Digitising female fertility and reproduction

Over the past few months, I have been working on writing about the findings of several research projects addressing the topic of digital technologies directed at female fertility and reproduction. These projects involve:

1) a critical content analysis of fertility and reproduction-related software and devices (especially apps);

2) an online survey of 410 Australian women’s use of pregnancy and parenting apps; and

3) focus groups and interviews with Australian and British women about their use of these technologies (these are still in progress).

Several outcomes have now been published drawing on these findings. They include a report (with Sarah Pedersen from Robert Gordon University, Aberdeen) outlining the findings of the online survey (this can be accessed here), an article on the gamification and ludification of pregnancy in apps (with Gareth Thomas from Cardiff University, available here) and a book chapter on the concept of the reproductive citizen and the range of digital technologies that are directed at helping women to monitor and regulate their fertility and reproduction (available here). Edit: two other articles have now been published: one based on the survey findings (here), and another on the pregnancy app study (here).

Some of the key findings are:

  • The survey showed that pregnancy and parenting apps were very popular among the survey respondents – three-quarters of the respondents (who were either pregnant or who had a baby in the past three years at the time of the survey) said that they had used at least one pregnancy app, while almost half had used at least one parenting app.
  • Googling information about pregnancy is very common among pregnant women, for whom too much information about pregnancy appears never to be enough (this finding emerged in the focus groups). They tend to invest their trust in the first few search findings that come up on their search engine, reasoning that because this is evidence of popularity, then these websites must be credible.
  • Despite the popularity of pregnancy and parenting apps, few women are contemplating the validity of the information presented in them, or demonstrated concern about the data security and privacy of the personal information that the apps may collect (this was evident in both the survey and the focus groups).
  • This genre of software is intensifying an already fervid atmosphere of self-surveillance, attempts at management and control and self-responsibility in which female fertility and reproduction are experienced and performed.
  • Stereotypical concepts of idealised female fertile and pregnant bodies are reproduced in apps and other software. They use highly aestheticised images and the promise of rational calculation and monitoring to seek to contain and control women’s fertility and reproduction.
  • Women in their fertile years – and particularly those contemplating pregnancy or already pregnant – are part of a highly commodified demographic. The information that they generate from their online practices possess a new form of value, biovalue, as part of the bioeconomy of personal health and medical data.

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.

The ‘royal foetus’ as fetish

First Ultrasound

First Ultrasound (Photo credit: amysinfo)

Within hours of Kate Middleton’s pregnancy being officially announced, references were being made on the internet to a new individual: the ‘royal foetus’. Several spoof Twitter accounts were set up on behalf of this personage, providing ‘live tweets from the royal womb’. Other tweeters commented that the royal foetus was already richer and in a greater position of power than they (see here for my Storify of initial reactions to Middleton’s pregnancy).

While this seems like harmless fun, underpinning these representations of the ‘royal foetus’ is an inexorable move in western cultures towards the infantilising of the unborn, positioning them as already babies well before birth. More so than at any other time in western cultural history, the unborn are considered separate from the maternal body, autonomous, possessing individuality, personality and full moral personhood from embryonic form onwards.

The emergence of the unborn into the public spotlight began with the beautiful images produced by photojournalist Lennart Nilsson (ironically mostly of dead embryonic and foetal specimens) from the 1950s onwards that showed unborn bodies floating serenely in space, seemingly untethered to the maternal body. It has intensified with the growing use of obstetric ultrasound since the late 1970s, a visualising technology that encourages pregnant women and their partners and family members to view the foetus as a little person in its own right, very much distinct from the body in which it is growing.

The image of the unborn has become a commodity. Since the development of 3/4D ultrasound marketed solely for ‘bonding’ purposes, potential parents are invited to begin their ‘baby albums’ with these ultrasounds, which are often widely shared with friends and family via social media platforms. Ultrasounds are now used in a range of goods, including advertisements, canvas art, scrapbooking materials, specialised photo frames, baby shower invitations, jewellery and maternity t-shirts (see here for my Pinterest collection ‘The Ultrasound as Cultural Artefact’).

