Maternal–fetal surgery (MFS) encompasses a range of innovative procedures aiming to treat fetal illnesses and anomalies during pregnancy. Their development and gradual introduction into healthcare raise important ethical issues concerning respect for pregnant women’s bodily integrity and autonomy. This paper asks what kind of ethical framework should be employed to best regulate the practice of MFS without eroding the hard-won rights of pregnant women. I examine some existing models conceptualising the relationship between a pregnant woman and the fetus to determine (...) what kind of framework is the most adequate for MFS, and conclude that an ecosystem or maternal–fetal dyad model is best suited for upholding women’s autonomy. However, I suggest that an appropriate framework needs to incorporate some notion of fetal patienthood, albeit a very limited one, in order to be consistent with the views of healthcare providers and their pregnant patients. I argue that such an ethical framework is both theoretically sound and fundamentally respectful of women’s autonomy, and is thus best suited to protect women from coercion or undue paternalism when deciding whether to undergo MFS. (shrink)

Throughout most of human history women have been defined by their biological role in reproduction, seen first and foremost as gestators, which has led to the reproductive system being subjected to outside interference. The womb was perceived as dangerous and an object which husbands, doctors and the state had a legitimate interest in controlling. In this article, we consider how notions of conflict surrounding the womb have endured over time. We demonstrate how concerns seemingly generated by the invisibility of reproduction (...) and the inaccessibility of the womb have translated into similar arguments for controlling women, as technology increases the accessibility of the female body and the womb. Developments in reproductive medicine, from in vitro fertilisation to surrogacy, have enabled women and men who would otherwise have been childless to become parents. Uterus transplants and ‘artificial wombs’ could provide additional alternatives to natural gestation. An era of ‘womb technology’ dawns. Some argue that such technology providing an alternative to ‘natural’ gestation could be a source of liberation for female persons because reproduction will no longer be something necessarily confined to the female body. ‘Womb technology’, however, also has the potential to exacerbate the labelling of the female body as a source of danger and an ‘imperfect’ site of gestation, thus replaying rudimentary and regressive arguments about controlling female behaviour. We argue that pernicious narratives about control, conflict and the womb must be addressed in the face of these technological developments. (shrink)

In biomedicine, practitioners often treat risk of disease as an illness in itself—suitable for monitoring and intervention. In some cases, increased diagnostics improve health outcomes by detecting problems early. Recently, however, science and technology studies scholars and medical practitioners have noted that the treatment of risk can also lead to unnecessary intervention and possible harm. Despite these findings, it is often hard to see changes in practice. Childbirth serves as an illuminating case because two models of health risk operate simultaneously—in (...) addition to the model valuing frequent intervention, there is another that seeks to mitigate risk by refusing medical surveillance. Based on interviews with birth providers and an analysis of professional documents, this article uses the case of fetal heart rate monitoring in American childbirth to demonstrate how some health providers are framing “intentional non-knowing” as a moral imperative to reduce medical risk. Studying the success and limitations of this “risk counterculture” illuminates how risk societies are changing in response to data suggesting that more information can have hurtful effects. This case integrates well-developed theories of knowledge production with less-developed theories of knowledge nonproduction, leading to a more fruitful discussion of the boundaries of responsible knowledge in risk management. (shrink)

Environmental chemicals accumulate in all human bodies and have the potential to affect the health of men and women, adults, and children. This article advances “precautionary consumption”—the effort to mediate personal exposure to environmental chemicals through vigilant consumption—as a new empirical site for understanding the intersections between maternal embodiment and contemporary motherhood as a consumer project. Using in-depth interviews, I explore how a group of 25 mothers employ precautionary consumption to mediate their children’s exposure to chemicals found in food, consumer (...) products, and the home. Most of the mothers in the study situate their children’s chemical “burdens” within their own bodies and undertake the labor of precautionary consumption as part of a larger and commodity-based motherhood project. In actively expanding the sphere of responsible motherhood to include managing children’s body burdens, these mothers navigate multiple and overlapping contexts that hold women accountable for children’s futures and value the agency of the proactive consumer. Yet, as the sphere of responsible mothering expands, women without financial resources, time, and family stability are pushed to the margins of normative motherhood. (shrink)

This paper argues that cyborg perspectives offer real possibilities for the debate around enforced caesareans and the search for a language to encompass embodied maternal subjectivity. It is suggested, with reference to the fictional narrative of Star Trek, that cyborg figures have the power to disrupt the liberal subject and the body in legal discourse, not least because the plethora of cyborgs challenges simple conceptions of connections/disconnections between bodies. Feminist readings of case law relating to enforced caesarean sections have raised (...) questions about the notion of autonomy at the heart of liberal legalism, have argued that law is complicit with white male techno-medicine's approach to childbirth and focused upon the pregnant woman's lived experience of pregnancy. The recent Court of Appeal decision in St George's Healthcare N.H.S Trust v. S., Regina v. Collins and Others, ex parte S., where the pregnant woman's self-determination was upheld, provides a good opportunity to confront both the liberal story and the idea of connectedness between mother and unborn child. (shrink)