According to the Academy of Nutrition and Dietetics’ influential position statement on vegetarianism, meat and seafood can be replaced with milk, soy/legumes, and eggs without any negative effects in children. The United States Department of Agriculture endorses a similar view. The present paper argues that the Academy of Nutrition and Dietetics ignores or gives short shrift to direct and indirect evidence that vegetarianism may be associated with serious risks for brain and body development in fetuses and children. Regular supplementation with (...) iron, zinc, and B12 will not mitigate all of these risks. Consequently, we cannot say decisively that vegetarianism or veganism is safe for children. (shrink)

The diet of expectant mothers was a significant issue of social, political and scientific concern between 1930 and 1960. However, while histories of maternity services and nutritional science are independently available, no existing study addresses the nutrition of expectant mothers in this period. Between 1900 and 1930, maternal mortality rates were rising despite improving clinical antenatal provisions. Breakthroughs in nutritional science resulted in the identification of key dietary components, while changing social attitudes meant hunger was increasingly being seen as a (...) humanitarian issue requiring a modern solution. As a result, the diet of expectant mothers first began to be addressed as a social concern in the 1930s. It subsequently made a transition into official policy as part of wartime rationing. The government entirely changed its attitude to maternal nutrition in a beneficial and successful way during the war; conferring to modern historians another example of war being a generator of change. Diet in pregnancy finally became the concern of the scientific community post-war, as illustrated by the work of the Royal College of Obstetrics and Gynaecology Nutrition Committee for Pregnancy, whose papers are considered for the first time here. This paper charts the rise of diet in pregnancy as a concern and considers the contributions of different communities involved between 1930 and 1960. It also notes that the actual recommended diet stayed the same. Thus while diet is the subject here, discussion focuses on why there were such distinct rearrangements of social, political and scientific forces around an issue that itself remained unchanged. (shrink)

Despite recent advances in ways to prevent transmission of HIV from a mother to her child during pregnancy, infants continue to be born and become infected with HIV, particularly in southern Africa where HIV prevalence is the highest in the world. In this region, emphasis has shifted from voluntary HIV counselling and testing to routine testing of women during pregnancy. There have also been proposals for mandatory testing. Could mandatory testing ever be an option, even in high-prevalence settings? (...) Many previous examinations of mandatory testing have dealt with it in the context of low HIV prevalence and a well-resourced health care system. In this discussion, different assumptions are made. Within this context, where mandatory testing may be a strategy of last resort, the objections to it are reviewed. Special attention is paid in the discussion to the entrenched vulnerability of women in much of southern Africa and how this contributes to both HIV prevalence and ongoing challenges for preventing HIV transmission during pregnancy. While mandatory testing is ethically plausible, particularly when coupled with guaranteed access to treatment and care, the discussion argues that the moment to employ this strategy has not yet come. Many barriers remain for pregnant women in terms of access to testing, treatment and care, most acutely in the southern African setting, despite the presence of national and international human rights instruments aimed at empowering women and removing such barriers. While this situation persists, mandatory HIV testing during pregnancy cannot be justified. (shrink)

Despite recent advances in ways to prevent transmission of HIV from a mother to her child during pregnancy, infants continue to be born and become infected with HIV, particularly in southern Africa where HIV prevalence is the highest in the world. In this region, emphasis has shifted from voluntary HIV counselling and testing to routine testing of women during pregnancy. There have also been proposals for mandatory testing. Could mandatory testing ever be an option, even in high‐prevalence settings? (...) Many previous examinations of mandatory testing have dealt with it in the context of low HIV prevalence and a well‐resourced health care system. In this discussion, different assumptions are made. Within this context, where mandatory testing may be a strategy of last resort, the objections to it are reviewed. Special attention is paid in the discussion to the entrenched vulnerability of women in much of southern Africa and how this contributes to both HIV prevalence and ongoing challenges for preventing HIV transmission during pregnancy. While mandatory testing is ethically plausible, particularly when coupled with guaranteed access to treatment and care, the discussion argues that the moment to employ this strategy has not yet come. Many barriers remain for pregnant women in terms of access to testing, treatment and care, most acutely in the southern African setting, despite the presence of national and international human rights instruments aimed at empowering women and removing such barriers. While this situation persists, mandatory HIV testing during pregnancy cannot be justified. (shrink)

