This chapter contains sections titled: A Riff on Infant Feeding Ethical Questions about Infant Feeding Closing Thoughts on Classification and Responsibility Notes.

In lieu of an abstract, here is a brief excerpt of the content:"To make a difference...":Narrative Desire in Global MedicineByron J. Good and Mary-Jo DelVecchio GoodIf, as Arthur Frank (2002) writes, "moral life, for better and worse, takes place in storytelling," this collection of narratives written by physicians working in field settings in global medicine gives us a glimpse of some aspects of moral experience, practice, and dilemmas in settings of poverty and low health care resources. These essays are written (...) from the midst of practice, in diverse settings in Africa, South Asia, Latin America, the Caribbean, and the United States. The majority of the writers are practitioners of contemporary 'global medicine'—physicians from North America or Europe who spend part of their lives flying into settings of poverty or special need to practice medicine and work with on-going collaborative clinical and public health systems—while a smaller number are working in the societies in which they were born. Although a few work for classic humanitarian organizations or have developed their own local NGO's, the great majority are engaged in the 'hybrid life' described by Robert Riviello and noted by Renée Fox, moving between academic medical centers and distant health care systems that are supported by local governments, major international organizations and funding agencies, and international NGO's like Partners in Health. These diverse forms of practice have become a common model for contemporary clinicians engaged in what has emerged as a new discipline of global health or global medicine, and these narratives give us a glimpse of some of the enduring, as well as newly emerging, forms of moral practice and ethical dilemmas characteristic of today's global medicine.Many of these stories are filled with the tension and pathos that makes clinical narratives powerful to read. Physicians are forced to make unfathomable decisions about whether to resuscitate and keep a baby alive, using all means available, or to let the infant die, whether to carry out a procedure that will save an infant in birth but would put the mother at risk, about how to deal with a cancer found in a very advanced state. However, virtually all of the stories transcend these classical stories of the decisions physicians are forced to make by being placed in settings of great scarcity of resources, which stand in particular contrast to the academic medical settings in North America or Europe where many of these global medicine specialists have trained and many continue to practice. The unspeakable inequality of resources emerges throughout these narratives as a kind of master theme, as the underlying moral, as opposed to plot, which gives meaning and sense to the stories. For those who practice medicine in such settings, global inequalities and scarcity of medical resources are deeply felt. They produce the rage that Jeffrey Deal describes. ("I learned to despise American churches during that time, a time when my world encompassed a dying newborn in Sudan, as well as the air conditioned padded seats [End Page 121] of our affluent suburban church.") They produce the distinctive experiences of helplessness and pain felt by clinicians who cannot separate how they would be able to treat such a patient at home from how they have to practice in these settings. For those clinicians working in their own societies, scarcity of resources often produces deep anger at the corrupt governments that fail to support basic human services for the great majority of their population. ("We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince," writes Haitian physician Paul Pierre about his experience prior to joining Partners in Health.)But for those who regularly travel back and forth across the divide between rich and poor, whether across national boundaries or within their own society, the challenge to live a moral life is unendingly complicated. While becoming a part of a struggle for global justice with colleagues and advocates from both sides of the divide, few of the narrators can avoid personal feelings of ambivalence and guilt at being able to easily move from one side of that divide to the other back home. Many fantasize about giving up their lives in the north to devote themselves... (shrink)

Public trust of conventionally produced food is now a pivotal issue for the Canadian food supply chain as consumers are increasingly demanding traceability, transparency and sustainability of the agri-food system. To ensure that Canadians understand what farmers do, how they do it, and why—there has been significant human and financial investment by both the agri-food industry and government over the last decade. Farmers, civil servants, and non-farming agricultural professionals alike are being encouraged to join the national conversation promoting the legitimacy (...) of conventional agriculture. As part of this large-scale effort, women in agriculture are advocating, in gendered ways, for the safety and legitimacy of the agri-food system and its conventional farming practices. This is being done by utilizing their motherhood capital. This motherhood capital legitimizes the authority granted to mothers as expert decisionmakers regarding their children’s food consumption. Through the usage of their motherhood capital, women are being positioned—and are positioning themselves—as an important voice in re-narrating the story of conventional agriculture through the circulation of their maternal foodwork experiences. Using their authority as mothers they are advocating for the safety, necessity, and trustworthiness of conventional agriculture to counter narratives of mistrust and risk. (shrink)

At the beginning of the twentieth century the high mortality rates of both mothers and babies during childbirth became a predominant concern in Britain and its empire, provoking outcries from medical and nursing professionals as well as politicians and the wider public. Infant mortality became the new marker of the vitality of the nation and a widely used indicator of general standards of health. Efforts to improve maternal and infant welfare were part of a broader shift in Britain towards (...) public health as a government responsibility. Measures taken to reduce mortality rates emphasized state-run initiatives in maternal education and antenatal care, the medicalization of childbirth, and scientific infant feeding and childrearing practices. This shift in health care policies resulted in profound changes to the experience of childbirth and to the role of the state in the area of social welfare... (shrink)

IntroductionMother–child interactions during the first years of life have a significant impact on the emotional and cognitive development of the child. In this work, we study how a prenatal diagnosis of malformation may affect maternal representations and the quality of these early interactions. To this end, we conducted a longitudinal observational study of mother–child interactions from the gestational stage until the baby completed 12 months of age.Participants and MethodsWe recruited 250 pregnant women from a local university hospital. Among them, 50 (...) mother–infant dyads participated in all stages of the study. The study group consisted of 25 pregnant women with fetuses with some structural alteration and the control group consisted of 25 pregnant women with fetuses without structural anomalies. We collected obstetric and socio demographic data and pregnancy outcomes. Anxiety and depressive state data were collected using the COVI and Raskin Scales. We video-recorded the mother–infant interactions during several stages, including when the child was a newborn and when the child was 2, 4, 6, 9, and 12 months of age. The quality of the mother infant interactions were measured using the Coding Interactive Behavior. The interactive moments recorded on video was composed of three different activities, each one lasting appoximately 3 min, which included Free Interaction, where the mother was instructed to interact “as usual” without any toy, Toy Interaction, where the mother and baby played with a puppv, and Song Interaction, where the mother and baby interacted while the mother sang the “Happy Birthday” song.ResultsIn the gestational phase, there was a significant difference between the groups with respect to anxiety and depression scores, which were significantly higher for the study group. In the postnatal phase, we found significant differences between the groups with respect to CIB scales after the child completed 6 months of age: the study group presented significantly higher values of Maternal Sensitivity at 6 months of age, of Baby Involvement at 9 and 12 months of age, and of Dyadic Reciprocity at 6, 9, and 12 months of age, while the control group presented significantly higher values of Withdrawal of the Baby at 6 months of age, and of Dyadic Negative States at 6 and 9 months of age.ConclusionThe support offered by the study favored the mother–infant bond and had a positive effect on the quality of interaction during the first year of life, despite the presence of prenatal diagnosis. (shrink)

It has recently been suggested that doctors have a duty to act in their patient's best interest and that this duty demands that life-sustaining treatment—including food and fluids—should sometimes be withheld or withdrawn and the patient allowed to die. In this article, the author explores the scope of the ‘best interests principle’ in the context of treatment decisions for seriously handicapped newborn infants. She argues that those who hold that it is permissible to starve or dehydrate an infant to (...) death are mistaken to think that this course of action is in the infant's best interests. While it may be true that there are times whendeath is, everything considered, in an infant's best interests, a slow and distressingmethod of bringing death about is not. Since death by dehydration and starvation is not benign, the withholding of food and fluids is generally not in an infant's best interests. The author concludes by suggesting thatwhenever the withdrawal or non-employment of life-sustaining means imposes a heavy burden on the infant, the ‘best interests principle’ would demand that the infant be killed rather than allowed to die. (shrink)

