Birth

This paper reconsiders Tommie Shelby's (2016) analysis of procreation in poor black communities. I identify three conceptual frames within which Shelby situates his analysis—feminization, choice-as-control, and moralization. I argue that these frames should be rejected on conceptual, empirical, and moral grounds. As I show, this framing engenders a flawed understanding of poor black women's procreative lives. I propose an alternative framework for reconceiving the relationship between poverty and procreative justice, one oriented around reproductive flourishing instead of reproductive responsibility. More generally, (...) the paper develops a methodological challenge for nonideal moral and political philosophy, especially concerning the obligations of the oppressed. Specifically, I argue that in the absence of descriptive and conceptual accountability, the "moral gaze" of the philosopher risks preserving, rather than destabilizing, oppressive ideologies. (shrink)

RESENHA: STONE, ALISON. Being Born: Birth and Philosophy. Oxford: Oxford University Press, 20219. ISBN: 978-0-19-884578-2.

Bobier and Omelianchuk argue that the Birth Strategy for addressing analogies between abortion and infanticide is saddled with a dilemma. It must be accepted that non-therapeutic late-term abortions are either, impermissible, or they are not. If accepted, then the Birth Strategy is undermined. If not, then the highly unintuitive claim that non-therapeutic late-term abortions are permissible must be accepted. I argue that the moral principle employed to defend the claim that non-therapeutic late-term abortions are morally impermissible fails to do so. (...) Furthermore, the principle that people have a right to bodily autonomy can be used as an argument for the conclusion that non-therapeutic late-term abortions are permissible and is intuitively stronger than the intuition for the opposite of this conclusion. This is because people having a right to bodily autonomy explains the impermissibility of rape and sexual assault. Consequently, the posited dilemma is defused and does not undermine the Birth Strategy. (shrink)

The past few years has seen a resurgence in the public interest in space flight and travel. Spurred mainly by the likes of technology billionaires like Elon Musk and Jeff Bezos, the topic poses both unique scientific as well as ethical challenges. This paper looks at the concept of generation ships, conceptual behemoth ships whose goal is to bring a group of human settlers to distant exoplanets. These ships are designed to host multiple generations of people who will be born, (...) live, and die on these ships long before it reaches its destination. This paper takes reproductive ethics as its lens to look at how genetic enhancement interventions can and should be used not only to ensure that future generations of offspring on the ships, and eventual exoplanet colonies, live a minimally good life but that their births are contingent on them living genuinely good and fulfilling lives. The paper makes the further claim that if such a thesis holds, it also does so for human enhancement on Earth. (shrink)

The common liberal understanding of reproductive autonomy – characterized by free choice and a principle of non-interference – serves as a useful way to analyse the normative appeal of having certain choices open to people in the reproductive realm, especially for issues like abortion rights. However, this liberal reading of reproductive autonomy only offers us a limited ethical understanding of what is at stake in many kinds of reproductive choices, particularly when it comes to different uses of reproductive technologies and (...) third-party reproduction. This is because the liberal framework does not fully capture who benefits from which reproductive options, the extent of the risks and harms involved in various reproductive interventions, and the reasons for why people are driven to make certain reproductive choices. (shrink)

This paper is a response to a recent paper by Bobier and Omelianchuk in which they argue that the critics of Giubilini and Minerva’s defence of infanticide fail to adequately justify a moral difference at birth. They argue that such arguments would lead to an intuitively less plausible position: that late-term abortions are permissible, thus creating a dilemma for those who seek to argue that birth matters. I argue that the only way to resolve this dilemma, is to bite the (...) naturalist bullet and accept that the intuitively plausible idea that birth constitutes a morally relevant event is simply mistaken and biologically misinformed. (shrink)

Philosopher Fiona Wollard recently advocated interpreting the achievements of women while giving birth. People readily recognize men-related achievements, like running a marathon, but not achievements related to giving birth. We expand on Woollard's notion of reproductive achievements, comparing them with ideas of human enhancement, which aims at humans becoming "stronger and faster". Criticisms to evolutionary psychology challenge its defense of a notion of a fixed human nature, and its disregard for the experience of birth. Some female scholars link human evolution (...) to the presence of premature infants requiring attention from mothers and alloparents. They explain why this gave an advantage to the human species, enhancing cooperation and other desirable traits. Other scholars develop philosophies of birth, mostly based on Arendt's conception of natality, questioning a human nature not sensitive to gender, excluding birth and childhood. Then we move to transhumanism, proponent of human enhancement. Transhumanism questions our biological inheritance for being flawed and outdated, including giving birth, restricting this to a source of great suffering. This assessment of the given does not consider its ambiguous, dialectical character. Because of that, tinkering with nature both accomplishes and frustrates the goals of human enhancement. (shrink)