There is increasing global pressure to ensure that pregnant women are responsibly and safely included in clinical research in order to improve the evidence base that underpins healthcare delivery during pregnancy. One supposed barrier to inclusion is the assumption that pregnant women will be reluctant to participate in research. There is however very little empirical research investigating the views of pregnant women. Their perspective on the benefits, burdens and risks of research is a crucial component to ensuring effective recruitment. (...) The Research In Pregnancy Ethics study set out to ascertain the views of pregnant women about research participation using an inductive thematic analysis. We conducted semi-structured interviews with 20 women who had participated in a double-blind randomised placebo controlled trial in Wellington while pregnant. Our results show that at least some pregnant women recognise the value and importance of research during pregnancy. The women we interviewed were deeply invested in the research process and outcomes. Key motivations for participating were altruism, playing a valuable civic role and the importance of research. The main perceived burdens related to inconvenience and time commitment. For some women, possible randomization to the placebo arm was regarded as a burden or disadvantage. (shrink)

In my feature article, ‘Pregnancy and superior moral status: a proposal for two thresholds of personhood’, 1 I argue that there are reasons to recognise that pregnant women have a superior moral status. This is a new argument on personhood in philosophy, and I am not surprised that it has generated some discussion. While I am grateful that many authors have engaged with my ideas, I have not identified from the six commentaries any aspect in my approach that would (...) need to be revised. I will do my best here, in the space available, to address the main points raised. Gibson starts off by correctly noting that my proposal rests on a starting assumption (which I do not defend) that we follow a first threshold of personhood, but then seems to leave this aside in the rest of his critique. 2 He says I have not justified... (shrink)

In the UK, it has been proposed that alongside the current advice to abstain from alcohol completely in pregnancy, there should be increased screening of pregnant women for alcohol consumption in order to prevent instances of fetal alcohol spectrum disorder. The Scottish Intercollegiate Guidelines Network published guidelines in 2019 recommending that standardised screening questionnaires and associated use of biomarkers should be considered to identify alcohol exposure in pregnancy. This was followed in 2020 by the National Institute for Health (...) and Care Excellence Draft Quality Standard, which recommended that pregnant women should have information on their alcohol consumption recorded throughout their pregnancy and this information transferred to the child’s health records. Most recently, Public Health England has stated that the alcohol intake of all women should be recorded throughout pregnancy, not just at the initial booking appointment and that tools such as blood biomarkers and meconium testing should be researched in order to determine true prevalence rates of alcohol in pregnancy. We argue that this proposed enhanced screening undermines women’s autonomy and their legal right to be sufficiently informed to consent to screening. We argue that there is no evidence that this kind of screening will result in a reduction of fetal harm and there is a danger that undermining the autonomy of women and the trust relationship between women and healthcare professionals may even increase harm to future children. (shrink)

International media have reported cases of pregnant women who have had their children apprehended by social services, or who were incarcerated or forced into treatment programs based on a history of substance use or lack of adherence to addiction treatment programs. Public discourse on the biology of addiction has been criticized for generating stigma and a diminished perception of self-control in individuals with an addiction, potentially contributing to coercive approaches and criminalization of women who misuse substances during pregnancy. We (...) explored whether this is the case based on literature from social psychology, ethics, addiction research, science communication, and philosophy. The literature shows that the relationship between public discourse on biological aspects of addiction and issues such as stigma and perceptions of diminished self-control are unclear, largely due to the complexity of these phenomena. However, concerns about the biological approach are nevertheless legitimate given the broader social and policy context of women’s health. (shrink)

Pregnancy is thought to be a metabolically very expensive endeavor, yet investigations have produced inconsistent results concerning the responsiveness of human birth weight to maternal nutritional stress or nutritional intervention. These findings have led some researchers to conclude that fetal growth is strongly buffered against fluctuations in maternal energy balance, making the fetus in effect a “nearly perfect parasite.” This buffering would appear to be a reasonable adaptive response given the high risk of morbidity and mortality associated with low (...) birth weight. However, a life-history approach leads to the prediction that maternal investment strategies in pregnancy should be geared toward maximizing lifetime reproductive success rather than simply the success of the current pregnancy, and by extension that maternal investment strategies should vary with reproductive value. The physiology of human pregnancy in fact appears to include a number of mechanisms that protect maternal energy resources from diversion to the fetus and preserve them for future reproductive events. These mechanisms include adjustment of blood flow to the uterus and perhaps minor adjustments in gestation length, although evidence for the latter is scant. Suggestions are made for ways of investigating these maternal options. (shrink)