An error that medicine has long shared is to attribute to a desire or an effect of the mother’s imagination during gestation, the deformities, growths or spots that a child bears at birth. The imagination would be capable of imprinting external modifications on a matter and would have an impact on the perceptions and sensory development of the fetus. Returning briefly to the genealogy and posterity of the topos, this article focuses on the successes and refutations of the Malebranchist paradigm (...) in the 18th century, through a corpus of medical popularization texts where the debates oppose the supporters of the imagination for whom emotion alters the organs of the fetus and the detractors of this thesis who only see it as prejudice. Mechanistic systems had in common that they avoided the soul to explain life. Although each era has its hermeneutic system of representations, and that medicine—closely dependent on the philosophical and moral conceptions of its time—is also a cultural production, it is nevertheless not uninteresting to question on the fortune of a motive and the scientific topicality of the question. What does the baby perceive in utero? Does he feel his mother’s pain? If so, what is the biological impact? To what extent can the maternal imagination and experience mark the child’s body? Informed by functional imaging technologies, recent research returns to the symbiotic link of mother-fetus interactions. Convergences appear between this 18th century and our 21st century. In no case did we want to contrast today’s scientists who are firmly in touch with reality and their predecessors who are prey to imagination. Science, whatever the era, always feeds on imagination. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Out of an Old Toy ChestMarina Warner (bio)The Soul of the ToyIn Baudelaire’s essay “La Morale du joujou,” written in l853, he remembers how the toyshop owner Madame Pancoucke, all wrapped in velvet and furs, beckoned the young Charles to choose something from her “treasure store for children.” Looking back down the years, the poet still sees in his mind’s eye the magic room overflowing with toys from floor (...) to ceiling that this “Fée du joujou” (Toy Fairy) opened to him. Without a second thought, he picked out “the most beautiful, the most expensive, the most garish, the freshest and the most bizarre of the playthings.” But his horrified mother insisted he choose another, less extravagant present, and the little Baudelaire had to resign himself and relinquish his toy.The word joujou (not jouet, the usual word for toy) is almost a pet name with a nursery ring like a “teddy” or a “dolly”; its repetition hints at baby talk and hence at playing, as when a child exchanges endearments and questions with a toy in imaginary conversations and elaborate scenarios. The toy in so many children’s games becomes part of an ongoing story and in this way initiates the first invented narratives in the child’s life.That scene of seduction, pleasure, and frustration with Mme. Pancoucke and his own mother catches Baudelaire’s lasting affection and reasoned admiration for toys. He called them “cette statuaire singulière” (this singular statuary); he was first a poet and then an art critic rather than a novelist, and as a flâneur of the boulevards and the galleries, he adopted a language of aesthetics, treating toys as an unusual form of sculpture. He recalls in pleasurable detail the miniature worlds conjured by Victorian nursery games and child’s play—from tiny “diligences” or mail coaches to detailed model furniture. But above all he muses in wonder at children’s ability to play without props or models, creating narratives, dialogue, and dramas [End Page 3] through fantasy alone: “All children talk to their toys; toys become actors in the great drama of life, reduced by the camera obscura of their small brains. Children bear witness through their games to their great faculty of abstraction and their high imaginative power. They play without playthings.”1Significantly, Baudelaire goes on to make the connection to creativity in general: “[The child’s] facility to satisfy the imagination shows the spirituality of childhood in its artistic conceptions. The plaything is the first initiation of a child to art.” Nothing will ever attain again, he says, the same degree of liveliness, or, crucially, the same intensity of presence or belief. For Baudelaire, the realization of childish make-believe cannot be regained: “Isn’t all of life found there in miniature, and much more vivid in colour, cleaner and shinier than real life?”2Yet Baudelaire’s essay lingers on the frustration that dims these vivid, shiny colors, for children, he says, also want to see the soul of a toy. He describes how they will turn about their playthings and shake them, hurl them to the ground, and often break them in their bafflement and even rage at their stubborn refusal to awaken into life. His meditation hints that at the point when make-believe fails, the vitality of toys vanishes and produces a primal encounter with mortality: “But where is the soul? It’s here that bewilderment and sadness begin.”3 The beginning of imagining stories brings with it frustration that the story is not powerful enough—it is not the real thing. In a connected prose poem entitled “Le Joujou du pauvre,” published nine years later, Baudelaire pursues this thought, as he observes an exchange between a beautiful, pampered child inside the exclusive railed park of a chateau. He has “a splendid toy, as fresh as its master, varnished, gilded, clothed in a purple dress and covered with plumes and glitter.”4 But the rich child is not interested in his doll, for on the other side of the railings a ragged street urchin shows him, in a little cage which he shakes about, a living rat—”drawn... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:94 Feminist Studies 47, no. 1. © 2021 by Feminist Studies, Inc. Jennifer C. Nash Black Lactation Aesthetics: Remaking the Natural in Lakisha Cohill’s Photographs In her 1992 essay “Selling Hot Pussy,” bell hooks recounts entering a “late night dessert place” with a group of colleagues who all began to laugh at a shelf of “gigantic chocolate breasts complete with nipples— huge edible tits.”1 For hooks, the chocolate Black (...) breasts are mammy imagery, a “displaced longing for a racist past when the bodies of black women were a commodity, available to anyone white who could pay the price.”2 For her white colleagues, the chocolate breasts are simply comical. Her colleagues’ response—their willingness to consume, laugh, and ignore racial, gendered, sexual violence—constitutes the racialized visual marketplace that hooks’s essay seeks to both describe and dismantle. The chocolate breasts become a rhetorical point of entry into hooks’s critical engagement with a visual marketplace where Black female bodies are delectable and disposable objects. hooks’s analysis has become part of a canon of Black feminist work exploring how Black breasts get taken up as signs of pathology, “excess flesh,” sexual deviance, hypersexuality, and alterity.3 From histories of the so-called Hottentot Venus and the preoccupation with her breasts, buttocks, and genitalia—including 1. bell hooks, “Selling Hot Pussy,” Black Looks: Race and Representation (Boston: South End Press, 1992), 61. 2. hooks, 61–62. 3. See Nicole R. Fleetwood, Troubling Vision: Performance, Visuality, and Blackness (Chicago: University of Chicago Press, 2010). Jennifer C. Nash 95 signature works by Zine Magubane, Janell Hobson, Samantha Pinto, and T. Denean Sharpley-Whiting4 —to scholarship on the construction of black women’s imagined corporeality as “social dead weight” by Sabrina Strings, Black feminists have given critical attention to the construction of Black breasts as the location of Black women’s imagined racial and sexual difference.5 If Black breasts have been culturally and scientifically constructed as deviant, excessive, pornographic, and desirous, they have largely been uncoupled from an identification with nutrition—from the capacity to sustain and feed babies—except their connection with wet nursing and their conscription into maternal labor for white children. In this imaginary, Black breasts provide nutrition only when recruited as white property, with their nurturance capacity oriented toward white health and futurity. We might understand the cultural inability to interpret Black breasts as nurturing Black life as part of what Andrea Freeman describes as the “unmothering” of Black women, the unseeing of Black maternity except to elevate it as a symbol of brokenness or pathology.6 But in recent years, as I argue in my forthcoming book Birthing Black Mothers, Black breasts have entered the US cultural imagination anew. Black breasts are increasingly viewed as in need of support through seemingly benign state interventions to encourage Black breastfeeding. Indeed, Black breasts are recruited by an array of actors who often find themselves strangely aligned to champion Black breastfeeding —including NGOs, public health campaigns, and reproductive justice efforts spearheaded by Black feminists—precisely because Black breastfeeding is thought to perform urgent political, emotional, and 4. See Zine Magubane, “Which Bodies Matter? Feminism, Poststructuralism, Race, and the Curious Theoretical Odyssey of the ‘Hottentot Venus,’” Gender & Society 15, no. 6 (2001): 816–834; Janell Hobson, Venus in the Dark: Blackness and Beauty in Popular Culture (New York: Routledge, 2005); Samantha Pinto, Infamous Bodies: Early Black Women’s Celebrity and the Afterlives of Rights (Durham, NC: Duke University Press, 2020); and T. Denean Sharpley-Whiting, Black Venus: Sexualized Savages, Primal Fears, and Primitive Narratives in French (Durham, NC: Duke University Press, 1999). 5. See Sabrina Strings, Fearing the Black Body: The Racial Origins of Fat Phobia (New York: NYU Press, 2019). 6. Andrea Freeman, “Unmothering Black Women: Formula Feeding as an Incident of Slavery,” Hastings Law Journal 69, no 1545 (2018): 1545–1606. 96 Jennifer C. Nash public health work. Black breastmilk is increasingly described as a crucial technology of Black life, one that supports Black infant life and inoculates it physically, psychically, and even spiritually against the array of anti-Black forces that wound and violate. The work that Black breast milk is thought to perform includes its posited... (shrink)