The gradual disappearance of the maternal body as it gives way to the fetishising of the foetus has occurred at the same time as pregnant women are positioned as being ever more important to the health and optimal development of their unborn (Lupton, forthcoming). It seems that dominant representations of the pregnant body either erase it completely, as in the visual imagery of the autonomous foetus, or position it as engulfing and threatening to the unborn. Pregnant women must negotiate these two paradoxical portrayals. Kate Middleton will do so in the context in which hers will be the most public pregnancy in the world. She will be under intense scrutiny to provide the ‘royal foetus’ with a uterine environment worthy of its rank.

Reference

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

The case of the pregnant CEO and the disappearing body

Marissa Mayer

Marissa Mayer (Photo credit: ifindkarma)

When it was announced last month that Marissa Mayer, the new CEO of Yahoo, a Fortune 500 company, was six months’ pregnant at the time of her appointment, many commentators in online and traditional news media forums were approving. It was noted that Yahoo’s decision to appoint her was a sign that women had come a long way and were no longer as disadvantaged by their reproductive choices. When Mayer further announced that she would only be taking few weeks off on maternity leave following the birth of her baby son, and that she would work from home even during this brief period of leave, again the reaction of many commentators was positive. It was argued that a good example was being set and that women even at the very top of their professions could both reproduce and continue in their successful careers.

The issue of the successful woman ‘having it all’  resurfaced for debate. Some commentators were concerned that Mayer’s decision to work through an extremely brief maternity leave would raise the expectations of employers in relation to their own female employees. Several ‘mummy bloggers’ pointed out that Mayer may not realise how having a baby may affect her priorities. Interestingly enough, little mention was made of the huge attention given only weeks before to Anne-Marie Slaughter’s article in The Atlantic, in which she identified the difficulties she and others had experienced in juggling motherhood with an extremely high-profile and demanding job.

To make it clear, I do not doubt that Mayer will be able to perform at the level expected of her during her pregnancy and following the birth of her son. I agree that it is salutary that she was promoted to the top job by recruiters who knew of her pregnancy. I imagine that Mayer will not display the projectile vomiting and uncontrolled emotional volatility evidenced in the pregnant women in the recent film What to Expect When You’re Expecting, an exaggerated portrayal of pregnant embodiment played for laughs (see here for my previous post on this). What I do want to do in contributing to this debate is bring the body back in (rather more subtly than this film did) and suggest that these bodily experiences may make Mayer’s first year in the job more challenging than if she had not gone through them.

All the noises of approval emerging in the traditional and social media, and the comments of Mayer herself, failed to acknowledge that pregnancy, childbirth, the post-partum period and the care of infants are supremely embodied experiences. The classic Cartesian mind/body split is evidenced in these discussions, assuming that one’s disembodied mind or will can and should take precedence over and control one’s fleshly body.

On one level the acceptance that a pregnant woman soon to give birth will be able to manage a top-level job is a feminist dream. It counters the common ideas in circulation for centuries that women are inferior to men because they are less able to exert rational control over their bodies and are therefore less capable of jobs involving high-level cognitive functioning. Such assumptions position the pregnant, menstruating or menopausal woman in particular as emotionally volatile, a slave to her hormones.

On the other hand, however, the discourse celebrating Mayer’s choice to work through her brief maternity leave loses sight of the fleshly body altogether. This attempt to make the body disappear bears with it its own limitations. Even those women who experience few health problems and feel very well during pregnancy cannot avoid the sheer physical reality of moving through space with their expanding and much heavier bodies, as the feminist philosopher Iris Marion Young (1990) has noted.

So too, childbirth, however it is experienced, demands much of women’s bodies, and it takes some time for women to recover in the postpartum period. This is especially the case if they have had the major abdominal surgery of caesarean section, extensive damage to the perineum or other physical trauma from a vaginal birth. Mayer will be dealing with these embodied experiences at the same time as she is learning to interact with and care for her new infant. Her baby son will himself be taking some time to adjust to life outside of the womb and making his own embodied needs powerfully apparent.