This paper demonstrates how the problematic kinds of epistemic power that physicians have can diminish the epistemic privilege that pregnant women have over their bodies and can put them in a state of epistemic powerlessness. This result, I argue, constitutes an epistemic injustice for many pregnant women. A reconsideration of how we understand and care for pregnant women and of the physician–patient relationship can provide us with a valuable context and starting point for helping to alleviate the knowledge/power problems that (...) are symptomatic of the current system and structure of medicine. I suggest that we can begin to confront this kind of injustice if medicine adopts a more phenomenological understanding of bodies and if physicians and patients—in this case, pregnant women—become what I call “epistemic peers.”. (shrink)

Pregnant people are often listed among groups that have been excluded from research on the basis of perceived vulnerability, to the detriment of the entire class. Lack of research among pregnant pe...

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential (...) for pregnancy.MethodsA literature review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

I argue that pregnant women have a duty to refrain from behaviours or to allow certain acts to be done to them for the sake of their foetus if the foetus has a reasonable chance of living and being in a harmed state if the woman does not refrain from those behaviours or allow those things to be done to her. There is a proviso: that her refraining from acting or allowing acts to be performed upon her does not significantly (...) harm her. This duty does not presuppose that the foetus is a person. It is grounded on principles of respect for the interests of sentient beings and prevention of harm to future individuals. I give an argument for a general duty of easy rescue. (shrink)

Limited research has been done among pregnant people participating in investigational drug trials. To enhance the ethical understanding of pregnant people’s perspectives on research participation, we sought to describe motives and risk perceptions of participants in a phase 1 trial of ledipasvir/sofosbuvir treatment for chronic Hepatitis C virus during pregnancy. Pregnant people with chronic HCV infection enrolled in an open-label, phase 1 study of LDV/SOF participated in semi-structured, in-depth interviews to explore their reasons for participation and experiences within the (...) study. Pregnant people took 12 weeks of LDV/SOF and were interviewed at enrollment and at the end of study. We recorded the interviews, transcribed them verbatim, coded them using NVivo software, and performed inductive thematic analysis. Nine women completed the study yielding 18 interview transcripts. We identified two themes regarding motives and one regarding risk perception. Motives— Women conceptualized study participation as part of the caregiving role they associate with motherhood; participating was viewed as an act of caregiving for their infants, their families, themselves, and other pregnant women with chronic HCV. Women also noted that they faced multiple barriers to treatment prior to pregnancy that created a desire to receive therapy through trial participation. Risk perception— Women acknowledged personal and fetal risk associated with participation. Acceptance of risk was influenced by women’s concepts of motherhood, preexisting knowledge of HCV and medical research, family members, intimate partners, or by the study design. Women enrolled in a phase 1 trial for chronic HCV therapy during pregnancy acknowledged risks of participation and were motivated by hopes for fetal and personal benefit and by lack of prenatal access to treatment. Ethical inclusion of pregnant people in research should acknowledge structural factors that contribute to vulnerability and data deficiencies for treatment in pregnancy. (shrink)

Research on opioid use in pregnancy is critically important to understand how the opioid epidemic has affected a generation of children, but also raises significant ethical and legal challenges. Embedded ethicists can help to fill the gaps in ethics oversight for such research, but further guidance is needed to help strike the balance between integration and independence.

BackgroundBeing pregnant is a vulnerable period for women with a history of eating disorders. A central issue in eating disorders is searching control of one’s body and food preferences. Pregnancy implies being increasingly out of control of this. Treatment and targeted prevention start with the patient’s experience. Little is known about how women with a history of eating disorder experience being pregnant.MethodWe interviewed 24 women with a history of eating disorder at the time of pregnancy, recruited from five (...) public pregnancy controls at local family health centers in Norway. Interviews were analyzed by means of ideal type analysis, with a particular focus on how the participants experienced pregnancy and perceived triggers in possible experiences of relapse or worsening during pregnancy. All participants completed the Eating Disorder Examination Questionnaire and were diagnosed by using the Eating Disorder Examination.ResultsOn becoming pregnant, 23 of the 24 participants experienced worsening or relapse of their disorder. This occurred both at first time and after several pregnancies, and either interviewed early or late in pregnancy. Ideal type analyses indicated seven different personal features associated with worsening or relapse: the “chaotic” “rigid” “perfect” “worried” “shameful” “motherhood fearing” and “the mother with lost identity” Perceived triggers of worsening or relapse were: “loss of control” “unpredictability” “competition” “change of appearance” “shame and nausea” and “loss of identity.”ConclusionPregnancy is a vulnerable period for women with a history of eating disorders. A great variation in personal psychological dynamics seems to interact with perceived triggers in worsening or relapse of eating disorder. Our findings have important implications in understanding mechanisms of relapse in pregnancy, preventing relapse and help tailoring adequate intervention. (shrink)

