Fat 2nd edition now published

Fat second edition

 

The second edition of my book Fat has now been published, with a great new cover. This version is twice as long as the first edition. Each chapter has been revised and updated and there is a lot more material in the new edition on how digital material represents fat bodies (for example, memes, GIFs, YouTube, hashtags, selfies and social media platforms such as Tumblr, Twitter and Instagram).

My author’s preface to the second edition is below. The link to the book on Google Books is here, which provides a preview of more content.

The first edition of Fat was completed in 2012, a time at which academic interest in understanding the discourses, practices and politics around fat bodies had been intensifying for some years. Several years later, this topic of study remains a fulcrum where various issues and controversies concerning identities and embodiment converge and intensify. To some extent, the panic about the so-called ‘obesity epidemic’ has died down, perhaps due to the news media losing interest and other health issues receiving policy attention. Meanwhile, the views of fat activists have made greater ingress into public debates about obesity; if remaining subject to controversy or denial. Some of the topics I covered in the first edition have become more complex, with new research paying greater attention to the intersectoral aspects of fat embodiment: how social class, ethnicity or race, sexual identity, age and geographical location shape experiences. Further discussion has sparked up around the question of who can speak about or advocate for fat people or engage in critical analyses of obesity politics – must they be fat-identifying people or can others participate in these debates?

Since I wrote the first edition, as part of a turn towards the visual in popular culture, the representation of human bodies of all shapes and sizes have received greater levels of coverage in new digital media forums. These media offer many more opportunities for self-representation and for body positive and fat activists to draw attention to their causes. However, the fit and thin body continues to dominate in these forums as the ideal body type, often around the ‘fitspiration’ label. Social media allow the vilification and stigmatizing of fat people to intensify and be more easily distributed to ever-larger audiences. New digital media and devices promote a culture of intensified self-monitoring and measuring of bodies, and comparing them against norms. Many more apps and wearable devices have come onto the market, aimed at encouraging and helping people to count calories and track their physical activity and body weight in the interests of conforming to these ideals. These media, therefore, have made bodies of all sizes ever-more visible and subject to private monitoring and public display. These issues and topics all receive attention in this second revised edition.

 

Digitised children’s bodies

This is an excerpt from the pre-print version of a chapter I have written on the topic of ‘digital bodies’. The full pre-print can be accessed here.

The sociomaterialist perspective has been taken up by several scholars writing about children’s bodies, particularly within cultural geography, but also by some sociologists and anthropologists (Prout, 1996; Horton and Kraftl, 2006a, 2006b; Lee, 2008; Woodyer, 2008). Researchers using a sociomaterialist approach have conducted studies on, for example, children’s use of asthma medication (Prout, 1996), the surveillant technologies that have developed around controlling children’s body weight in schools (Rich et al., 2011), children’s sleep and the objects with which they interact (Lee, 2008), the interrelationship of objects with pedagogy and classroom management of students’ bodies (Mulcahy, 2012) and sociomaterial practices in classrooms that lead to the inclusion or exclusion of children with disabilities (Söderström, 2014). Outside sociomaterialist studies, young children’s interactions with digital technologies have attracted extensive attention from social researchers, particularly in relation to topics such as the potential for cyber-bullying, online paedophilia and for children to become unfit and overweight due to spending too much time in front of screens (Holloway et al., 2013). However few researchers thus far have directed their attention to the types of digital technologies that visually represent children’s bodies or render their body functions, activities and behaviours into digital data; or, in other words, how children’s bodies become digital data assemblages.

From the embryonic stage of development onwards, children’s bodies are now routinely monitored and portrayed using digital technologies. A plethora of websites provide images of every stage of embryonic and foetal development, from fertilisation to birth, using a combination of digital images taken from embryo and foetus specimens and digital imaging software  (Lupton, 2013). 3/4D ultrasounds have become commodified, used for ‘social’ or ‘bonding’ purposes. Many companies offering 3/D ultrasounds now come to people’s homes, allowing expectant parents to invite family and friends and turn a viewing of the foetus into a party event. This sometimes involves a ‘gender reveal’ moment, in which the sonographer demonstrates to all participants, including the parents, the sex of the foetus . Some companies offer the service of using 3D ultrasound scan files to create life-sized printed foetus replica models for parents.