Infant feeding decisions are highly emotionally charged. I argue elsewhere that many problems surrounding infant feeding decisions result from a moralized context created by mistakes in our assumptions about maternal duties including the mistaken assumption that mothers have a defeasible moral duty to breastfeed. Mothers have a reason, but not a moral duty to breastfeed. Even those who are convinced by my argument in the case of full-term babies, might find it harder to accept in the (...) case of premature babies. It might seem that mothers do have a defeasible moral duty to breastfeed or, as is more likely to be appropriate in such cases, to express breastmilk. Here, I explain why preterm neonates present a tricky case for the right not to breastfeed. I show why, nonetheless, moral pressure for mothers to express breastmilk in the neonatal unit is neither permissible nor pragmatically advisable. I argue that instead we should address structural barriers to providing breastmilk and support donor milk initiatives. (shrink)

What makes a multimillion-dollar, transnational intimate industry possible when most people see it as exploitative? Using the newly emergent case of commercial surrogacy in India, this article extends the literature on stratified reproduction and intimate industries by examining how surrogacy persists and thrives despite its common portrayal as the “rent-a-womb industry” and “baby factory.” Using interview data with eight infertility specialists, 20 intended parents, and 70 Indian surrogate mothers, as well as blogs and media stories, we demonstrate how market (...) actors justify their pursuits through narrating moral frames of compassion and altruism that are not incidental but systematic to and constitutive of transnational surrogacy. We observed two predominant moral frames: surrogacy liberates and empowers Indian women from patriarchal control; and surrogacy furthers reproductive rights. Within these frames, the market exchange of money for babies is cast as compassion, which allows commissioning clients to sidestep accusations of racism, classism, and sexism. Yet, we reveal that the ability to navigate around these threats relies on racist, classist, and sexist tropes about Third World working-class women. Further, we find that surrogate mothers did not experience significant changes in economic status after surrogacy. (shrink)

SummaryCross-sectional studies in Australia and the Philippines and a longitudinal prospective study in a selected Australian sample of breast-feeding mothers have shown that basal serum prolactin concentrations are elevated during 15–21 months of lactational amenorrhoea.A predictive model of serum PRL levels and return of cyclic ovarian activity during full breast-feeding, partial breast-feeding and weaning has been developed from the results of breast-feeding behaviour and serum PRL, gonadotrophin and oestradiol measurements in 34 mothers breast-feeding (...) on demand for a mean of 67 weeks.Breast-feeding patterns influence serum PRL levels. Important factors during full breast-feeding are the age of the baby, the longest interval between feeds at night and total 24-hr suckling time, and following the introduction of supplements, the mean interval between feeds, together with the total 24-hr suckling time and the number of solid supplements per day.The precise mechanisms whereby breast-feeding regulates cyclic ovarian activity remain unknown. Gonadotrophin secretion appears to be quantitatively normal, but qualitative changes, secondary to altered hypothalamic activity, may be the most important factor. A direct inhibitory effect of PRL on ovarian follicular development and steroidogenesis remains possible.Ovulation with a normal luteal phase is probable for 30% of breast-feeding mothers before the first menses, but is unlikely before 6 months, provided breast-feeding is frequent day and night.Measurement of serum PRL is a sensitive index of the return of menstruation and fertility during lactation in the population studied. (shrink)

In this paper I argue that a newborn child and the Mother, defined as any person who takes up the role of other,1 reflect the ontological connectedness of God and humankind. The relationship between the infant and other is experienced by the child as if the two are one, and in this, life is first experienced by the infant as being ‘not alone’. The human interactions that we experience, or do not in early infancy, have such a profound psychological (...) effect on us that we continue to be impacted by them for our whole lives and to this end I assert that the experience of at-one-ness I will write about, fundamentally establishes the experience of the infant in the context of God, self and the other. (shrink)

Breastfeeding advocates have criticised the phrase ‘breast is best’ as mistakenly representing breastfeeding as a departure from the norm rather than the default for infant feeding. Breastfeeding mothers have an interest in representing breastfeeding as the default, for example, to counteract criticism of breastfeeding outside the home. This connects to an increasing trend to frame feeding babies formula as harmful, which can be seen in research papers, public policy and information presented to parents and prospective parents. Whether (...) we frame infant-feeding decisions in terms of harming or benefit, protection or risk matters because these distinctions are generally morally significant and thus holding that those who decide to use formula ‘harm’, ‘risk harm’ to their babies or describing formula feeding as ‘dangerous’ is likely to contribute to guilt associated with formula feeding and thus to undermine the well-being of vulnerable women. It may undermine attempts to improve breastfeeding rates by leading women to reject information about health outcomes surrounding infant-feeding decisions. However, these distinctions do not apply easily to infant-feeding decisions, in part because of difficulties in determining whether we should treat breastfeeding as the normative baseline for infant feeding. I show that neither the descriptive ‘facts of the matter’ nor moral or pragmatic considerations provide an easy answer before discussing how to respond to these considerations. (shrink)

Unlike chimpanzees, human infants engage in persistent adult-directed (AD) crying, and human mothers produce a special form of infant-directed vocalization, known as motherese. These complementary behaviors are hypothesized to have evolved initially in our hominin ancestors in conjunction with the evolution of bipedalism, and to represent prelinguistic substrates that paved the way for the eventual emergence of protolanguage.