Research Ethics, Volume 18, Issue 2, Page 132-150, April 2022. Limited research has been done among pregnant people participating in investigational drug trials. To enhance the ethical understanding of pregnant people’s perspectives on research participation, we sought to describe motives and risk perceptions of participants in a phase 1 trial of ledipasvir/sofosbuvir treatment for chronic Hepatitis C virus during pregnancy. Pregnant people with chronic HCV infection enrolled in an open-label, phase 1 study of LDV/SOF participated in semi-structured, in-depth interviews (...) to explore their reasons for participation and experiences within the study. Pregnant people took 12 weeks of LDV/SOF and were interviewed at enrollment and at the end of study. We recorded the interviews, transcribed them verbatim, coded them using NVivo software, and performed inductive thematic analysis. Nine women completed the study yielding 18 interview transcripts. We identified two themes regarding motives and one regarding risk perception. Motives— Women conceptualized study participation as part of the caregiving role they associate with motherhood; participating was viewed as an act of caregiving for their infants, their families, themselves, and other pregnant women with chronic HCV. Women also noted that they faced multiple barriers to treatment prior to pregnancy that created a desire to receive therapy through trial participation. Risk perception— Women acknowledged personal and fetal risk associated with participation. Acceptance of risk was influenced by women’s concepts of motherhood, preexisting knowledge of HCV and medical research, family members, intimate partners, or by the study design. Women enrolled in a phase 1 trial for chronic HCV therapy during pregnancy acknowledged risks of participation and were motivated by hopes for fetal and personal benefit and by lack of prenatal access to treatment. Ethical inclusion of pregnant people in research should acknowledge structural factors that contribute to vulnerability and data deficiencies for treatment in pregnancy. (shrink)

In the USA, there are missed opportunities to diagnose hepatitis C virus in pregnancy because screening is currently risk-stratified and thus primarily limited to individuals who disclose history of injection drug use or sexually transmitted infection risks. Over the past decade, the opioid epidemic has dramatically increased incidence of HCV and a feasible, well-tolerated cure was introduced. Considering these developments, recent evidence suggests universal HCV screening in pregnancy would be cost-effective and several professional organisations have called for updated (...) national policy. Historically, universal screening has been financially disincentivised on the healthcare system level, particularly since new diagnoses may generate an obligation to provide expensive treatments to a population largely reliant on public health resources. Here, we provide ethical arguments supporting universal HCV screening in pregnancy grounded in obligations to respect for persons, beneficence and justice. First, universal prenatal HCV screening respects pregnant women as persons by promoting their long-term health outside of pregnancy. Additionally, universal screening would optimise health outcomes within current treatment guidelines and may support research on treatment during pregnancy. Finally, universal screening would avoid potential harms of risk-stratifying pregnant women by highly stigmatised substance use and sexual behaviours. (shrink)

Because mourning and memorializing a miscarriage seems to imply acceptance of foetal personhood, feminists have been reluctant to address the often traumatic but common experience of pregnancy loss. Feminist anthropologists of reproduction have argued that adopting a view of personhood as constructed and negotiated, rather than inherent, solves this dilemma and enables the development of a feminist discourse of pregnancy loss. This article aims to make a critical contribution to such a discourse by analysing representations of lost babies (...) and children in online pregnancy loss memorials. It focuses on two genres of representation, idealized angels and medical ultrasound images. It argues that the dominance of a biological model of personhood limits the ability of both forms of representation to secure the status of memorialized children as real. However, pregnancy loss memorials do communicate the anguish of grieving parents, in part through the very unrepresentability of their loss. They also provoke a questioning of the taken for granted subject of `the child', whether imagined or real, absent or present. (shrink)