During the COVID-19 pandemic, several hospitals implemented “birthing alone” policies, banning companions from accompanying individuals giving birth. We offer an ethical analysis of these policies. First, we examine them through a consequentialist framework of risks and benefits. Second, we consider the significance of birth, highlighting the unique ways in which risks, relationships, and rights are understood in the context of obstetrics. We conclude that birthing alone policies are largely unjustified, as the harm they are certain to cause outweighs their possible (...) benefits and because they fail to take into account what matters to mothers. (shrink)

Islam gives legal precedence to purity of lineage and known parenthood of all children. In Islam treatment to infertility using IVF is permitted within validity of marriage contract with no genes mixing. The paper shows that the Qur’ān, the word of Allah, and science, the deeds of Allah are not in major conflicts in defining the start of human life. The Holy Qur’ān provides an elegant description of origin, developmental stages of intra-uterine life. The Hadith explains two positions one that (...) believes human embryo get ensouled at conception and the other after 40 days of conception. The paper aims to find that Islam confers moral respect to human embryo, but it also clarifies the absence of full human rights to a developing foetus. In Islam, human embryonic use is probably permissible for therapeutic and reproductive purpose keeping intact the principles of Shari’ah. (shrink)

In this paper, the concept of birth affirmation is clarified in both the psychological dimension and the philosophical dimension. In the psychological dimension, we propose two interpretations: 1) Possible world interpretation: Even if I could imagine a possible world in which my ideal was realized or my grave sufferings were resolved, I would never think, at the bottom of my heart, that it would have been better to have been born to that possible world. 2) Anti-antinatalistic interpretation: I would never (...) think, at the bottom of my heart, that it would have been better not to have been born. In the philosophical dimension, we propose the following interpretation: The comparison of betterness or worseness between the actual world and a possible world and between my having been born and my not having been born should be impossible. In the final part of this paper, the differences from other related concepts and frequently asked questions are discussed. (shrink)

Obstetric violence – psychological and physical violence by medical staff towards women giving birth – has been described as structural violence, specifically as gender violence. Many women are affected by obstetric violence, with awful consequences. The phenomenon has so far been mainly investigated by the health and social sciences, yet fundamental theoretical and conceptual questions have gone unnoticed. Until now, the phenomenon of obstetric violence has been understood as one impeding autonomy and individual agency and control over the body. In (...) this article I will argue that the phenomenon of obstetric violence occurs in a specific state of embodied vulnerability and that might be destructive for subjectivity since it fails to recognize that state and instead disallows support and demolishes relationships and interdependence. This might introduce a conceptual shift and the phenomenon might be reconceptualized as a moment where vulnerability is misrecognized and ambiguity, relations and support are banned. In this case violence is recognized as cutting the original links to our bodies and the world that constitute our phenomenological condition, instead of as hurting the autonomous subject. Obstetric violence, thus, calls to be reflected upon through de Beauvoir’s ideas on ambiguity, the embodied and situated subject and the subject as essentially construed in relations. I believe that de Beauvoir’s conception of the authentic embodied subject as necessarily ambiguous – immanent and transcendent at the same time and ineludibly linked to the world and its others – will be extremely useful for construing this new understanding of how obstetric violence happens and of what precisely constitutes its damage. (shrink)

Childbirth in the United States is in crisis. This is especially true for Black and brown mothers. This childbirth emergency constitutes a failure of the social contract: because society has failed to provide minimally decent care for all birthing mothers, but especially for Black and brown mothers, it is necessary to allow mothers to choose home birth. I amplify the voices of Black and brown scholars and midwives to defend home birth, and I argue that home birth is safe and (...) empowering and that it is rational for those who desire it to choose it. (shrink)