The posting to social media sites such as Facebook, Twitter, Instagram and YouTube of the foetus ultrasound image has become a rite of passage for many new parents and often a way of announcing the pregnancy. Using widgets such as ‘Baby Gaga’, expectant parents can upload regular status updates to their social media feeds automatically that provide news on the foetus’s development. While a woman is pregnant, she can use a range of digital devices to monitor her foetus. Hundreds of pregnancy apps are currently on the market, including not only those that provide information but others that invite users to upload personal information about their bodies and the development of their foetus. Some apps offer a personalised foetal development overview or provide the opportunity for the woman to record the size of her pregnant abdomen week by week, eventually creating a time-lapse video. Other apps involve women tracking foetal movements or heart beat. Bella Beat, for example, is a smartphone attachment and app that allows the pregnant women to hear and record the foetal heart beat whenever she likes and to upload the audio file to her social media accounts.

YouTube has become a predominant medium for the representation of the unborn entity in the form of ultrasound images and of the moment of birth. Almost 100,000 videos showing live childbirth, including both vaginal and Caesarean births, are available for viewing on that site, allowing the entry into the world of these infants to be viewed by thousands and, in the case of some popular videos, even millions of viewers. Some women even choose to live-stream the birth so that audiences can watch the delivery in real time. Following the birth, there are similar opportunities for proud parents to share images of their infant online on social media platforms. In addition to these are the growing number of devices on the market for parents to monitor the health, development and wellbeing of their infants and young children. Apps are available to monitor such aspects as infants’ feeding and sleeping patterns, their weight and height and their development and achievements towards milestones. Sensor-embedded baby clothing, wrist or ankle bands and toys can be purchased that monitor infants’ heart rate, body temperature and breathing, producing data that are transmitted to the parents’ devices. Smartphones can be turned into baby monitors with the use of apps that record the sound levels of the infant.

As children grow, their geolocation, educational progress and physical fitness can be tracked by their parents using apps, other software and wearable devices. As children themselves begin to use digital technologies for their own purposes, they start to configure their own digital assemblages that represent and track their bodies. With the advent of touchscreen mobile devices such as smartphones and tablet computers, even very young children are now able to use social media sites and the thousands of apps that have been designed especially for their use (Holloway et al., 2013). Some such technologies encourage young children to learn about the anatomy of human bodies or about nutrition, exercise and physical fitness, calculate their body mass index, collect information about their bodies or represent their bodies in certain ways (such as manipulating photographic images of themselves). These technologies typically employ gamification strategies to provide interest and motivation for use. Some involve combining competition or games with self-tracking using wearable devices. One example is the Leapfrog Leapband, a digital wristband connected to an app which encourages children to be physically active in return for providing them with the opportunity to care for virtual pets. Another is the Sqord interactive online platform with associated digital wristband and app. Children who sign up can make an avatar of themselves and use the wristband to track their physical activity. Users compete with other users by gaining points for moving their bodies as often and as fast as possible.

In the formal educational system there are still more opportunities for children’s bodies to be monitored measured and evaluated and rendered into digitised assemblages. Programmable ‘smart schools’ are becoming viewed as part of the ‘smart city’, an urban environment in which sensors that can watch and collect digital data on citizens are ubiquitous (Williamson, 2014). The monitoring of children’s educational progress and outcomes using software is now routinely undertaken in many schools, as are their movements around the school. In countries such as the USA and the UK, the majority of schools have CCTV cameras that track students, and many use biometric tracking technologies such as RFID chips in badges or school uniforms and fingerprints to identify children and monitor their movements and their purchases at school canteens (Taylor, 2013; Selwyn, 2014). A growing number of schools are beginning to use wearable devices, apps and other software for health and physical education lessons, such as coaching apps that record children’s sporting performances and digital heart rate monitors that track their physical exertions (Lupton, 2015).

We can see in the use of digital technologies to monitor and represent the bodies of children a range of forms of embodiment. Digitised data assemblages of children’s bodies are generated from before birth via a combination of devices that seek to achieve medical- or health-related or social and affective objectives. These assemblages may move between different domains: when, for example, a digitised ultrasound image that was generated for medical purposes becomes repurposed by expectant parents as a social media artefact, a way of announcing the pregnancy, establishing their foetus as new person and establishing its social relationships. Parents’ digital devices, and later those of educational institutions and those of children themselves when they begin to use digital devices, potentially become personalised repositories for a vast amount of unique digital assemblages on the individual child, from images of them to descriptions of their growth, development, mental and physical health and wellbeing, movements in space, achievements and learning outcomes. These data assemblages, containing as they do granular details about children, offer unprecedented potential to configure knowledges about individual children and also large groups of children (as represented in aggregated big data sets).

References

Holloway D, Green L and Livingstone S. (2013) Zero to Eight: Young Children and Their Internet Use. London: LSE London, EU Kids Online.