Knowledge is a presumed motivator for changed consumption practices in ethical eating discourse: the consumer learns more about where their food comes from and makes different consumption choices. Despite intuitive appeal, scholars are beginning to illuminate the limits of knowledge-focused praxis for ethical eating. In this paper, we draw from qualitative interviews and focus groups with Toronto mothers to explore the role of knowledge in conceptions of ethical foodwork. While the goal of educating children about their food has become (...) central to Canadian and American discourses of “good” mothering, we identify a paradoxical maternal expectation surrounding meat consumption: to raise informed child consumers who know where their food comes from, and to protect children from the harsh realities of animal slaughter. Rather than revealing the story behind the meat on a child’s plate, mothers seek to shield children from knowledge of meat production. Our analysis of the child consumer contributes to ethical eating scholarship and illuminates a larger paradox surrounding knowledge of meat in an industrialized food system. In the practice of feeding children, mothers confront the visceral discomforts of meat consumption; their reactions speak to discordant feelings involved with eating meat in a setting far-removed from the lives and deaths of animals. Ultimately, the paper illustrates the limits of consumer-focused strategies for food-system change that call on individual mothers to educate young consumers and protect childhood innocence, all while getting ethically-sourced meals on the table. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:MATERNAL COMPASSION IN THE THOUGHT OF RENÉ GIRARD, EMIL FACKENHEIM, AND EMMANUEL LÉVINAS Ann W. Astell Purdue University l;ike empathy, compassion is a word that seldom occurs in the /writings of René Girard,' who prefers to answer to Martin Heidegger's "anxiety" [Die Sorge] before death by speaking instead of a "concern for victims" [le souci des victims].2 Maternal corn-passion does enter Girardian analysis directly, however, in his discussion ofthe (...) biblical good harlot, a compassionate mother whom Girard calls "the most perfect figura Christi that can be imagined" (1978, 241). In this paper I focus on the neglected theme of maternal compassion in the writings of Girard, letting them enter into conversation, first, with Emil Fackenheim's reflections on the plight and actions of Jewish mothers during the Holocaust and, second, with themes sounded in the philosophy of Emmanuel Lévinas. I argue that maternal compassion is actually central to Girard's understanding of the unveiling of the victimage mechanism, because it sees goodness in the very life of every potential victim, regardless ofwhat that person has done or is capable ofdoing, simply because he or she exists, has a face. The "innocence" of every victim is reducible to the innocence of the infant, because an infant within a sacrificial system can substitute for every other possible victim. The infant and, even more, the unborn bring us back to the very origins of life, to the Creator. There 1 On empathy and Girard, see my "Saintly Mimesis, Contagion, and Empathy." " See James William's comment on this topic in René Girard, ISee Satan Fall Like Lightning (177, note 4). The locus classicus for Martin Heidegger's "anxiety" is his Being and Time, sections 39-42. 16Ann W. Astell is, as Plato asserts and Lévinas reminds us, a "Good beyond being" that, on a transcendent plane, constitutes the "innocence" ofevery human being that lives, protesting against any one's murder. To illustrate the triangulation of desire, the rivalry of doubles, the mimetic crisis, and its possible outcome in victimage, René Girard turns to the famous biblical story ofthe judgment of Solomon in 3 Kings 3:16-28. In that story two women, two harlots, approach the king, each claiming to be the mother ofa single, living infant, over whom they are fighting. "The symmetry is obvious," Girard writes, "and it represents the very essence of human conflict" (1978, 238). Unable to determine the truth ofthe case on the basis of their conflicting testimonies, the wise king tests them by proposinga sacrificial solution that parodies distributivejustice. He decides to cut the baby in half, giving each woman an equal share, the symmetrical division ofthe victim mirroring the symmetry between the litigants. "The Latin word decidere," Girard notes, "mean etymologicalIy to divide by the sacrificial knife, to cut the throat of a victim" (1978, 238). The proposed sacrifice is averted because its horrific promise of an equal apportionment of parts of the baby's body—a sameness that would confirm the two as doubles—reveals a significant difference between the two women. According to the usual reading of the passage, one of the mothers, having (either deliberately or accidentally) killed her own baby by smothering him, lacks any genuine love for the other woman's infant. As Girard explains, "The only thing that counts for her ispossessing what the other onepossesses. In the last resort, she is ready to accept being deprived ofthe child as long as her opponent is deprived of it in the same way.... All that counts is her fascination with her hated model and rival" (1978, 239). The other woman, however, filled with yearning for the life ofthe child to whom she has given birth, reveals herself to be its true mother by renouncing her maternal rights in a passionate plea: "I beseech thee, my lord, give her the child alive, and do not kill it" (3 Kings 3:26). Commenting on the passage, Girard characterizes the values of the false mother as sacrificial, those ofthe good mother as anti-sacrificial. With reference to the child whose fate hangs in the balance, the distinction is clear enough. The true mother begs for the baby... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021) by Sarah RichardsonQuill KuklaQuill Kukla, review of Sarah Richardson's The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021)I had been eagerly anticipating the release of Sarah Richardson's meticulously researched The Maternal Imprint: The Contested Science of Maternal-Fetal Effects (2021) for several years, and I was not disappointed. A leading feminist scholar of the history and philosophy of (...) science, Richardson traces the scientific history of the idea that pregnant people's bodies control the future health, character, and well-being of their offspring. She also explores how this science is translated into social messaging and shaped by social ideology. Richardson delves into the details of the methodology, motivations, results, and communication of the science of maternal influences. She reveals a history of shaky results, contested methods, and socially loaded messaging, unified by a sustained interest in framing maternal bodies as sites of risk and responsibility for birth outcomes.A central narrative of the book is that the perceived location and mechanism through which pregnant bodies control fetal development keeps shifting around; over time, scientists have located this maternal influence in the uterine environment, the cytoplasm, the methylation of DNA, maternal nutrition, and even in the emotions, thoughts, and imagination of the mother, among other locations.1 Each time a version of the maternal influence hypothesis re-emerges, targeting a different bodily location and mechanism, it comes along with similar social messaging: pregnant people are distinctively responsible for the 'quality' of their children; their bodies are distinctive sites of risk, in need of social management; and their influence can be understood and controlled independent of the context in which they live. Given how many times this scientific hypothesis and its accompanying social messaging has died and been reborn, it is hard not to conclude, with Richardson, that background ideology compels us to keep searching for new stories that take this same form. The idea that pregnant people's bodies are understood as decontextualized and heightened sites of risk and responsibility for birth outcomes, in need of systematic discipline (both self-discipline and social discipline) in order to ensure their production of proper offspring, is one that has been explored [End Page e-1] in quite a bit of depth within feminist theory and reproductive ethics over the last thirty years. To name just a few, Barbara Duden's Disembodying Women: Perspectives on Pregnancy and the Unborn (1993), Deborah Lupton's "Risk and the Ontology of Pregnant Embodiment" (1999), Lisa Mitchell's Baby's First Picture: Ultrasound and the Politics of Fetal Subjects (2001), and my own Mass Hysteria: Medicine, Culture, and Mothers' Bodies (2005) are all works firmly within this tradition. What is new about Richardson's book is not the development and exploration of this cultural narrative and imaginary, but rather her rigorous and skillful analysis of the science that has grown out of and undergirded it. Richardson is a masterful writer, who makes scientific details comprehensible and fascinating. Her historical and epistemological analyses of exactly what shaped the science at each stage, what each scientific iteration did and didn't manage to show, and how these different scientific movements were translated into public messaging, is sharp and compelling. Richardson shows us the inner workings of how scientific programs build momentum; how scientists make methodological decisions; and how results feed into ongoing research programs. From this book, we also develop a rich sense of just how much uncertainty is baked into the science of human development, and how both scientific and public excitement about a given research program are mostly independent of the success and security of the science that comes out of it. The book traces 150 years of the history of the science of maternal influences, culminating in the current focus on epigenetics—which, like various past maternal influence theories, has ignited our broader social imagination. Epigenetics, roughly, is the study of molecular changes outside our DNA that control how genes express themselves. Environmental stimuli (such as stress) can cause changes in methylation, and thereby influence the expression of the genome: "Epigenetic markers that help determine whether a... (shrink)

The Enigma of Desire: Sex, Longing and Belonging in Psychoanalysis, introduces new perspectives on desire and longing, in and outside of the analytic relationship._ _This exciting volume explores the known and unknown, ghosts and demons, sexuality and lust. Galit Atlas discusses the subjects of sex and desire and explores what she terms the Enigmatic and the Pragmatic aspects of sexuality, longing, female desire, sexual inhibition, pregnancy, parenthood and creativity. The author focuses on the levels of communication that take place in (...) the most intimate settings: between mothers and their babies; between lovers; in the unconscious bond of two people— in the consulting room, where two individuals sit alone in one room, looking and listening, breathing and dreaming. Atlas examines the ways in which different languages, translations and integrations focus on birth, death, sexuality, and human bonds. In _The Enigma of Desire_ each chapter opens with a narrative, a therapeutic story which illustrates both the analyst’s and patient’s desires and the ways these interact and emerge in the consulting room. This book will be of interest to anyone who is interested in the intricacies of sex and desire and of great appeal to psychoanalysts, therapists and mental health professionals. (shrink)