Although no doubt Mayer will have plenty of help from paid and unpaid carers, unless she employs a night-nanny or her partner rises to deal with bottle-feeds, nappy changes and infant soothing during the night, she will experience major sleep deprivation. Even if she does not breastfeed, she will have to deal with leakages and physical sensations as her breasts adjust to hormonal changes following the birth.

Mayer is in a rare top position as CEO of a major company. Yet this exalted position means that she, even more than other women, will be expected to conform to what philosopher Drew Leder (1990) has termed the ideal of the ‘absent body’: the body of which we and others are unaware because it is so fully under our rational control. The culture of the professional world in particular seeks to ignore the demands of the fleshly body. Cultural geographer Robyn Longhurst’s (2001) research with New Zealand and Scottish people in managerial work positions, both men and women, found that the interviewees strongly emphasised the importance of presenting a corporate body image at work. This involved being well-groomed, wearing a standard ‘corporate uniform’ of business suit and having a body that was physically fit and not overweight. Even cosmetic surgery is now becoming part of the techniques of the presentation of the professional self for some people in their quest to present the most perfect image possible.

All these practices of the self combined to present a corporate identity that was considered tightly controlled of its body boundaries, impervious to outside penetration and therefore powerful and rational. In such a context, the body, in effect disappears: its demands, its privations, its leakages, are all covered over in the interests of presenting a self that is rational, of the mind, competent and controlled. It is for this reason, as Longhurst (2001, 2005) points out, that women in such workplaces often find it difficult when they are pregnant and experiencing nausea, fatigue, the frequent need to urinate or crippling back-ache, all common bodily experiences in pregnancy, as they feel that they must not let their bodies betray them.

In pointing out these issues, I want to avoid any suggestion that women are any more at the mercy of their bodies than are men and that they therefore cannot perform successfully in top-level jobs. John Coates (2012) showed in his recent book on male traders at the New York Stock Exchange that much of their behaviour is influenced by fluctuations in hormones such as testosterone, adrenaline and cortisol. This leads in some cases to excessive exuberance bordering on mania or conversely pessimism that can then affect their decision-making and have major repercussions for the economy. As Longhurst’s research showed, both men and women in the professional workplace are expected to conform to a certain body demeanour and presentation. Those individuals who are overweight, perspire heavily, have a drinking problem, have a disability or chronic illness, are emotionally volatile and so on are viewed as not conforming to the desired norm, regardless of their gender.

I certainly do not wish to support contentions that pregnant women and new mothers should withdraw from the public sphere, as was common in previous eras. But a continuing corporate culture in which the demands and needs of the living, fleshly body are ignored or discounted potentially disadvantages all workers

References

Coates, J. (2012) The Hour Between Dog and Wolf: Risk Taking, Gut Feelings and the Biology of Boom or Bust. Toronto: Random House Canada.

Leder, D. (1990) The Absent Body. Chicago: University of Chicago Press.

Longhurst, R. (2001) Bodies: Exploring Fluid Boundaries. London: Routledge.

Longhurst, R. (2005) Maternities: Gender, Bodies and Space. London: Routledge.

Young, I.M. (1990) Throwing Like a Girl and Other Essays in Feminist Philosophy and Social Theory. Bloomington: Indiana University Press.

The ‘milkmother’: an intriguing way of conceptualising motherhood

National Museum

National Museum (Photo credit: Wikipedia)

The other day I came across a new term in the feminist journal Hecate – ‘milkmother’, a term invented and used by Pamela Douglas (2010). Douglas uses ‘milkmother’ to ‘denote the pregnant, birthing, and physiologically, or metaphorically lactating woman’. She argues that ‘lactating’ not only incorporates its literal meaning — secreting breast milk for the consumption of an infant — but also a metaphorical meaning  — ‘offering the particular minute-by-minute physical nurturance that very young children require, regardless of feeding method’. Lactating in this metaphorical meaning, therefore, involves the giving of the self to one’s child in the myriad of ways that is demanded of mothers: touching, cleaning, holding, cuddling, stroking, feeding, dealing with illness, rocking to sleep, constantly thinking about and meeting the child’s needs.