It has been shown that various types of stress initiate different physiological and neuroendocrine disorders. Oxytocin is mainly produced in the supraoptic nucleus and paraventricular nucleus of the hypothalamus. Hypothalamic OT has antistress effects and attenuates the hypothalamic–pituitary–adrenal axis. One mechanism behind the antistress effects of OT is mediated through the inhibition from GABAA receptors on corticotropin-releasing factor expression at the PVN. Various manual therapies such as acupuncture, transcutaneous electrical nerve stimulation, and massage initiate the stimulation of somatosensory neurons of (...) the body. It is well-known that TENS simulates OT expression, while it inhibits CRF expression at the PVN following chronic stress loading in rodents. Upregulation of OT expression at the hypothalamus is activated by the somatosensory stimulation, which is mediated via the spinothalamic pathway. Thus, somatosensory stimulation is beneficial in treating stress-associated symptoms. Hypothalamic OT is associated with the social behaviors, including maternal care and affiliation. Childhood neglect and/or child abuse are severely responsible for deleterious long-term effects on the cognitive/social activity and behavioral development. At parturition, a profound amount of OT is released into the systemic circulation in response to vaginal and cervical stimulation caused by the body of fetus, which induces the onset of maternal behavior. Peridural anesthesia effectively impairs the sensitivity to vaginal and cervical stimulation at parturition. OT levels in cerebrospinal fluid is significantly reduced following peridural anesthesia. The vaginal delivery mothers had significantly more OT pulses than the caesarian section mothers. Due to low levels of endogenous OT, maternal behavior could be interrupted by epidural anesthesia and CS at parturition because of the reduction of the usual sensory input from the genitalia. (shrink)

Research suggests that some fathers and birth partners can experience post-traumatic stress disorder after witnessing a traumatic birth. Birth-related PTSD may impact on many aspects of fathers’ and birth partners’ life, including relationship breakdown, self-blame and reducing plans for future children. Despite the potential impact on birth partners’ lives there is currently no measure of birth-related PTSD validated for use with birth partners. The current study therefore adapted the City Birth Trauma Scale for use with birth partners. The City Birth (...) Trauma Scale is a 29-item questionnaire developed to measure birth-related PTSD according to DSM-5 criteria: stressor criteria, symptoms of re-experiencing, avoidance, negative cognitions and mood, and hyperarousal, as well as duration of symptoms, significant distress or impairment, and exclusion criteria or other causes. A sample of 301 fathers/birth partners was recruited online and completed measures of birth-related PTSD, bonding, and demographic details. Results showed the City Birth Trauma Scale had good reliability and psychometric and construct validity. The fathers/birth partners version has the same two-factor structure as the original scale: general symptoms and birth-related symptoms, which accounted for 51% of the variance. PTSD symptoms were associated with preterm birth and maternal and infant complications. Overall, the City Birth Trauma Scale provides a promising measure of PTSD following childbirth that can be used in research and clinical practice. (shrink)

Advances in reproductive medicine have opened up new scenarios, changing our experience and our understanding of what it means to be a parent. Literature and cinema have quickly turned their attention to new forms of reproduction, and often do what doctors in centres for assisted reproduction advise against: they reveal secrets, re-unite the various different protagonists, who make the new life possible, and explore the dramatic and sometimes tragic entanglement of birth stories. Significantly, literary and filmic stories also give voice (...) to those whose voice is seldom heard: the children. In my contribution, after providing a brief summary of the history of assisted reproductive technologies, I discuss some contemporary novels and films, in English and Italian, that deal with these new scenarios. Examples include The Kids Are All Right (2010) by American director Lisa Cholodenko, Google Baby (2009) by Israeli director Zippi Brand Frank, Venuto al mondo [Brought into the world] (2012) by Italian director Sergio Castellitto, Carissimi [Dearest] by Italian writer Letizia Muratori, Non mi vendere, mamma! [Do not sell me, mom!] (2016) by Italian writer Barbara Alberti, and Katherine Carlyle (2015) by British novelist Rupert Thomson. I argue that each birth has a story and that we cannot struggle free from the stories that make us any more than we can ignore the fact that we were brought into the world. (shrink)

The number of cesarean sections performed globally has been consistently rising since the 1980s.1 The number of cesareans performed now greatly exceeds the number that experts predict are necessary.2 In Brazil, the world's "cesarean capital," over half of births are surgical. In the United States, approximately one third of babies are delivered by cesarean, and in the United Kingdom around 26 percent of births are by cesarean.3 Cesarean section can be a life-saving intervention when vaginal birth poses a risk to (...) woman or fetus.4 However, some doctors believe that cesareans performed in the absence of an emergency carry substantial risks for limited or no benefit (Wagner 2000... (shrink)