While across the animal kingdom offspring are born smaller than their parents, notable exceptions exist. Several dipteran species belonging to the Hippoboscoidea superfamily can produce offspring larger than themselves. In this essay, the blood‐feeding tsetse is focused on. It is suggested that the extreme reproductive strategy of this fly is enabled by feeding solely on highly nutritious blood, and producing larval offspring that are soft and malleable. This immense reproductive expenditure may have evolved to avoid competition with other (...) biting flies. Tsetse also transmit blood‐borne parasites that cause the fatal diseases called African trypanosomiases. It is discussed how tsetse life history and reproductive strategy profoundly influence the type of vector control interventions used to reduce fly populations. In closing, it is argued that the unusual life history of tsetse warrants their preservation in the areas where human and animal health is not threatened. (shrink)

Background There is longstanding consensus on the need to include pregnant women in research. The goal of clinical research is to find highly regulated, carefully controlled, morally responsible ways to generate evidence about how to effectively and safely prevent illness or treat sick people. This manuscripts present a conceptual analysis of the ethicality of clinical trials in 3 scenarios: where the pregnant is involved in clinical trials as a participant during pregnancy for data that addresses pregnancy complications, where the pregnant (...) woman consents to clinical trial participation for an unborn baby that has complications, to generate data on complications at this stage of life, and where the mother may consent for participation of their newborn child in clinical trials. Methods Conceptual analysis. Findings Investigators often choose to exclude pregnant women and newborns from research, even where there is possibility for them to benefit from the study intervention. Objections include vulnerability of pregnant women, altered pharmacokinetics and risk of adverse effects, with a need to balance potential maternal and fetal risks and benefits of research participation. While the objections may be valid, not performing research magnifies what should be a carefully controlled risk during research, pushing this risk into the clinical setting, and subsequently posing a challenge to clinicians who are faced with making treatment decisions for pregnant patients with limited evidence of efficacy and safety. The potential benefits of fair inclusion in clinical trials outweigh the potential risks. Conclusion Research involving pregnant women is necessary to provide women with effective treatment during pregnancy, to promote fetal safety, and to reduce avoidable harm from suboptimal care and to provide pregnant women, their fetuses and newborns. (shrink)

Background There is longstanding consensus on the need to include pregnant women in research. The goal of clinical research is to find highly regulated, carefully controlled, morally responsible ways to generate evidence about how to effectively and safely prevent illness or treat sick people. This manuscripts present a conceptual analysis of the ethicality of clinical trials in 3 scenarios: where the pregnant is involved in clinical trials as a participant during pregnancy for data that addresses pregnancy complications, where the pregnant (...) woman consents to clinical trial participation for an unborn baby that has complications, to generate data on complications at this stage of life, and where the mother may consent for participation of their newborn child in clinical trials. Methods Conceptual analysis. Findings Investigators often choose to exclude pregnant women and newborns from research, even where there is possibility for them to benefit from the study intervention. Objections include vulnerability of pregnant women, altered pharmacokinetics and risk of adverse effects, with a need to balance potential maternal and fetal risks and benefits of research participation. While the objections may be valid, not performing research magnifies what should be a carefully controlled risk during research, pushing this risk into the clinical setting, and subsequently posing a challenge to clinicians who are faced with making treatment decisions for pregnant patients with limited evidence of efficacy and safety. The potential benefits of fair inclusion in clinical trials outweigh the potential risks. Conclusion Research involving pregnant women is necessary to provide women with effective treatment during pregnancy, to promote fetal safety, and to reduce avoidable harm from suboptimal care and to provide pregnant women, their fetuses and newborns. (shrink)

Make happy clients of brand-new parents, and you're on your way to chronicling that baby's entire life with your camera. Sandy Puc' knows the secrets, and shares them in this guide.

In lieu of an abstract, here is a brief excerpt of the content:Handle With CareDonna TuckerMy name is Donna Tucker, and I'm a state tested nursing assistant (STNA)! I have been an STNA for 33 years. I simply love it. It is so rewarding to me to know I make a difference in the lives of my patients. I go in to my job with a smile on my face, an upbeat attitude, open arms, broad shoulders, ears, and a caring (...) heart. I set examples to all around me. I am a mentor, I am a go-to person for my director of nursing (DON). Other STNAs come to me with problems or questions or concerns and together we take care of it. I am an expert committee member for my state's aging panel. I am a committee member for Career Nursing Assistants. I work a lot with Geni Gipson, the founder of this committee. I am a published author and the mother of one daughter and two sons. I have six grandchildren. I just wouldn't like doing anything else. I love my job and family and my teacup poodle, Baby!Let's say I have talked to friends who are not STNAs about my job. I tell them that there is always going to be someone's grandma, grandpa, sister, brother, aunt, uncle, mother, father, etc. who will one day need to be placed in a home. I tell them how good I feel when I can help them. STNAs are not going away, and the door to the home I work at will not close. In some cases it's like taking care of a child. The way you give them a bath, dress them, feed them, take care of incontinence problems. No, I agree, not everyone can do my job. I hear that from my friends a lot. So I tell them, I thank God I can do the job I have.What I do when the resident comes to our facility, I introduce myself to them and to their family. I ask the resident, "Are you spoiled?" Sometimes they say no not at all. I tell them, "Well you are in for a treat. I love to spoil and that's one of the things we do around here." If they say yes, I tell them, "Well we have our work cut our for us, because we have to spoil you even more." I usually get lots of smiles from the family and resident. After they settle for a while, and the family is alone, I ask the [End Page 153] family questions about their loved one. I like to get a story about the resident from family so I can use it in my conversation later with the resident. I assure the family their loved one will be treated exactly the way they themselves would treat them. We are not trying to replace the family. We are filling in as family while they are away from the loved one. Then after the family is gone, I keep checking in on the resident, visit for a spell and chat. I ask them if they need anything. I just want the resident to feel safe, loved, and comfortable.Demanding family members can mean different things. For example, if they come in to help feed their loved one—I had a family member tell me, "I want mother's food now so I can feed her." I tell the family the cart that is coming now is room trays and as soon as we deliver the room trays, because we want our residents to get hot meals, I will call the kitchen and get that tray for your mother ASAP. Some family members just want you to drop all you are doing to assist their loved one. When a family member asks for something we are pretty prompt to get up and take care of it. It assures them that we will not put off anything asked of us. Sometimes it's the family member's way to show their loved one, "Well, I'll take care of this" so their loved one knows they are loved by family. Some family members just feel bad... (shrink)

In 1993, debates over mandatory HIV testing reemerged in New York when politicians and journalists launched a compaign to “unblind” results of a survey of HIV prevalence in newborns. This article reports on the findings from a content analysis of 108 “Baby AIDS” news stories published in New York newspapers in 1993 and 1994. In constructing a discourse of blame for the infection of “innocent” babies, “Baby AIDS” news stories demonstrate that racist, heterosexist, and sexist assumptions about HIV transmission, motherhood, (...) and public HIV surveillance are fundamentally intertwined. The article concludes that arguments by AIDS analysts that homophobia and racism are distinct and independent dimensions of policy and popular understandings of HIV are not only misguided but also dangerous. (shrink)

ArgumentWhile science and economy are undoubtedly interwoven, the nature of their relationship is often reduced to a positive correlation between economic and scientific prosperity. It seems that the modern scholarship focusing on “success stories” tends to neglect counterintuitive examples such as the impact of economic crises on research. We argue that economic difficulties, under certain circumstances, may also lead to the prosperous development of scientific institutions. This paper focuses on a particular organism, the Pine Institute in Bordeaux in France. Not (...) only was it a key actor in the process of defining the discipline of resin chemistry, but also it remained for years at the heart of the local resin producing industry. Interestingly, there is an actual inverse correlation between the Institute's budgets and the prices and production of resinous products. The Pine Institute's existence seemed to have been driven by the crisis of the resin industry. (shrink)