The fields of HIV care in pregnancy and reproductive genetics have always been ‘exceptional’ in that patients are highly concerned about the potential for stigma and the corresponding need for privacy and confidentiality. However, the two fields have diverged in how they have addressed these concerns. The systematic review analyzed 61 manuscripts for similarities and differences between the fields of HIV care in pregnancy and reproductive genetics in the United States, with respect to privacy, confidentiality, disclosure, and stigma. (...) The systematic review revealed that the field of HIV care in pregnancy has insufficiently addressed patient concerns about privacy, confidentiality, and stigma compared to the field of reproductive genetics. Failure to adequately protect confidentiality of HIV-positive patients, and failure to reduce stigma associated with HIV testing and treatment are deficiencies in the delivery of care to HIV-positive pregnant woman and barriers to reducing vertical transmission of HIV. Im.. (shrink)

Infertility is recognized as a major problem of modern society. Assisted Reproductive Technology is the one of many available treatment options to cure infertility. However, the efficiency of the ART treatment is still inadequate. Therefore, the procedure’s quality is constantly improving and there is a need to determine statistical predictors as well as contributing factors to the successful treatment. There is a concern over the application of adequate statistical analysis to clinical data: should classic statistical methods be used or would (...) it be more appropriate to apply advanced data mining technologies? By comparing two statistical models, Multivariable Logistic Regression analysis and Artificial Neural Network it has been demonstrated that Multivariable Logistic Regression analysis is more suitable for theoretical interest but the Artificial Neural Network method is more useful in clinical prediction. (shrink)

Today, many pregnancy guides mention a nesting instinct. According to this, pregnant women would be seized by an urge to create the right environment for their child, for example to buy baby equipment or clean the apartment. The concept of the nesting instinct forms a specific configuration of knowledge: While it is widespread in the popular field, it occupies a marginal position in the scientific field. In this paper, I will investigate the historical epistemology of this form of knowledge. (...) In so doing, the following questions are addressed: How did the knowledge about a nesting instinct during pregnancy form? How was the nest as a specific natural-anthropogenic environment constructed? And to what extent do notions of gender and environment interact here? To answer these questions, the study takes the perspective of a history of knowledge in transit, in the longue durée from the nineteenth century to the present. The investigation reveals a gradual feminization of the concept of environment in the knowledge of the nesting instinct. Whereas in the nineteenth century it was often considered a male behavioral pattern and the nest was an analogy to the house, in the first decades of the twentieth century, the instinct transformed into a primarily female characteristic, with the nest representing the interior of the home. A decisive condition for this circulation of knowledge was that the nest became a ‘metaphorical thing’. As such, the nest did not simply lead to naturalization, but denoted a natural-social in-between space that increasingly became the goal of female care work. (shrink)

This book provides extensive and critical engagement with some of the most recent and compelling arguments favoring abortion choice. It features original essays from leading and emerging philosophers, bioethicists and medical professionals that present philosophically sophisticated and novel arguments against abortion choice. The chapters in this book are divided into three thematic sections. The first set of essays focuses primarily on unborn human individuals--zygotes, embryos and fetuses. In these chapters it is argued, for example, that human organisms begin to exist (...) at conception and that zygotes, embryos and fetuses are persons. These chapters also explore questions about whether or not zygotes, embryos and fetuses are part of their mothers' bodies. The second set of essays focuses primarily on elective abortion and the debates surrounding it. These chapters consider whether or not opponents of abortion are commonly hypocritical, how opponents of abortion should think about adoption, how emerging technologies may affect the current debate and whether or not those participating in the debate should rely on analogies to support their case. Finally, the third set of essays shifts focus from the legal and moral status of elective abortion to its place in medical practice. In these chapters it is argued that elective abortion embodies a kind of ableism, and that elective abortion is medically unnecessary, harmful to women's mental health and that telemedicine abortion poses significant risks to women's health. Agency, Pregnancy and Persons offers an up-to-date examination of unborn human beings, the debates surrounding elective abortion and the place of elective abortion within medical practice. It will be of interest to medical professionals and those who work in philosophy, bioethics and medical ethics alike. (shrink)

In recent years, tremendous progress has been made toward recognizing the need for improved medical knowledge for pregnant people, a population group that has long been excluded from clinical trial...

This brief report raises the ethical dilemma encountered by an obstetrician involved in the care of a pregnant woman with life-threatening disease. This is a particularly difficult issue if the maternal well-being is in conflict with the survival of the unborn child.