Horton J and Kraftl P. (2006a) Not just growing up, but going on: Materials, spacings, bodies, situations. Children’s Geographies 4(3): 259-276.

Horton J and Kraftl P. (2006b) What else? some more ways of thinking and doing ‘Children’s Geographies’. Children’s Geographies 4(1): 69-95.

Lee N. (2008) Awake, asleep, adult, child: An a-humanist account of persons. Body & Society 14(4): 57-74.

Lupton D. (2013) The Social Worlds of the Unborn, Houndmills: Palgrave Macmillan.

Lupton D. (2015) Data assemblages, sentient schools and digitised health and physical education (response to Gard). Sport, Education and Society 20(1): 122-132.

Mulcahy D. (2012) Affective assemblages: body matters in the pedagogic practices of contemporary school classrooms. Pedagogy, culture and society 20(1): 9-27.

Prout A. (1996) Actor-network theory, technology and medical sociology: an illustrative analysis of the metered dose inhaler. Sociology of Health and Illness 18(2): 198-219.

Rich E, Evans J and De Pian L. (2011) Children’s bodies, surveillance and the obesity crisis. In: Rich E, Monaghan LF and Aphramor L (eds) Debating Obesity: Critical Perspectives. Houndsmills: Palgrave Macmillan, 139-163.

Selwyn N. (2014) Data entry: towards the critical study of digital data and education. Learning, Media and Technology: 1-19.

Söderström S. (2014) Socio-material practices in classrooms that lead to the social participation or social isolation of disabled pupils. Scandinavian Journal of Disability Research online first.

Taylor E. (2013) Surveillance Schools: Security, Discipline and Control in Contemporary Education, Houndmills: Palgrave Macmillan.

Williamson B. (2014) Smart schools in sentient cities. dmlcentral.

Woodyer T. (2008) The body as research tool: embodied practice and children’s geographies. Children’s Geographies 6(4): 349-362.

Medical diagnosis apps – study findings

Over 100,000 medical and health apps for mobile digital devices have now been listed in the Apple App Store and Google Play. They represent diverse opportunities for lay people to access medical information and track their body functions and medical conditions. As yet, however, few critical social researchers have sought to analyse these apps.

In a study I did with Annemarie Jutel we undertook a sociological analysis of medical diagnosis apps, and two articles have now been published from the study. Annemarie is a sociology of diagnosis expert and we were interested in investigating how these apps represented the process of diagnosis. We drew on the perspective that apps are sociocultural artefacts that draw on and reproduce tacit norms and assumptions. We argue that from a sociological perspective, digital devices such as health and medical apps have significant implications for the ways in which the human body is understood, visualised and treated by medical practitioners and lay people alike, for the doctor-patient relationship and the practice of medicine.

In one article, published in Social Science & Medicine, we focused on self-diagnosis apps directed at lay people. We undertook a search using the terms ‘medical diagnosis’ and ‘symptom checker’ for apps that were available for download to smartphones in mid-April 2014 in the Apple App Store and Google Play. We found 35 self-diagnosis apps that claimed to diagnose across a range of conditions (we didn’t include apps directed at diagnosis of single conditions). Some have been downloaded by tens or hundreds of thousands, and the case of WebMD and iTriage Health, millions of smartphone owners.

Our analysis suggests that these apps inhabit a contested and ambiguous site of meaning and practice. The very existence of self-diagnosis apps speaks to several important dimensions of contemporary patienthood and healthcare in the context of a rapidly developing ecosystem of digital health technologies. They also participate in the quest for patient ‘engagement’ and ‘empowerment’ that is a hallmark of digital health rhetoric (or what I call ‘digital patient engagement’).

Self-diagnosis apps, like other technologies designed to give lay people the opportunity to monitor their bodies and their health states and engage with the discourses of healthism and control that pervade contemporary medicine We found that app developers combined claims to medical expertise in conjunction with appeals to algorithmic authority to promote their apps to potential users. While the developers also used appeals to patient engagement as part of their promotional efforts, these were undermined by routine disclaimers that users should seek medical advice to effect a diagnosis. While the cautions that are offered on the apps that they are for ‘entertainment purposes only’ and not designed to ‘replace a diagnosis from a medical professional’ may be added for legal reasons, they detract from the authority that the app may offer and indeed call into question why anyone should use it.