Breaking bad news (BBN) to parents whose newborn has a major disease is an ethical dilemma. In Saudi Arabia, BBN about newborns is performed according to the parental preferences that have been reported from non-Arabic/non-Islamic countries. Saudi mothers' preferences about BBN have not yet been studied. Therefore, we aimed to elicit the preferences of Saudi mothers about BBN concerning newborns. We selected a convenience sample of 402 Saudi mothers, aged 18-50 years, who had no previous experience (...) with BBN. We selected them via a simple number-randomization scheme from the premises of a level III Saudi hospital between October of 2009 and January of 2011. We used a hypothetical situation (BBN about trisomy 21) to elicit their preferences about BBN concerning newborns via a structured verbal questionnaire composed of 12 multiple-choice questions. We expressed their preferences as percentages (95% confidence interval), and we used the Kendall's W test (W) to assess the degree of agreement in preferences. The Saudi mothers preferred that BBN be conducted with both parents together (64% [60-69]), albeit with weak levels of agreement (W = 0.29). They showed moderate agreement in their preferences that BBN should be conducted early (79% [75-83], W = 0.48), in detail (81% [77-85], W = 0.52), in person (88% [85-91], W = 0.58), and in a quiet setting (86% [83-90], W = 0.53). With extremely weak agreement, they preferred to have a known person present for support during BBN (56% [51-61], W = 0.01), to have close bodily contact with their babies (66% [61-70], W = 0.10), and to have no another patients present (64% [59-68], W = 0.08). They showed moderate levels of agreement in their desires to detail, in advance, their preferences about process of BBN by giving a reversible, written informed consent that could be utilized for guidance, if needed (80% [76-84], W = 0.36). In our experience, Saudi mothers' preferences about BBN concerning newborns are varied, suggesting that a "one-size-fits-all" approach is inappropriate. A reversible, written informed consent detailing their preferences about BBN that would be kept in their medical records and utilized for guidance, if needed, may be the best solution, given this level of diversity. These findings merit further study. (shrink)

Andrew was a desperately premature baby weighing under two pounds. He died after months of "heroic' efforts in an intensive care facility. The story of his short cruel institutionalised life is a case study in the limits and excesses of modern medicine. The night he told us our son Andrew was about to die the doctor who had taken charge of him six months before also told us we were "intellectually tight' that we had "no feelings only thoughts and (...) words and strategies'. We were "bad parents'. As the parents of a five-year-old daughter we knew the love a mother and father feels for children. Yet as Andrew's parents we were used to condemnation and insult. Andrew was a baby born 15 weeks prematurely weighing only 1lb 12oz and in a state of painful deterioration almost from the start. We wanted him to be allowed to die a natural death. Andrew's story is the story of what can happen when a baby becomes hopelessly entrapped in an intensive care unit where the machinery is more sophisticated than the code of law and ethics governing its use. The letter printed below was sent to the administrator and numerous personnel of the hospital that controlled the life and death of our son. The physician-in-chief of that hospital characterised it as a "carefully documented critique'. The letter appear here somewhat edited and abridged and the names of people and institutions have been changed all but our own. It is the personal record of what happened to our baby and to us. (shrink)

Using birth stories as our object of inquiry, this article examines the ways in which normative discourses about gender, disability and Down syndrome construct the birth stories of three mothers of children with Down syndrome. Their stories are composed of the mothers’ recollections of the first hours after birth as a time when their infants are separated from them and their postpartum needs are ignored. Together, their stories illustrate socio-cultural tropes that position Down syndrome as a dangerous form (...) of the “other” and mothers who give birth to children with Down syndrome as implicated in transgressing cultural norms. (shrink)

Despite the entrenched acceptance of normal science in health care, it appears that authoritative, positivist, linear, risk averse, certainty-based thinking can only get us so far along the route of optimum health. This paper examines labor and childbirth as a paradigm case of a complex adaptive system (CAS) and offers the example of techniques used in a master-level course on normal childbirth to illustrate how maternity care clinicians can be introduced to complexity-based thinking through reflexive analysis of real life clinical (...) narratives. It suggests that these techniques might be used as a basis for answering the question, what is likely to work for this person, in this situation, given the range of evidence, and given their values and beliefs, my values and beliefs, and my clinical skills and knowledge? Topics discussed in this paper include complexity, pregnancy, and childbirth; mainstreaming complexity-focused decision making in maternity care; and using story in practice. In conclusion, complexity theory appears to offer a good explanatory model for pregnancy and childbirth, both in general, and for specific individuals. Future work in this area should examine the efficacy and limits to formal story telling in maternity care, with the aim of increasing optimal maternity care for mothers and babies, and for the staff and organizations that deliver the care. (PsycINFO Database Record (c) 2010 APA, all rights reserved). (shrink)

This article examines cinematographic observational studies of infants conducted by a loosely connected group of female psychologists and physicians in the USA from the 1930s to the 1960s. Largely forgotten today, these practitioners realized detailed and carefully planned research projects about infant behavior in a variety of settings—from the laboratory to the well-baby clinic. Although their studies were in conversation with better-known works, such as John Bowlby's research on attachment and René Spitz's films on institutionalized infants, they differed in a (...) close examination of individual characteristics of babies and a critical attitude toward contemporary notions of ‘pathological mothering’. In closely following the work of several researchers, including but not limited to pediatrician Margaret Fries (1898–1987), the clinical psychologist Sibylle Escalona (1915–96) and her team members—child psychiatrist Mary Leitch (1914–?) and avant-garde photographer Ellen Auerbach (1906–2004)—and psychologist Anneliese Korner (1918–2010), I argue that their cinematographic works shed a more nuanced light on the landscape of infant research and child psychiatry in the mid 20th century, and open a way for alternative readings of gender, psychoanalysis, and scientific observation at that time. (shrink)

Herbert, Dilinie Christmas is a special time in the Christian calendar. The Christmas story begins with a heavily pregnant Mary riding on the back of a donkey alongside her husband into the city of Bethlehem. Their search for board to see them till the morning is futile. A somewhat kind Inn keeper shows them to his stable, where the animals are accommodated.. That night Mary gives birth to baby Jesus and she lays the newborn down in a manger. (...) The Inn is symbolic of prosperity for those fortunate to share in its comforts. To have to reside instead in the stable reflects that there is not space in the Inn and some people, for not immediately apparent reasons, live on the outside. (shrink)

This article looks at the way the Brazilian writer and educator Nísia Floresta addresses issues of race and class within her construction of nationhood. This is achieved through a consideration of the specific subject of maternal breast-feeding as discussed by Floresta in two texts, written in Brazil and France, respectively. A comparison of these works reveals a very different engagement with race and class factors in determining women's claim to citizenship. Floresta, in common with early 19th-century European feminism, believed (...) this claim to lie within the domestic sphere, primarily in the role of mother and educator. The article considers how, as a vital aspect of that role, she portrays maternal breast-feeding as both natural and patriotic. It also highlights the extent to which Floresta was influenced by the prevailing concerns of her contemporaries regarding the risks of wet nursing and the threat posed by household slaves, before going on to consider how this discourse leads Floresta to exclude black slave women from her vision of patriotic motherhood, while acknowledging the maternity of women of all classes in a European context. Patriotic concerns, shaped by racial prejudices, overshadow Floresta's feminism, prohibiting the kind of unifying discourse of motherhood, which she claimed to profess. (shrink)

It is now medically possible for a baby to have two biological mothers. A fertilized ovum from one woman can be implanted into a second woman for gestation in her uterus. In fact, there have been several such cases. The ova donor is the mother in the genetic sense: her genetic material,along with that of the sperm donor,appears in the developing baby. The uterine hostess is the birth mother: she gestates the fetus and gives birth to it. In essence, (...) the two female reproductive functions, genetic and gestational, can be and have been divided from each other. Our current conception of biological maternity has lagged behind these technological marvels and still assumes that both functions will be performed by the same woman. At a time when two "biological mothers" can and do make claims for the same child,each on the ground that she is the "true mother", it is crucial to examine our concepts of biological maternity and their relation to our social policies about maternity in these cases. In this paper I will argue that the best social and legal policy would involve a prima facie preference for the claims of the gestational mother over the claims of the genetic mother for custody of the child in a contest (if there is no question of parental unfitness on either side). That is, in any dispute, presumption should be in favor of the gestational mother. This argument is made independent of considerations about pre-birth and pre-conception contracts, because the issues raised about the roles of gestational and genetic maternity are substantial in themselves and have obvious implications about the acceptability of such contracts.Rather, I argue that a revision of our concept of biological maternity which emphasizes the importance of gestation and which would prefer the claims of the gestational over the genetic mother would have positive benefits for both women and newborns. (shrink)

