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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
    • 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?
    • 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