregnancy
    Is ‘choice’ always really a choice?
    Whose choice is it?
    Is non-directiveness by medical professionals fair?
  • Nilsson: The autonomous, extra-terrestrial embryo/foetus
    7
    weeks
    20
    weeks
    Source:
    http://www.lennartnilsson.com/child_is_born.html
  • Visual Medical Knowledge
    What we see must be true (an assumption)
    Medical gaze looked into corpses but is now trained
    on live bodies
    Ultrasound relies on soundwaves to build up a picture
    12 week ultrasound scan is routine, 20 week common
    Women’s haptic hexus (embodied knowledge of pregnancy)
    is displaced by the optic hexus (visual knowledge of
    pregnancy)
  • Ultrasound: The sound and light ‘show’
    Bonding with a ‘greyish’ blur
    Social birth precedes biological
    birth
    20 weeks
    12 weeks
  • 12 weeks - Twins
    20 weeks
  • Fathers and Ultrasound Scans
    Seeing the baby as ‘real’
    Feeling like a father
    Respect for and trust of:
    Technology
    The authority of healthcare (professionals)
  • 3D/4D screening technologies
    Less need for interpretation
  • Marketinghttp://www.ultrasoundnow.co.uk
    ‘3D/4D scanning is an amazing three dimensional picture of your baby on the screen. Your baby can be seen moving, yawning, sucking its thumb and even smiling.  A truly magical experience!’
    ……..
    ‘You will receive a CD of your scan which you can then use to reproduce the pictures… and e-mail them to friends. You will also receive a DVD… to be played time and time again.’
    ……..
    PLEASE NOTE:
    ‘We consider all our scans to be diagnostic and never scan just for entertainment. The health of you and your baby is our primary concern so our sonographers will be checking that your baby is developing normally’…
    ……..
    Package 1 - £190.00
    45 minute appointment with DVD, CD, 6 printed pictures and pregnancy progress report
    Package 2 - £150.00
    45 minute appointment with CD, 6 printed pictures and pregnancy progress report
  • Is the Scan a Social or a Medical Event?
    Medical professionals: gathering information about the ‘foetal patient’
    Couples: seeking visual confirmation to share with their social network
    ‘Bad news’ will transform the scan’s meaning for the couple