In our other article, published in the new journal Diagnosis, we directed attention at diagnosis apps that are designed for the use of medical practitioners as well as lay people. We analysed 176 such apps that we found in Google Play and the Apple App Store in December 2013. While 36 of these were directed at lay people, the remainder were for medical practitioners. The Diagnosis article mainly concentrates on the latter, given that our other article was about the self-diagnosis apps for lay people.

Our research suggests that these apps should be used with great caution by both lay people and practitioners. The lack of verifiable information provided about the evidence or expertise used to develop these apps is of major concern. The apps are of very variable quality, ranging from those that appear to have the support and input of distinguished medical experts, specialty groups or medical societies to those that offer little or nothing to support their knowledge claims. While at one end of the spectrum we can see apps as a delivery system for information which has been subject to the conventional forms of academic review, at the other extreme, we see apps developed by entrepreneurs with interests in many topics outside medicine, with little input from medical sources, or with inadequate information to ascertain what the sources might be. The lack of information provided by many app developers also raises questions about how users can determine the presence of conflicts of interest and commercial interests that might determine content.

The cultural specificity of digital health technologies

Digital health technologies configure a certain type of practising medicine and public health, a certain type of patient or lay person and a specific perspective on the human body. The techno-utopian approach to using digital health technologies tends to assume that these tacit norms and assumptions are shared and accepted by all the actors involved, and that they are acting on a universal human body. Yet a cursory examination of surveys of digital health technology use demonstrates that social structural factors such as age, gender, education level, occupation and race/ethnicity, as well as people’s state of health and their geographical location play a major role in influencing how such technologies are taken up among lay people or the extent to which they are able to access the technologies.

An American study of the use of some digital health technologies using representative data collected by the National Cancer Institute in 2012, for example, found no evidence of differences by race or ethnicity, but significant differences for gender, age and socioeconomic status (Kontos et al. 2014). Female respondents were more likely to use online technologies for health-related information, as were younger people (under less than 65) and those of higher socioeconomic status. People of low socioeconomic status were less likely to go online to look for a healthcare provider, use email or the internet to connect with a doctor, track their personal health information online, using a website to track to help track diet, weight or physical activity or download health information to a mobile device. However they were more likely to use social media sites to access or share health information. Women were more likely than men to engage in all of these activities.

While there is little academic research on how different social groups use apps, market research reports have generated some insights. One report showed that women install 40 per cent more apps than men and buy 17 per cent more paid apps. Men use health and fitness apps slightly more (10 per cent) than women (Koetsier 2013). A Nielsen market report on the use of wearable devices found that while men and women used fitness activity bands in equal numbers, women were more likely to use diet and calorie counter apps (Nielsen 2014).

As these findings suggest, gender is one important characteristic that structures the use of digital health technologies. The digital technology culture is generally male-dominated: most technology designers, developers and entrepreneurs are male. As a result, a certain blindness to the needs of women can be evident. For example, when the Apple Health app was announced in 2014, destined to be included as part of a suite of apps on the Apple Watch, it did not include a function for the tracking of menstrual cycles (Eveleth 2014). Gender stereotypes are routinely reproduced in devices such as health and medical apps. As I noted in my study of sexuality and reproduction self-tracking apps, the sexuality apps tend to focus on documenting and celebrating male sexual performance, with little acknowledgement of women’s sexuality, while reproduction apps emphasise women’s over men’s fertility.

App designers and those who develop many other digital technologies for medical and health-related purposes often fail to recognise the social and cultural differences that may influence how people interact with them. Just as cultural beliefs about health and illness vary from culture to culture, so too do responses to the cultural artefacts that are digital health technologies. Aboriginal people living in a remote region of Australia, for example, have very different notions of embodiment, health and disease from those that tend to feature in the health literacy apps that have been developed for mainstream white Australian culture (Christie and Verran 2014). It is therefore not surprising that a review of the efficacy of a number of social media and apps developed for health promotion interventions targeted at Aboriginal Australians found no evidence of their effectiveness or benefit to this population (Brusse et al. 2014).

Few other analyses have sought to highlight the cultural differences in which people respond to and use digital health technologies. This kind of research is surely imperative to challenge existing assumptions about ‘the user’ of these technologies and provide greater insights into their benefits and limitations.

New project on fitness self-tracking apps and websites

My colleague Glen Fuller and I have started a new project on people’s use of fitness self-tracking apps and platforms (such as Strava and RunKeeper). We are interviewing people who are active users of these devices, seeking to identify why they have chosen to take up these practices, what apps and platforms they use, how they use them and what they do with the personal data that are generated from these technologies. We are interested in exploring issues around identity and self-representation, concepts of health, fitness and the body, privacy, surveillance and data practices and cultures.