Care of the critically ill newborn includes support for the birth mother/parents with regular updates around the clinical condition of the baby, and involvement in discussions around complex decision-making issues. Discussions around continuation or discontinuation of life-sustaining are challenging even in the most straightforward of cases, but what happens when the birth mother is critically unwell? Such cases can lead to uncertainty around who should assume the parental role for these difficult discussions. In this round table discussion, we explore (...) the ethical, moral and legal uncertainties raised by coincident severe maternal and neonatal illness in the context of surrogacy. (shrink)

An experimental breast-feeding education programme conducted at the Philippine General Hospital in Manila demonstrated that women could be motivated to improve their breast-feeding practices and lengthen their period of lactational amenorrhoea in comparison to a control group. Mothers who participated in the programme breast-fed their babies more frequently, delayed the introduction of regular supplements, used fewer bottles and pacifiers and maintained night feeding longer than mothers who were not exposed to the positive breast-feeding messages. (...) The programme was successful in lengthening the period of amenorrhoea among women with elementary, high school, or technical school education, but not among college-educated women. Different educational approaches may be necessary for women of different education levels. (shrink)

The human capacity for intersubjective engagement is present, even when one is limited in speaking, pointing, and coordinating gaze. This paper examines the everyday social interactions of two differently-disposed actors—a non-speaking autistic child and his speaking, neurotypical mother—who participate in shared attention through dialogic turn-taking. In the collaborative pursuit of activities, the participants coordinate across multiple turns, producing multi-turn constructions that accomplish specific goals. The paper asks two questions about these collaborative constructions: 1) What are their linguistic and discursive (...) structures? 2) How do embodied actions contribute to these constructions? Findings show that the parent and child repeatedly co-produced multi-turn constructions that had consistent structures, implying a sophisticated ability to anticipate the completion of action trajectories. Examining the embodied actions of interactants revealed that the child often accommodated to the parent’s demands for participation. Nonetheless, the child occasionally pursued his own goals by improvising with and within multi-turn constructions. He launched constructions to redirect parental attention, and otherwise produced surprising actions within the turn-taking structure of these constructions. The paper concludes that multi-turn constructions in the midst of activities are a primordial site in which to begin observing the competencies of non-speaking autistic children for intersubjective engagement. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Prayer for the BabyKatherine J. GoldWe didn’t talk much about religion in medical school. Rightly so, it seemed to me at the time. I didn’t know how or why it would fit in to my patient care other than respecting patients who used their faith as a coping strategy. I was not at all religious and didn’t like the thought of talking about such things with patients. And (...) in my clinical experiences, it rarely came up.When I got to my last year of school, I signed up to work for a month with an obstetrician–gynecologist in her outpatient clinic. I don’t recall how I met her but remember she was respected for her outpatient teaching so it seemed like it would be a good experience to work with her. (I’ll refer to her by a fictional name here.)“Call me Maria,” she told new patients, enveloping them in a warm, supportive style. They did, and I adjusted to her caring approach, shadowing her as we saw patients during pregnancy, those with abnormal uterine bleeding, patients with pelvic pain, others needing pelvic surgeries. It was an odd experience for me, six months pregnant myself, to be seeing other patients during their own pregnancies.One day, about a week in to my rotation, a couple came in together for an appointment two weeks after an early miscarriage. I watched Dr. Copeland (as a student I just couldn’t call my attending by her first name) give them a hug and we sat down. She asked how they were doing and they shared their story, tears flowing as the mother recounted her emotions over the last week and support from their friends. I had the impression that they attended the same church as Dr. Copeland from their conversation. At the end of the visit everyone stood up.“Shall we pray?” Dr. Copeland asked, and they all took hands. I edged back, away from their small circle, uncertain what to do. I had never seen prayer in medical practice and certainly not initiated by the doctor. Not being religious myself, I felt uncomfortable. I didn’t know the protocol. This was not a setting where I knew what to do. So I leaned [End Page 200] quietly against the wall, trying to be unobtrusive, feeling my baby kicking while I watched. All of them bowed their heads and Dr. Copeland said a brief prayer. I watched the mother as her shoulders relaxed. They said “amen” and squeezed hands and hugged one last time. I thought about that interaction for weeks afterwards. I was uncomfortable, but clearly the patients were not. If there were a role for religion in medicine, I reflected, this might be a place for it. It had been accepted by the family without hesitation, so somehow Dr. Copeland knew it would be alright. It had been used in a healing way.There were several other visits where Dr. Copeland prayed with patients. Sometimes she seemed to know them from her church; at other times, I wasn’t sure. But there never seemed to be a misstep—patients never seemed surprised or awkward with her approach. Did they choose her because of shared beliefs? Did she have a reputation of using faith in her practice and patients selected her for this reason? I wasn’t sure. But it was always the same. They would bow their heads and pray. I would stand back a little uncertainly, but the patients were always grateful and appreciative, thanking Maria by her first name as they left.As I spent more time with her, I looked for other ways that faith might impact Dr. Copeland’s practice and asked questions when I thought there might be relevance. I knew from others that she was opposed to abortion, though I never heard her talk about it openly and I was unsure how this might be manifest in her practice. I watched her prescribe birth control (I knew some religious physicians who did not). I watched her send a patient with a second trimester fetal death to the hospital to be induced for delivery. I wondered if someone... (shrink)

This article explores how the Slovenian women's lifestyle magazine Naša žena (Our Woman) helped the Yugoslavian socialist project construct and shape the ideal socialist woman, and argues that she became the crucial ally in implementing socialist ideas in the everyday lives of Slovenians. The article shows how texts on food preparation and consumption, as well as those touching on household management and family care, published in Naša žena from 1960 to 1991 played an important part in the ‘civilising’ process that (...) shaped behaviour, directed cultural and social practices, influenced social relations and constructed women's identities during socialism. We show how food-related texts (articles, recipes, columns, advertisements and advertorials) were never far removed from the larger political and economic socialist realities. In fact, they bore witness to changes in living standards and told stories about gender regimes, socialist ideologies and fantasies. These texts belong to a corpus of social transcripts that guide collective understandings of what it means to select, prepare, cook and eat food; what constitutes good cooking and eating; and who is responsible for preparing meals. Despite official socialist feminist rhetoric about freeing women from backward patriarchal arrangements, this article shows that texts offering food-related advice in socialist Yugoslavia contained explicit instructions for the ‘correct’ performance of the social roles of women, legitimising women's roles as worker, mother, wife and housekeeper. Above all, a woman was to be an ‘engineer’ of the private domain whose goals were to feed her family and keep the nation healthy and hence productive, and to modernise her kitchen in support of the technological and economic development of Yugoslavia. (shrink)

As a culture, we have a tendency to measure motherhood in terms of a set of signal moments that have become the focus of special social attention and anxiety; we interpret these as emblematic summations of women's mothering abilities. Women's performances during these moments can seem to exhaust the story of mothering, and mothers often internalize these measures and evaluate their own mothering in terms of them. "Good" mothers are those who pass a series of tests—they bond (...) properly during their routine ultrasound screening, they do not let a sip of alcohol cross their lips during pregnancy, they give birth vaginally without pain medication, they do not offer their child an artificial nipple during the first six months, they feed their children maximally nutritious meals with every bite, and so on. This reductive understanding of mothering has had counterproductive effects upon health care practice and policy, encouraging measures that penalize mothers who do not live up to cultural norms during signal moments, while failing to promote extended narratives of healthy mothering. (shrink)