Ectogenesis, or the use of an artificial womb to allow a foetus to develop, will likely become a reality within a few decades, and could significantly affect the abortion debate. We first examine the implications for Judith Jarvis Thomson’s violinist analogy, which argues for a woman’s right to withdraw life support from the foetus and so terminate her pregnancy, even if the foetus is granted full moral status. We show that on Thomson’s reasoning, there is no right to the death (...) of the foetus, and abortion is not permissible if ectogenesis is available, provided it is safe and inexpensive. This raises the question of whether there are persuasive reasons for the right to the death of the foetus that could be exercised in the context of ectogenesis. Eric Mathison and Jeremy Davis have examined several arguments for this right, doubting that it exists, while Joona Räsänen has recently criticized their reasoning. We respond to Räsänen’s analysis, concluding that his arguments are unsuccessful, and that there is no right to the death of the foetus in these circumstances. (shrink)

Recently, I argued that human subjects in artificial wombs (AWs) “share the same moral status as newborns” and so, deserve the same treatment and protections as newborns. This thesis rests on two claims: (A) “Subjects of partial ectogenesis—those that develop in utero for at time before being transferred to AWs—are newborns,” and (B) “Subjects of complete ectogenesis—those who develop in AWs entirely—share the same moral status as newborns.” In response, Elizabeth Chloe Romanis argued that the subject in an AW is (...) “a unique human entity…rather than a fetus or a newborn.” She provides four lines of response to my essay. First, she argues that I have “misconstrued” what birth is. Once we correct that error, it becomes clear that subjects of partial ectogenesis have not been born. Second, she argues that my claims imply that non-implanted embryos (existing in vivo) “would also be ‘born.’” But that is absurd. Third, she claims I fail to “meaningfully respond” to distinctions she draws between subjects of ectogenesis and neonates. Finally, she criticizes my essay for focusing on subjects of AWs rather than focusing on pregnant persons (who should be at the “centre” of debates over AWs). I respond to each of these charges. In doing so, I reaffirm that (contra Romanis) some subjects of ectogenesis are newborns and all subjects of ectogenesis—even those that have not been born—share the same moral status as newborns. (shrink)

The reception of Elaine Scarry’s landmark text, The Body in Pain, focuses in part on exploring how pain might be understood as beneficial or therapeutic. Childbirth is often cited as the paradigmatic instance of this kind of beneficial pain. This essay examines conceptualizations of labour pain in biomedical, natural childbirth and reproductive justice movements that explore the limits of Scarry’s description of pain as ‘unshareable’. Political struggles over pain in childbirth centre on the legibility of pain in labour. Feminist and (...) natural childbirth activists have developed an understanding of pain at birth as central to maternal subjectivity, where pain is a biopolitical force and its management a means of self-transformation. Alongside calls for reproductive justice, the essay considers how the visibility and expressivity of labour pain could contribute to what Imogen Tyler and Lisa Baraitser term a new ‘natal politics’ that addresses concerns for the disproportionate injury and death experienced by Black birth givers. (shrink)

English law is unambiguous that legal personality, and with it all legal rights and protections, is assigned at birth. This rule is regarded as a bright line that is easily and consistently applied. The time has come, however, for the rule to be revisited. This article demonstrates that advances in fetal surgery and (anticipated) artificial wombs do not marry with traditional conceptions of birth and being alive in law. These technologies introduce the possibility of ex utero gestation, and/or temporary existence (...) ex utero, and consequently developing human beings that are novel to the law. Importantly, therefore, the concepts of birth and born alive no longer distinguish between human beings deserving of legal protection in the way originally intended. Thus, there is a need for reform, for a new approach to determining the legal significance of birth and what being legally alive actually encompasses. Investigating the law of birth is of crucial importance, because of the implications of affording or denying the subjects of new reproductive technologies rights and protections. A determination of the legal status of the subject of fetal surgery or an artificial womb will determine what can and cannot be done to each entity. Moreover, the status afforded to these entities will drastically impact on the freedoms of pregnant women. (shrink)

Alison Stone investigates how human existence is conditioned by the fact that it begins with birth. How does birth shape the way we are in the world, and the meaning of our lives? Philosophers have written much about death, but neglected birth. Stone brings natality into philosophical view, offering fascinating insights into the human condition.