The city in which we live and work, Canberra, is an ideal place to conduct this project, as there are many ardent cyclists and runners living here.

See here for our project’s website and further details of the study.

Representations of bodies/selves online

Another excerpt from  my forthcoming book Digital Sociology, taken from Chapter 8, ‘The Digitised Body/Self’.

People discuss and visually represent their (and others’) bodies incessantly as part of using social media. The body is represented in ever finer detail on the types of digital networks and platforms that are now available for use. Social media sites such as YouTube, Tumblr, Pinterest, Instagram and Flickr focus on the uploading, curating and sharing of images, including many of bodies. Facebook and Twitter also provide opportunities for users to share images of bodies. Bodies receive much digital attention, particularly those of celebrities, but increasingly those of ordinary users. Female celebrities, in particular, are the subject of continual digital visualising by paparazzi and fans and constant commentary in social media and news sites on the appropriateness and attractiveness or otherwise of their bodies (Gorton and Garde-Hansen 2013).

Due to the plethora of online platforms and apps devoted to human anatomy, the internal organs and workings of the human body have moved from being exclusively the preserve of medical students and surgeons to being open to the gaze of all. Online technologies now allow anyone with access to a computer to view highly detailed visual images of the inside of the body. Although these images may have been produced for medical students and medical practitioners and other health care workers, they are readily available to the general public. Tapping in the search term ‘human anatomy’ will call up many apps on the Apple App Store or Google Play which provide such details. Many websites also provide graphic images of the human body. The Visual Human Project used computer technologies to represent in fine detail the anatomical structure of male and female cadavers. Each body was cross-sectioned transversely from head to toe and images of the sections of their bodies using Magnetic Resonance Imaging and Computed Tomography were uploaded to a computer website and can also be viewed at the National Museum of Health and Medicine in Washington (The Visible Human Project  2013).

All shapes and sizes of living human bodies are available for viewing online. Sites as diverse as those supporting people wishing to engage in self-starvation or purging (the so-called ‘pro-ana’ or ‘thinspiration’ sites) and promoting cosmetic surgery, used by fat activists seeking to represent the fat body in positive ways that resist fat-shaming, sites for people engaged in self-harming practices or body-building, for transgender people and tattoo or body piercing devotees, not to mention the huge variety of sites devoted to pornography and sexual fetishes, all display images of a wide variety of body shapes and sizes and of bodies engaged in a multitude of practices that are both normative and go beyond the norm. In addition there are the sites that represent bodies undergoing various forms of medical procedures (there are many videos of surgery on YouTube), providing vivid images or descriptions of the ills and diseases from which bodies may suffer.

Social and other digital media have facilitated the sharing of images and descriptions of many varied forms of human life, from the very earliest stage of human development. A huge range of representations of embryos and foetuses, and indeed even the moment of fertilisation of a human ovum by a sperm cell can be viewed on the internet. Such media as YouTube videos of conception and embryonic development and websites such as the Human Embryo Project featuring detailed images and descriptions of each stage of unborn development allow people to gaze upon and learn about the unborn human. Proud parents now routinely post obstetric ultrasound images of their unborn to social media sites to announce a pregnancy. Some parents who have experience miscarriage, foetal loss or stillbirth use memorialisation websites or make videos to post on YouTube featuring ultrasound images, hand- or footprints of the dead unborn and even images of its dead body. As a result, via digital media the unborn human entity now receives a far greater degree of visibility than at any other time in the past (Lupton 2013).

At the other end of the human lifespan, the dead are achieving a kind of online immortality. Just as with the online memorialisation of the dead unborn, people’s death can be announced and memorialised via a plethora of online media. A digital afterlife may be achieved using these technologies. For example, Facebook pages are now frequently used to memorialise people who have died. The dead person’s own personal Facebook page may be used by others to communicate their feelings with each other about the person’s death, or they may establish a dedicated Facebook Group to exchange thoughts and memories about that individual (Bollmer 2013, Brubaker et al. 2013).

Commercial websites have been established that provide ‘afterlife online services’, as one such website puts it, that help people ‘plan for your digital death and afterlife or memorialize loved ones’ (The Digital Beyond  2013). They encourage the bereaved to submit photos and stories about a dead person or provide an online site for people to store their own memorabilia about their lives or important documents in anticipation of their death, leave or send posthumous messages, plan their funerals and provide details of what should happen to their social media profiles after death. Such terms as ‘digital estate’ or ‘digital assets’ are used to denote important documents, images and other information that have been rendered into digital formats for storage and distribution following a person’s death. Some services provide the facility for people to send email messages, images and audio or video recordings up to 60 years following their death. The LifeNaut platform allows people to create a ‘mindfile’: a personal archive of images, a timeline of their life, documents, places they have visited, and other information about themselves, as well as an avatar that will react and respond with their beliefs, attitudes and mannerisms. The company also provides a storage facility for preserving the individual’s DNA material. All of these data are preserved for the benefit of future generations.