Mothers use online resources frequently to obtain information on pregnancy, birth, and parenting. Yet, second-time mothers may have different concerns than first-time mothers given they have a newborn infant and another child at home. The current study conducted an on-line textual analysis of the posts of second-time mothers during pregnancy and the first months postpartum on the BabyCenter LLC website, one of the largest online parenting communities. Latent Dirichlet Allocation analysis on roughly 16,000 posts to (...) BabyCenter birth clubs in 2017 by approximately 4,000 users revealed second-time mothers relied on the online support of the BabyCenter community to share and discuss topics of pregnancy, birth, and child rearing. Second-time mothers also raised questions about preparing their firstborn children for a new baby sibling, how they would care for two children, whether they would love the second one as much as the first, and how the second child would change family dynamics. Future research needs to recognize that second-time mothers may have distinct concerns surrounding the birth of their second baby, and antenatal education and parenting classes may need to be modified to be more inclusive of these women’s needs and perspectives. Online parenting communities offer avenues to support women as they make the transition from one child to two and may provide targeted opportunities to disseminate evidence-based practices that can assist these women and their children. (shrink)

Ethical dilemmas abound in the neonatal intensive care unit as hour-to-hour life and death decisions are made for premature or compromised newborns. This book is a rich tapestry of parental perceptions woven from the many stories parents tell about their experiences with a baby in the unit, as well as major events after discharge related to the ethical decision making.

In lieu of an abstract, here is a brief excerpt of the content:The Contemplative Classroom, or Learning by Heart in the Age of GoogleBarbara NewmanIn his provocative essay “Slow Knowledge,” David Orr outlines the countervailing assumptions of what he calls “the culture of fast knowledge.” Among these are the widely shared, though rarely examined, beliefs that “only that which can be measured is true knowledge; the more knowledge we have, the better; there are no significant distinctions between information and knowledge; (...) and wisdom is an undefinable, hence unimportant category.”1 If all this were true, it would follow that computers are fast overtaking humans as the next intelligent species. Or, to put it differently, the two species have been colluding for some time to produce smarter machines and dumber people, as we humans abdicate more and more of our mental tasks. Moreover, when it comes time to weigh values—to ask not how quickly or efficiently some task can be done, but whether it ought to be done at all—we are strangely disinclined to challenge digital fatalism, which has become the default logic of late capitalism. Whenever a new digital option appears, we assume that if it can be done and someone somewhere is doing it, then it should be done and we ought to do it too. So even the local hardware store has to be on Facebook so customers can “like” it, and the AAR needs a Twitter account to send weekly tweets. We seldom pause to ask questions about means and ends, unintended consequences, or the sheer mindless clutter of our lives—let alone the implications of this or that new app for our descendants down to the seventh generation, or the enlightenment of all sentient beings. Surface obliterates depth; instant stimulation trumps mature reflection; short-term profit overrules the long-range good.Computers themselves are of course morally neutral. Nonetheless, it is useful to recall why contemplation is the antithesis of the fast knowledge they promote. Contemplative practice is grounded in such values as presence, mindfulness, inwardness, and the integration of mind and body. The last point is worth stressing, for all knowledge, even the most spiritual, is embodied; we are still biological beings, not cyborgs. Though contemplatives of the past have often been fierce ascetics, even the most emaciated hermit could scarcely despise the body to the degree that we find in [End Page 3] some contemporary Internet addicts. Consider the following, reported in July 2012 in Newsweek:When the new DSM [Diagnostic and Statistical Manual of Mental Disorders] is released next year, Internet Addiction Disorder will be included for the first time, albeit in an appendix tagged for “further study.” China, Taiwan, and Korea recently accepted the diagnosis, and began treating problematic Web use as a grave national health crisis. In those countries,... the story is sensational front-page news. One young couple neglected its infant to death while nourishing a virtual baby online. A young man fatally bludgeoned his mother for suggesting he log off (and then used her credit card to rack up more hours). At least 10 ultra-Web users, serviced by one-click noodle delivery, have died of blood clots from sitting too long.2Even short of such extremes, numerous studies have linked excessive Internet use in the United States with increased rates of depression, anxiety, suicidal thoughts, and obsessive-compulsive behavior. Teens admit to being exhausted by the constant need to update their Facebook status and answer countless texts, yet they are afraid to log off for fear that some excitement may pass them by. There is even a new acronym, FOMO, for the fear of missing out. If a central aim of contemplative practice is to dismantle and disengage from the “false self,” there is no better tool for constructing false selves than social media. In her book Alone Together, the social psychologist Sherry Turkle quotes a young man who told her, “What I learned in high school was profiles, profiles, profiles, how to make a me.”3 Another student said he maintained four avatars onscreen at all times, along with his email, video games, and—yes—coursework. His “real life,” he said, was “just one more window,... not usually my best one.”4But social... (shrink)

Most sources providing information on infant feeding strongly recommend breastfeeding. The WHO and UNICEF recommend that women breastfeed their babies and that health professionals promote breastfeeding. This creates severe pressure on women to breastfeed, a pressure which is ethically questionable since many women have physical or emotional problems with breastfeeding. In this article, we use insights from the ethics of risk to criticize the current breastfeeding policy. We argue that there are problems related to balancing aggregate wellbeing versus individual (...) wellbeing, that not enough attention is paid to alternatives, that women’s emotions and their need for free choice should be considered and that issues of equity are currently overlooked. We also criticize the way scientific information is presented in the current policy. We conclude that the official sources of information on infant feeding should be revised. Information should be more nuanced and designed to support mothers, and families in making a free choice on what is the best way to feed their babies. (shrink)

The purpose of this paper is to explore the possible connections between the Virgin Mary, Myra Hindley and Rosemary West. The paper is divided into five sections. In the first, I explore the role of Mary in Christian theology and provide a Christian feminist response to this. In the second, I address some of the theoretical issues involved in studying female serial killers; this includes outlining the role of the media in responding to news stories involving female killers. In the (...) third, I separately address media responses to Myra Hindley and Rosemary West. In the fourth, I explore psychoanalytic perspectives on mothers and mothering. In the conclusion I attempt to bring together and synthesize the significant threads of the paper. (shrink)

Mother-to-child transmission of the Human Immunodeficiency –Virus is a serious public health problem, contributing up to 90% of childhood HIV infections. In Tanzania, the prevention-of-mother-to-child-transmission feature of the HIV programme was rolled out in 2000. The components of PMTCT include counselling and HIV testing directed at antenatal clinic attendees. It is through the process of Provider Initiated Counseling and Testing that counselling is offered participant confidentiality and voluntariness are upheld and valid consent obtained. The objective of the study was to (...) explore antenatal clinic attendees’ experiences of the concept of voluntariness vis- a- vis the implementation of prior counseling and subsequent testing for HIV under the PITC as part of their antenatal care. In-depth interviews were conducted with17 antenatal clinic attendees and 6 nursing officers working at the Muhimbili National Hospital antenatal clinic. The study data were analyzed using qualitative content analysis. Antenatal clinic attendees’ accounts suggested that counselling and testing for HIV during pregnancy was voluntary, and that knowledge of their HIV status led them to access appropriate treatment for both mother and her newborn baby. They reported feeling no pressure from nursing officers, and gave verbal consent to undergo the HIV test. However, some antenatal clinic attendees reported pressure from their partners to test for HIV. Healthcare providers were thus faced with a dilemma of disclosure/ nondisclosure when dealing with discordant couples. Antenatal clinic attendees at MNH undertook the PITC for HIV voluntarily. This was enhanced by their prior knowledge of HIV, the need to prevent mother- to- child transmission of HIV, and the effectiveness of the voluntary policy implemented by nursing officers. (shrink)

Critical congenital heart disease screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. Considerations (...) include the treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand. (shrink)