Obstetric violence—violence in the labor room—has been described in terms not only of violence in general but specifically of gender violence. We offer a philosophical analysis of obstetric violence, focused on the central role of gendered shame for construing and perpetuating such violence. Gendered shame in labor derives both from the reifying gaze that transforms women's laboring bodies into dirty, overly sexual, and “not‐feminine‐enough” dysfunctional bodies and from a structural tendency to relate to laboring women mainly as mothers‐to‐be, from whom (...) “good motherhood” is demanded. We show that women who desire a humane birth are thus easily made to feel ashamed of wanting to be respected and cared for as subjects, rather than caring exclusively for the baby's well‐being as a good altruistic mother supposedly should. We explore how obstetric violence is perpetuated and expanded through shaming mechanisms that paralyze women, rendering them passive and barely able to face and fight against this violence. Gendered shame has a crucial role in returning women to “femininity” and construing them as “fit mothers.” To stand against gendered shame, to resist it, on the other hand, is to clearly challenge obstetric violence and its oppressive power. (shrink)

The development of biotechnologies has broadly interfered with a number of life processes, including human birth. An important moral question arises from the application of such medical technologies to birth: do biotechnological advancements violate human dignity? Many valid arguments have been raised. Yet bioethicists are still far from reaching a consensus on how best to protect the dignity of human birth. Confucianism is an influential ethical theory in China and presents a distinctive understanding of human dignity. In this paper, we (...) reconstruct the two Confucian concepts of dignity—namely, universal dignity and personal dignity. We then apply these concepts to human birth in the context of biotechnologies involving embryos and genetic enhancement. We conclude that the dual Confucian understanding of dignity contributes a valuable perspective to the question of whether biotechnologies related to human birth violate human dignity. (shrink)

Arendt’s “natality,” a promising foundation for humanness that might be expanded to include those with profound cognitive disabilities, emerges in part out of Arendt’s creative interpretation of Augustine. Returning to Augustine provides natality with resources to escape the weaknesses of Arendt’s thought when viewed from the perspective of disability theory: The traps of grounding human dignity in rationality, of downplaying expressions of creativity in non-political spheres, and of denigrating the role of the body.

Medical literature on the protective effects of salpingectomy against ovarian cancer has challenged Catholic health care institutions to reexamine policies that prohibit tubal sterilization at the time of cesarean section. Salpingectomy performed for a woman whose fallopian tubes are known or suspected to have a serious and present pathology—risk-reducing salpingectomy—is morally justifiable as a therapeutic intervention. However, salpingectomy performed at the time of another medically indicated procedure, such as cesarean section, on an otherwise fertile woman whose fallopian tubes are presumed (...) to be healthy—opportunistic salpingectomy—constitutes direct sterilization and fails to meet the conditions of double effect. Moreover, until magisterial guidance clarifies the right application of Catholic teaching to the specific question of opportunistic salpingectomy, Catholic health care institutions should, out of prudential judgment and to avoid scandal, avoid establishing institution policies that permit the practice. (shrink)

This essay offers a critical analysis of Hannah Arendt's notion of natality through the lens of Adriana Cavarero's feminist philosophy of birth. First, I argue that the strength of Arendtian natality is its rootedness in an ontology of uniqueness, and a commitment to human plurality and relationality. Next, I trace with Cavarero three critical concerns regarding Arendtian natality, namely that it is curiously abstract; problematically disembodied and sexually neutral; and dependent on a model of vulnerability that assumes equality rather than (...) asymmetry. This last issue is further developed in the final section of the essay, where I examine the idea that birth, for Cavarero, becomes the very concept by which we can distinguish and normatively differentiate acts of care and love from acts of wounding and violence. Upholding the normative distinction here depends on a conceptual distinction between vulnerability and helplessness. To maintain the ethical potential of the scene of birth, I argue that we have to insist on the very characteristics Cavarero attributes to it—ones, as this essay aims to show, that are ultimately missing in the Arendtian account thereof. (shrink)

The thesis of this paper is that – in order to avoid trivializations – a Philosophy of Birth needs to elaborate a precise concept of transformation and distinguish it carefully from that of adaptation. While transformation goes beyond the limited self-referential perspective of an individual and, on the social level, of the gregarious identity, adaptation aims at strengthening or preserving the old self-referential equilibrium. Transformation is driven by what Zambrano has called, with an exceptionally happy expression, the “hunger to be (...) born completely”. Such a hunger pushes one to continue one’s own birth through the encounter with the Other. Transformation has a creative feature that is made possible by two factors: the surplus of the effect over the cause, and the priority of the real over the possible. These premises lead to a radical questioning of the primacy of the possible on the real, at least as it has been conceived so far in mainstream Western philosophy, with few exceptions, such as Schelling, Bergson and Scheler. In the first part of this text, I shall consider a new Philosophy of Birth in the light of the concept of transformation and in this regard deal with several core themes such as the hunger to be born completely, the new beginning, creative time, the priority of the real over the possible, the limits of finalism, the surplus of effect over cause, and the creative force that expresses itself in the act of ideation. In the second part, I shall analyze the relation between birth and death and focus especially on their intimate and reciprocal connection by referring to the image of the seed that, after falling on the ground, germinates and breaks its own integument. (shrink)