The increasingly digitised representation of people is highlighted in artist Adam Nash’s collaborative art project Autoscopia (Autoscopia  2013). In this project the available online images for individuals are derived from web searches and configured into new, recombinant portraits of that individual (anyone can try it using their own name or any other person’s name). These digitised portraits then enter into the internet via tweeted links, thus recursively feeding themselves back into the latest versions of the portraits. In this project, data-as-data (the digitised image data that are mined by the Autoscopia computer program from many parts of the internet) are remodulated for the purposes of the art project into a different type of image, one formed from many images.

This art project raises intriguing questions about the ways in which digital data forms can be configured and reconfigured (or in Nash’s terms modulated and remodulated) that have implications more broadly for the power of digital data to configure embodiment. A digitised map, for example, demonstrating outbreaks of infectious diseases in certain geographical locations (as produced by the Health Map platform) is a modulation of various types of data that have been entered into the platform, whether from mining social media or by users themselves reporting their own illnesses. These visualisations are virtual body fragments, representing as they do various bodily sensations and signs reinterpreted as symptoms and mapped in geo-located form. Bodies themselves become represented as forms of disease in this mapping technology, their fleshly reality stripped down to their symptoms. Infectious diseases are also reinterpreted as digital objects via such technologies. They are constantly remodulated by new data inputs just as the digital portraits produced through the Autoscopia project continually reconstitute the ‘reality’ of an individual’s visage.

Digital technology practices produce new and constantly changing forms of digitised cyborg assemblages. When engaging in digital technologies, bodies and selves become fragmented in certain ways as various types of data on our selves and our bodies are transmitted along specific pathways but then joined together in new formations (Enriquez 2012). Via these accumulations of data about individuals’ bodies, the body is extended beyond the flesh into digital data archives. The data assemblages thus configured have separate, although intertwined, lives in relation to the fleshly bodies that they represent (Bollmer 2013).

The data assemblages that are configured from the diverse forms of data that are produced from our digital interactions are constantly shifting and changing as new data are added to them. Data doubles feed back information to the user in ways that are intended to encourage the user’s body to act in certain ways. When individuals receive positive comments or likes from social media friends or followers on the images or information they post about their bodies, thus may encourage them to continue in the enterprise of embodiment that they so publicised (whether this is a certain hairstyle, way of dress, use of cosmetics or fitness or weight-loss regime). If responses are negative or non-committal, users may represent their bodies or engage in different bodily practices in response. The flow of information, therefore, is not one-way or static: it is part of a continual loop of the production of bodily-related data and response to these data. Digital data doubles support a reflexive, self-monitoring awareness of the body, bringing the body to the fore. They are part of the augmented reality of the digital cyborg assemblage.

References

Autoscopia  (2013) Accessed 26 September 2013. Available from http://www.autoscopia.net/about.html

Bollmer, G.D. (2013) Millions now living will never die: cultural anxieties about the afterlife of information. The Information Society, 29 (3), 142-151.

Brubaker, J., Hayes, G. and Dourish, P. (2013) Beyond the grave: Facebook as a site for the expansion of death and mourning. The Information Society, 29 (3), 152-163.

The Digital Beyond  (2013) Accessed 19 December 2013. Available from http://www.thedigitalbeyond.com/online-services-list

Enriquez, J.G. (2012) Bodily aware in cyber-research. In H. Breslow and A. Mousoutzanis (eds) Cybercultures: Mediations of Community, Culture, Politics. Amsterdam: Rodopi, 59-72.

Gorton, K. and Garde-Hansen, J. (2013) From old media whore to new media troll: the online negotiation of Madonna’s ageing body. Feminist Media Studies, 13 (2), 288-302.

Lupton, D. (2013) The Social Worlds of the Unborn. Houndmills: Palgrave Macmillan.

The Visible Human Project  (2013) Accessed 28 March 2014. Available from http://www.nlm.nih.gov/research/visible/visible_human.html

 

The body-being-born: how women conceptualise and experience the moment of birth

Newborn child, seconds after birth. The umbili...