Objective Routine prenatal screening for Down syndrome challenges professional non-directiveness and patient autonomy in daily clinical practices. This paper aims to describe how professionals negotiate their role when a pregnant woman asks them to become involved in the decision-making process implied by screening.Methods Forty-one semi-structured interviews were conducted with gynaecologists–obstetricians and midwives in a large Swiss city.Results Three professional profiles were constructed along a continuum that defines the relative distance or proximity towards patients’ demands for professional involvement in the decision-making (...) process. The first profile insists on enforcing patient responsibility, wherein the healthcare provider avoids any form of professional participation. A second profile defends the idea of a shared decision making between patients and professionals. The third highlights the intervening factors that justify professionals’ involvement in decisions.Conclusions These results illustrate various applications of the principle of autonomy and highlight the complexity of the doctor–patient relationship amidst medical decisions today. (shrink)

In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals might feel pressured to opt for partial ectogestation to preserve their or their fetus’ well-being; moreover, (...) they point out that the feelings of loss in the context of AAPT are likely to be worse than the ones reported in neonatal intensive care units cases. Finally, they advocate for care pathways focusing on how the transfer of a fetus to the AAPT could affect the pregnant person, with particular attention to managing the grief potentially caused by the pregnancy loss. I praise the authors for such a call to action—especially since partial ectogestation is expected to become a reality in the short-term future—and I share their demands for additional and more attentive care of (formerly) pregnant patients. However, I am concerned that their approach is so focused on negative feelings towards pregnancy loss that it risks becoming …. (shrink)

In the proem of the “Theogony” Hesiod describes the conception and birth of the Muses. At ll. 58-60 he specifies that Mnemosyne’s pregnancy lasted one entire year, ένιαντός. This unusual one-year pregnancy puzzles Hesiod’s commentators; West, for example, translates ένιαντός as ‘due time’ rather than ‘year’. The purpose of this article is to argue that Hesiod intended ένιαντός to mean ‘year’.

Nietzsche employs the concept of pregnancy metaphorically at various points in his writings; discussing the pregnancy of philosophers (GM III 8, BGE 292), spiritual pregnancy (EH, Clever 3; GS 72) and being pregnant with thoughts or deeds (D 552). I explore how Nietzsche uses the notion of pregnancy in Dawn, arguing that it connects to the theme of self-cultivation. I employ the various associations that Nietzsche makes with pregnancy, including the unknown, selfishness, strangeness, and solitude, (...) to elucidate Nietzsche’s understanding of self-cultivation. I show how the metaphor of pregnancy, in which we do not control what we give birth to, both expresses and helps us explore the problem of what, if the self is made up of and directed by many competing drives, shapes and directs self-cultivation. I argue that Nietzsche’s deliberate references to the context of Plato’s discussion of pregnancy involve a self-conscious challenge to Plato’s concept of the philosopher, and of philosophy, and a reimagining of what they will give birth to. The appropriation of Plato’s famous metaphor thus underscores how Nietzsche’s concept and method of self-cultivation contrasts to Plato’s care for the soul and is rooted in attentiveness to the body and its drives. (shrink)

Although Plato's notion of spiritual pregnancy has received a great deal of critical attention in recent years, the development of the metaphor in the Symposium has not been fully analysed. Close attention to the details of the image reveals two important points which have so far been overlooked: There are two quite different types of spiritual pregnancy in the Symposium: a ‘male’ type, which is analogous to the build-up to physical ejaculation, and a ‘female’ type, which is analogous (...) to the physical experience of pregnancy as normally understood. (shrink)