The main claim of this article is that the plasticity of the human formation process does not consist in receiving passively an already-given shape, like hot wax stamped by a seal. Rather, it creates ever new shapes and makes a person overcome her own self-referential horizon. Furthermore, I argue that this formation process is directed by desire, meant as “hunger for being born completely” (Zambrano). The human being comes into the world without being born completely, and it is precisely such (...) hunger that directs human positioning into the world. (shrink)

Background: The birth story has been widely understood as a crucial source of knowledge about childbirth. What has not been reported is the effect that birth stories may have on primigravid women’s understandings of birth. Findings are presented from a qualitative study exploring how two generations of women came to understand birth in the milieu of other’s stories. The prior assumption was that birth stories must surely have a positive or negative influence on listeners, steering them towards either medical or (...) midwifery-led models of care. Methods: A Heideggerian hermeneutic phenomenological approach was used. Twenty UK participants were purposively selected and interviewed. Findings from the initial sample of 10 women who were pregnant in 2012 indicated that virtual media was a primary source of birth stories. This led to recruitment of a second sample of 10 women who gave birth in the 1970s-1980s, to determine whether they were more able to translate information into knowledge via stories told through personal contact and not through virtual technologies. Results: Findings revealed the experience of ‘being-in-the-world’ of birth and of stories in that world. From a Heideggerian perspective, the birth story was constructed through ‘idle talk’. Both oral stories and those told through technology were described as the ‘modern birth story’. The first theme ‘Stories are difficult like that’, examines the birth story as problematic and considers how stories shape meaning. The second ‘It’s a generational thing’, considers how women from two generations came to understand what their experience might be. The third ‘Birth in the twilight of certainty,’ examines women’s experience of Being in a system of birth as constructed, portrayed and sustained in the stories being shared. Conclusions: The women pregnant in 2012 framed their expectations in the language of choice, whilst the women who birthed in the 1970s-1980s framed their experience in the language of safety. For both, however, the world of birth was the same; saturated with, and only legitimised by the birth of a healthy baby. Rather than creating meaningful understanding, the ‘idle talk’ of birth made both cohorts fearful of leaving the relative comfort of the ‘system’, and of claiming an alternative birth. Keywords: United Kingdom, Pregnancy, Parturition, Childbirth, Midwifery, Personal narratives, Qualitative research, Hermeneutics. (shrink)

The subject of life, birth and death constitutes one of the main topics in Democritus’ reflection on human questions. He seeks to understand what men think about the processes of birth and death and how they, accordingly, determine their behavior and attitudes. His reflections comprise a wide range of perspectives and aspects that include examining human behaviour and investigating how it reveals a certain temperament or inclination, inquiring about the nature of these processes and extending the analyses of the processes (...) of birth and death to whole beings through the couple generation-corruption. In the present paper, I intend to examine the main theses and arguments which appear in the testimonies and fragments through which Democritus’ thought was transmitted from antiquity. Furthermore, I will also discuss the hypotheses that for Democritus the most important opposition was not life-death, but rather birth-death and that, at the same time, his idea of nature and life comprises both processes in the perspective of atomistic philosophy. I shall show that corruption has to be considered in two different ways, that is, in the context of physical processes that keep the kosmos in its persistence and in the context of the existence of natural beings, both living and lifeless. (shrink)

Basic understandings of subjectivity are derived from the principles of masculine embodiment such as temporal stability and singularity. But pregnancy challenges such understandings because it represents a sort of splitting of the body. In the pregnant situation, a subject may experience herself as both herself and an other, as well as neither herself nor an other. This is logically untenable—an impossibility. If our discourse depends on singular, fixed referents, then what paradigms of identity are available to the pregnant subject? What (...) could be the pregnant subject's ontology? -/- Eric Bapteste and John Dupré offer the idea that organisms are processual beings. In their view, the ecological interrelationships between the objects of biology are defining, and render them dynamic processes, rather than stable things. Does Bapteste and Dupré’s processual ontological account accommodate pregnant organisms, including pregnant people? -/- Here, I analyze the processual account and determine whether it can accommodate the phenomenon of pregnancy. I find that a processual ontology captures a great deal about pregnant embodiment and is a significant improvement over Cartesian and anti-metaphysical accounts. However, in order to accommodate pregnancy, what we still need from an ontology is the inclusion of subjectivity. (shrink)