Newborn child, seconds after birth. The umbilical cord has not yet been cut. (Photo credit: Wikipedia)

Although there is a large body of literature about labour and childbirth in the social sciences, surprising few researchers have sought to investigate women’s experiences of the moment of birth.

Virginia Schmied and I recently published an article in the Sociology of Health & Illness that drew on interview data with Australian women who had recently given birth. We asked women to recount their birth stories to us, and the data that eventuated gave interesting insights into women’s perceptions and experiences of what we call ‘the body-being-born’. We use this term to refer to the foetus/infant, an ambiguous body at the moment of birth because it is not quite inside but not quite outside the maternal body. When inside the maternal body, this body is technically a foetus; once expelled from the maternal body, it is called an infant. But in the process of vaginal labour and birth itself, when the body-being-born is passing through the cervix, parts of this body (most commonly its head) slip inside and outside the maternal body, moving back and forth as the woman works to deliver the body.

This stage of labour, therefore, is a highly liminal one, involving the two-in-one foetal/maternal body in the process of individuating to become two separate bodies over a period of time.  Women who gave birth vaginally without anaesthetic often described this process as a ‘splitting’ of their bodies, a sensation of their bodies ‘opening to the world’ over which they had no control.

We found that most of the women we interviewed struggled to conceptualise this process, as it was so foreign to their embodied experiences. They also needed to take some time following the birth to come to terms with the idea that the foetus was now ‘my baby’: a body/self that was physically separate from their own, now foreign and strange as it was outside their bodies. As one of our interviewees put it:

The midwife handed her straight to me and I held her, but I had held her for a while, I just was — it was like looking at her and wondering ‘Where did this baby came from?’ You know, despite what I’d gone through, it was hard to associate that she was actually mine and she was out of my stomach … Even holding her for the first few minutes — just, it wasn’t like she was mine, my kid, which is weird …when you think of what you went through, it was really quite strange.

This is a time in which women have to deal physically and emotionally with the disrupted boundaries of their bodies, the significant distortion and opening that has occurred with the birth and the splitting of body/self. There is a sense of disbelief, of wonder that this amazing, unique and strange process has happened to them.

An important finding from our study was that women who had undergone a caesarean section had even greater difficulties coming to terms emotionally and conceptually with the notion that their infant was now separate from them; that they had, indeed, ‘had a baby’. Because they did not undergo the physical rigours and often intense pain of prolonged labour and the experience of actually expelling the body-being-born from their own bodies, and because their bodies were numbed to surgically deliver, women who had had a caesarean took longer to accept the fact that the infant was now out of their bodies. They talked about feeling alienated from their infants and struggling to come to terms that it was actually ‘my baby’. In the words of another of our interviewees:

It was very hard to think that she was my daughter after she was born, because I had a caesarean under general anaesthetic and all of a sudden I’m not pregnant any more. And I wake up a few hours later and you’re presented with a baby. You think, ‘Oh, why isn’t this, why aren’t I feeling any kicks in my abdomen anymore?’ — you know. And there’s the baby and it’s very hard to relate to it.

Virginia and I conclude our article by arguing that the circumstances in which women give birth are pivotal to how they experience the process of coming to terms with the body that was once inside them emerging to the outside. Our findings suggest that health professionals and attendants working with women in labour and childbirth need to allow not only for the physical and the emotional but also the ontological dimensions of how a woman experiences both her own body and that of the body-being-born, and the significant difference that undergoing a caesarean section can make to the woman being able to achieve the transition from two bodies in one to two separate bodies successfully.

Infant embodiment: how we think about and treat babies

The future King Louis XIV as an infant with hi...

The future King Louis XIV as an infant with his wet nurse (Photo credit: Wikipedia)

My article entitled ‘Infant embodiment and interembodiment: a review of sociocultural perspectives’ has been published in the latest issue of the journal Childhood. In the article I argue that the ways in which we think about and conceptualise infants’ bodies have been little explored, despite what is now a huge literature on the sociology and anthropology of the human body. Much of this literature addresses adults’ bodies; some of it looks at the embodiment of adolescents; a smaller proportion has discussed young children’s bodies. But very few academic articles or books have devoted specific attention to the youngest humans of all: those aged under two.

One exception is the American writer Jean Liedloff’s book The Continuum Concept, first published in 1975. In the book she describes her observations of child rearing practices of the Yequana, an indigenous tribe living in a jungle region of South America, with whom she lived for two and a half years. Liedloff found that these native Americans engaged in constant physical contact with their infants – they slept with their babies, breastfed them on demand for several years, and carried them everywhere in their arms or a sling, never putting them down on the ground until the infant began to crawl.