Pregnancy has been traditionally defined as the period during which developing embryos are incubated in the body after egg–sperm union. Despite strong similarities between viviparity in mammals and other vertebrate groups, researchers have historically been reluctant to use the term pregnancy for non‐mammals in recognition of the highly developed form of viviparity in eutherians. Syngnathid fishes (seahorses and pipefishes) have a unique reproductive system, where the male incubates developing embryos in a specialized brooding structure in which they are (...) aerated, osmoregulated, protected and likely provisioned during their development. Recent insights into physiological, morphological and genetic changes associated with syngnathid reproduction provide compelling evidence that male incubation in these species is a highly specialized form of reproduction akin to other forms of viviparity. Here, we review these recent advances, highlighting similarities and differences between seahorse and mammalian pregnancy. Understanding the changes associated with the parallel evolution of male pregnancy in the two major syngnathid lineages will help to identify key innovations that facilitated the development of this unique form of reproduction and, through comparison with other forms of live bearing, may allow the identification of a common set of characteristics shared by all viviparous organisms. BioEssays 29:884–896, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Each year in the UK there are approximately 250,000 miscarriages, 3,000 stillbirths and 3,000 terminations following a diagnosis of fetal-abnormality. This paper draws from original empirical research into the experience of pregnancy loss and the accompanying decisionmaking processes. A key finding is that there is considerable variation across England in the range of options that are offered for disposal of pregnancy remains and the ways in which information around disposal are communicated. This analysis seeks to outline the key (...) features of what constitutes effective communication in this context, where effective communication is taken to mean that patients are provided with the key information necessary, in an appropriate manner, so that they are fully able to make a decision. A primary source of evidence includes interviews with the bereaved and pregnancy-loss support workers, in order to understand how the options available, and associated necessary procedures, are communicated. In addition, patient information leaflets are also analyzed as they offer an important tool for information delivery at a difficult and emotionally charged time. Following this, an overview is provided of the information that these leaflets should contain, along with guidance on effective presentation of this information. (shrink)

BackgroundFindings suggest pandemic control measures have modified maternal health practices, compromising the quality of care provided to new and expectant mothers and interfering with their birthing experiences. For this reason, this study explored the lived experiences of post-partum Victorian mothers during the pandemic as well as the potential influence of control measures over their perceptions regarding the health system.MethodsThis study used a qualitative approach. Recruitment was conducted between May and June 2021, using both the Australian Breastfeeding Association’s social media pages (...) and snowball recruitment. Interviews were semi-structured using open-ended questions relating to key themes. Seven Victorian post-partum mothers were identified and their transcripts analysed using Interpretative Phenomenological Analysis.ResultsMothers described how unexpected changes to maternal care exacerbated feelings of uncertainty regarding pregnancy and birth. Mothers also differentiated between impacts by the health system and the role healthcare professionals played in moderating these effects. Whilst visitor restrictions provided some benefit, restrictions to familial and social support left many of the mothers feeling alone during their pregnancy and interfered with their immediate post-partum experience.ConclusionThis study illustrates the importance of evidence-based practice in maternal care and provides insights for both health professionals and policy analysts in developing new or modifying existing guidelines that better balance the needs of expectant and post-partum mothers with pandemic control measures. (shrink)

The Hague Conference on Private International Law currently has a Parentage/Surrogacy Project, which evaluates the legal status of children in cross-border situations, including situations involving international contract pregnancy. Should a convention focusing on international contract pregnancy emerge from this project, it will need to be consistent with the Hague convention on Intercountry Adoption. The latter convention prohibits adoptions unless, among other things, ‘the competent authorities of the receiving State have determined that the prospective adoptive parents are eligible and (...) suited to adopt’. Included in it, therefore, is a parental vetting or licensing requirement. In our view, a similar requirement must also appear in any Hague Convention on international contract pregnancy if the two conventions are to be ethically consistent with one another. In particular, there should be a licensing requirement in such a convention for at least some of the prospective parents in contract pregnancy arrangements. We consider several arguments against this conclusion, and argue that none of them is successful. (shrink)

The transition to parenthood is both a joyous and a challenging event in a relationship. Studies to date have found mostly negative effects of the birth of the first child on the parental relationship. We propose that partners' pre-pregnancy individual happiness may serve as a buffer against these negative effects. We predicted that parents who are happy prior to pregnancy fare better in terms of relationship commitment after childbirth than unhappy parents. To test our prediction, we used data (...) of a 5-wave longitudinal study among 109 Dutch newlywed couples who had their first child during the study and a comparison group of 55 couples who remained childless. We found that the relationship commitment of fathers with higher pre-pregnancy happiness and fathers with a partner with higher pre-pregnancy happiness increased slightly in the years after childbirth, whereas the relationship commitment of fathers with lower pre-pregnancy happiness and fathers with a partner with lower pre-pregnancy happiness decreased. In addition, the relationship commitment of mothers with a happier partner prior to pregnancy decreased only slightly across the transition to parenthood but showed a steeper decline for mothers with a partner with average or lower pre-pregnancy happiness. In line with the idea that happiness acts as a resource when partners have to deal with relationship challenges, individual happiness predicted changes in relationship commitment for parents, but not for partners who remained childless. (shrink)