Arendt claims that our natality (i.e., our condition of being born) is the “source” or “root” of our capacity to begin (i.e., of our capacity to initiate something new). But she does not fully explain this claim. How does the capacity to begin derive from the condition of birth? That Arendt does not immediately and unambiguously provide an answer to this question can be seen in the fact that her notion of natality has received very different interpretations. In the present (...) paper, I seek to clarify the notion. I bring together and examine Arendt’s scattered remarks about natality and propose a new interpretation that responds to the stated question. Along the way, I show how the various existing interpretations have arisen and argue that, in view of that question, they are inadequate. (shrink)

I became a philosopher because I was fascinated by the ethics of abortion. Not only is abortion a crucial practical issue – a matter of life or death – but it forces us to grapple with some of the hardest and yet most significant philosophical questions: If we agree that all human beings have a right to life, what entities do we count as human beings? What characteristics, if any, are necessary? What happens when one entity’s life clashes with another’s (...) bodily integrity? What are the roles of responsibility, consent and fore-knowledge? (shrink)

Drawing on sociological and anthropological studies, the aim of this article is to reconstruct how obstetric technologies contribute to a moral conception of pregnancy and motherhood, and to evaluate that conception from a normative point of view. Obstetrics and midwifery, so the assumption, are value-laden, value-producing and value-reproducing practices, values that shape the social perception of what it means to be a “good” pregnant woman and to be a “good” mother. Activities in the medical field of reproduction contribute to “kinning”, (...) that is the making of particular social relationships marked by closeness and special moral obligations. Three technologies, which belong to standard procedures in prenatal care in postmodern societies, are presently investigated: informed consent in prenatal care, obstetric sonogram, and birth plan. Their widespread application issupposed to serve the moral goal of effecting patient autonomy. A reconstruction of the actual moral implications of these technologies, however, reveals that this goal is missed in multiple ways. Informed consent situations are marked by involuntariness and blindness to social dimensions of decision-making; obstetric sonograms construct moral subjectivity and agency in a way that attribute inconsistent and unreasonable moral responsibilities to the pregnant woman; and birth plans obscure the need for a healthcare environment that reflects a shared-decision-making model, rather than a rational-choice-framework. (shrink)

In a recent article in the American Journal of Obstetrics and Gynecology, Frank Chervenak et al. argue that home birth is less safe than hospital birth, and that physicians have a dual duty to avoid any collaboration with home birth midwives and to make hospital birth more psychologically and socially supportive to accommodate women who want more choices during labor. The assertion that home birth is significantly less safe than hospital birth has been responded to by Howard Minkoff and Jeffrey (...) Ecker and by a recent large observational study of home birth outcomes in America. Minkoff and Ecker argue that the evidence supports, at most, a minimal increased.. (shrink)

Ziel dieser Studie ist die Konzeption eines Menschenbildes, einer Denk- und Handlungsdimension, die nicht nur den universalen Menschen in den Mittelpunkt ruckt, sondern auch die Pluralitat, Herkunftigkeit, Leiblichkeit, Geschlechtlichkeit und Endlichkeit der Menschen als grundlegend anerkennt. Ein Denken von der Geburt her bestatigt den generativen Zusammenhang der Menschen untereinander und bestimmt deren Selbstverstandnis und ihr Verhaltnis zu sich selbst, zum Anderen, zur Welt und Geschichte. Somit hat die philosophische Ergrundung und Neufassung des Geborenseins Konsequenzen fur Politik und Ethik. Vor dem (...) Hintergrund, dass Sterblichkeit und Tod in der Philosophiegeschichte eine dominante Rolle gespielt haben, untersucht die Autorin die philosophischen Bedeutungen, die metaphorischen Vereinnahmungen, die Missachtungen und die Vergessenheit des Geborenseins von der Antike uber die Aufklarung bis hin zur Gegenwart. In einem zweiten Teil geht es um psychologische, phanomenologische und moralphilosophische Betrachtungen des Geborenseins, die Notwendigkeit einer methodischen Erweiterung von Husserls Transzendentalphanomenologie hin zu einer generativen Phanomenologie und um eine Neuformulierung des Natalitatkonzepts von Hannah Arendt im Sinne einer politischen Ethik. (shrink)