Another book-length analysis of infant-care practices is The Myth of Motherhood (1981). French historian Elizabeth Badinter details her research in this book into a period in the seventeenth and eighteenth centuries in France when aristocratic and middle-class women commonly farmed out their newborn infants to wet nurses. These wet nurses were paid to breastfeed and care for the baby, in most cases for several years. While infants of the aristocracy were usually cared for by the wet nurse at home, those of the more populous middle-class were simply sent to live with the wet nurse’s home. In both cases, the wet nurse became the ersatz mother and the actual mothers had little or no contact with their infants. Although many of these infants died due to extreme neglect on the part of their wet nurses, who usually had many infants to feed and care for, the practice continued to be extremely fashionable among members of French society who could afford it.

These two books, vastly different in terms of the human societies and the practices of infant care they describe, are similarly instructive: in detailing these diametrically opposed approaches to infants and infant care, they highlight the contingent and varying ways in which societies and cultures think about and treat their very youngest members. The one, focusing on a contemporary non-developed society that had had little contact with western ideas and practices, and the other, on a privileged social stratum in a western society some centuries ago, demonstrate that notions of appropriate infant care and ways to treat the infant body are constructed via social, cultural, historical and political processes. Infant bodies are gestated and born, but in conditions that are always subject to change in terms of how these bodies are conceptualised and treated by others, which has implications for how infants themselves experience their bodies.

In my article I discuss these aspects of infant embodiment. Drawing on the work of Merleau-Ponty (1962) on the phenomenology of embodiment, I make the point that infants’ bodies are always interembodied, or experienced in relation to others’ bodies. Indeed the care bestowed upon infants by their mothers extends the intersubjective and interembodied relationship that developed in the womb. I adopt the terminology used in a fascinating article by anthropologist Tahhan (2008) of ‘skinship’. This concept of ‘skinskip’ relates to the embodied closeness we feel to others’ bodies via acts of intimacy, physical proximity and caring that may involve blurring the boundaries between bodies and selfhoods. I think that it has great relevance to how caregivers relate to infants and goes some way to explaining the positive dimensions of concepts of infants’ bodies. Although she does not use the term, skinship is one aspect championed by Liedloff in The Continuum Concept in her describing of the benefits of constant physical contact with infants.

Via interembodiment, or skinship, carers’ and infants’ bodies interact, intermingle and are interdependent. This interdependence can be challenging and confronting in the context of contemporary western societies, where bodies are generally understood as ideally autonomous and separate from each other. While caring for an infant can be very pleasurable and sensual, it can also be extremely demanding and frustrating. It is socially unacceptable to admit this openly, but such a perspective finds expression in baby-care books such as those by Gina Ford, a British ex-nanny whose books on producing a ‘contented baby’ are bestsellers in the Anglophone world. Ford advises parents as to the importance of rigid scheduling of feeding, sleeping and even cuddling to ensure a ‘contented baby’ who does not wake its parents at night or encroach overly on their autonomy.

From this perspective the infant is positioned as an ‘uncivilised’, close to animalistic, being who requires much training to render its behaviour acceptable for entering human society. Establishing the autonomy and individuated embodiment of the infant is a priority, and the recommended bodily practices accord with this goal. The discourse of ‘training’ the infant, as if it were an animal, to conform to adults’ expectations and their ideals of autonomy and independence is common in these accounts.

As I contended in a previous post, there is often a blurring of categories between young children and animals. While companion animals such as dogs and cats have progressively become represented as child-substitutes and treated as if they are children, infants and young children in turn are often represented culturally as animalistic, not fit to occupy the ‘civilised’ spaces outside the domestic sphere such as the café, restaurant or aeroplane.

The relationship that we have with infants, therefore, can be paradoxical and ambivalent. At the same time as infants are viewed as increasingly precious, adorable and vulnerable, requiring and inspiring large amounts of caring and attention, they are also considered to be overly demanding, detracting from our own independence and right to autonomy.

References

Badinter, E. (1981) The Myth of Motherhood: An Historical View of the Maternal Instinct. London: Souvenir Press.

Liedloff, J. (1975/1989) The Continuum Concept: In Search of Happiness Lost. London: Penguin.

Merleau-Ponty, M. (1962) The Phenomenology of Perception (translated by C. Smith). London: Routledge & Kegan Paul.

Tahhan D (2008) Depth and space in sleep: intimacy, touch and the body in Japanese co-sleeping rituals. Body & Society, 14(4), 37—56.