Obstetric violence has been analyzed from various perspectives. Its psychological effects have been evaluated, and there have been several recent sociological and anthropological studies on the subject. But what I offer in this paper is a philosophical analysis of obstetric violence, particularly focused on how this violence is lived and experienced by women and why it is frequently described not only in terms of violence in general but specifically in terms of gender violence: as violence directed at women because they (...) are women. For this purpose, I find feminist phenomenology most useful as a way to explain and account for the feelings that many victims of this violence experience and report, including feelings of embodied oppression, of the diminishment of self, of physical and emotional infantilization. I believe that the insights to be found in feminist phenomenology are crucial for explaining how and why this phenomenon is different in kind from other types of medical violence, objectification, and reification. Iris Marion Young’s description of feminine existence under patriarchy, as conformed by a perpetual oppressive “I cannot,” is at the center of my analysis. I argue that laboring bodies are at least potentially perceived as antithetical to the myth of femininity, undermining the feminine mode of bodily comportment under patriarchy and thereby seriously threatening the hegemonic powers. Violence, then, appears to be necessary in order to domesticate these bodies, to make them “feminine” again. (shrink)

What role does birth play in the debate about elective abortion? Does the wrongness of infanticide imply the wrongness of late-term abortion? In this paper, I argue that the same or similar factors that make birth morally significant with regard to abortion make meaningful viability morally significant due to the relatively arbitrary time of birth. I do this by considering the positions of Mary Anne Warren and José Luis Bermúdez who argue that birth is significant enough that the wrongness of (...) infanticide does not imply the wrongness of late-term abortion. On the basis of the relatively arbitrary timing of birth, I argue that meaningful viability is the point at which elective abortion is prima facie morally wrong. (shrink)

Deborah is a thirty-three-year-old who presented to labor and delivery at thirty-seven weeks gestation with complaints of contractions. Upon arrival, she explained that her fetus, Nathan, had been diagnosed with a “lethal” condition by her primary obstetrician. At twenty-two weeks gestation, an amniocentesis confirmed trisomy 13, a chromosomal abnormality leading to miscarriage or stillbirth in nearly one-half of affected pregnancies. During the admission process, Deborah voices the worry that due to Nathan's brain and heart structure, vaginal delivery could be traumatic (...) and cause him to suffer. Deborah wishes for him to have as painless and as dignified a death as possible; cesarean section, she feels, will achieve this. Yet with her history of three prior vaginal deliveries, normally progressing labor, and poor fetal prognosis that is unlikely to improve with cesarean delivery, there is no maternal or fetal indication for a cesarean section. Should the obstetrician proceed with a cesarean delivery despite knowing that it would expose the mother to surgical risks with little or no corresponding fetal or neonatal benefit? (shrink)

Much of the discourse in the bioethics literature on what is often called “cesarean delivery on maternal request” has focused on balancing respect for patient autonomy with attention to the short- and long-term risks of this procedure to maternal and neonatal well-being. And while there has been some analysis of the social and economic costs inherent in performing cesareans, much of the clinical and ethical analysis has concluded that, given the degree of risk to the mother and neonate from a (...) primary or single repeat cesarean delivery, there is sufficient justification for pregnant women to request and obtain this procedure from obstetricians willing to meet such requests. However, these same analyses often caution that physicians should not offer these elective cesareans to all women, but only to those who initiate the request. This paper analyzes recommendations that do not promote universal access to these procedures and concludes that such a policy is ethically unjustifiable, as it treats women who do not inquire about such procedures differently. Depriving appropriate candidates—for example, healthy women who are good surgical candidates and desire only one or two children—of information about elective cesarean delivery is a form of undue influence on women's decision-making. (shrink)

Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and (...) English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one’s training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a “professional.” Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth. The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and address patients’ concerns about excessive interventions. Creating a sustained culture of comprehensive safety, which cannot be achieved in planned home birth, informed by compassionate and respectful treatment of pregnant women, should be a primary focus of professional obstetric responsibility. (shrink)

Transhumanist thought on overpopulation usually invokes the welfare of present human beings and the control over future generation, thus minimizing the need and meaning of new births. Here we devise a framework for a more thorough screening of the relevant literature, to have a better appreciation of the issue of natality. We follow the lead of Hannah Arendt and Brent Waters in this respect. With three overlapping categories of words, headed by “natality,” “birth,” and “intergenerations,” a large sample of books (...) on transhumanism is scrutinized, showing the lack of sustained reflection on the issue. After this preliminary scrutiny, a possible defense of natality in face of modern and transhumanist thought is marshaled, evoking a number of desirable human traits. One specific issue, the impact of modern values on natality, is further explored, reiterating that concerns about overpopulation and enhanced humans should keep in sight the natural cycle of birth and death. (shrink)