The concept of the milkmother for me encapsulates the blurring of the boundaries of the body/self a woman experiences during pregnancy, childbirth and caring for infants and young children (Lupton 2012). As I noted in an earlier post ‘Pregnancy and loss of control’, pregnant bodies are considered permeable and uncontained. So too, for women engaging in caring for their infants and young children, their bodies/selves become intertwined with those of their children. This involves what sociologists of the body describe as ‘intercorporeality’, or the blurring of boundaries between bodies. Milkmothers find themselves as embodied subjects, thinking through and with their bodies as they interact with their children. Their sense of self becomes intersubjective, or linked to that of another/s. No longer autonomous and individuated, milkmothers respond to their children in relational and interdependent ways.

This blurring of subjectivity and bodies, however, can be confronting. Some women experience pregnant embodiment as confronting in its two-bodies-in-one state, and feel as if their own body is being ‘taken over’ by the preborn body. They even describe pregnancy as like being occupied by an alien Other. Many women feel challenged by the demands made upon them by their infants and young children. These feelings are articulated when women discuss their embodied relationship with the breastfeeding infant. Many find the intercorporeality of the experience highly pleasurable and contributing to strong feelings of intimacy and tenderness with the infant. Others find this intercorporeality confronting and engulfing of their own sense of body/self. In one of my articles (Lupton, 2000) I referred to the ‘love-hate’ relationship some women talked about in interviews about their early mothering experiences. They had invested in the ideal of the ‘good mother’ as always ‘being there’ for her children, but also found this to be difficult to live up to.

My research suggests that the experience of motherhood, at least during the period of infancy and early childhood, may never fully include a strong sense of individuation from one’s child’s body (see Lupton 2012). Nor does this process necessarily follow a clear trajectory: mothers may move between states of interconnectedness, at times feeling very close and ‘at one’ with their foetus/infant, at other times experiencing their bodies/selves as very separate from, and even in conflict with, the infant body/self.

Being a milkmother clashes with the independent, autonomous self that is so valued in post-femininist western societies. It also conflicts with the ‘Yummy Mummy’ persona that Douglas discusses in her article. The ‘Yummy Mummy’ appears to be supremely untroubled by any bodily or emotional effects of caring for her children and expresses the same autonomous self of those without children. Her body is slim, fit and attractive, not leaking fluids such as breast milk or rendered flabby from excess weight put on during pregnancy. Unlike the ‘milkmother’, therefore, this maternal archetype appears to be able to contain and discipline her body, and to individuate her sense of self and embodiment from her children. She appears serenely unchanged by the enormous physical and emotional alterations caused by pregnancy, childbirth and motherhood.

Douglas calls for more positive representations of the milkmother that goes beyond the unrealistic ‘Yummy Mummy’ persona. The emotional and bodily experiences of mothers of infants and young children, she asserts, need to be recognised and celebrated but not airbrushed. The blurring of bodily boundaries, the heightened emotions of the caring experience (including the frustration, anger and even hate that women may feel at times towards their children) and the physical changes, both reversible and irreversible, wrought by motherhood — all these should be acknowledged and accepted as integral to the experience of early motherhood.

References

Douglas, P. (2010) Yummy mummy and the medicalised milkmother. Hecate, 36(1/2), 119–35.

Lupton, D. (2000) ‘A love/hate relationship’: the ideals and experiences of first-time mothers. Journal of Sociology, 36(1), 50–63.

Lupton, D. (2012) Configuring Maternal, Preborn and Infant Embodiment. Sydney Health & Society Group Working Paper No. 2. Sydney: Sydney Health & Society Group. Available here.

Pregnancy and loss of control

A recent review of the pregnancy film What to Expect When You’re Expecting observed that it conforms to the ‘frat house movie of the 1980s’ genre in its focus on unruly bodies and leaking body fluids such as vomit and urine (http://tinyurl.com/6wxpf8x ). This film joins a long line of cinematic representations of pregnant women as ruled by their hormones, emotionally volatile, permeable and altogether departing from the conventions of orderly embodiment. The pregnant woman who cries, loses her temper, eats strange things or eats excessively, balloons to huge proportions and experiences her waters breaking in public have all become stock-in-trade images of pregnancy in popular culture.

These depictions of pregnant women conforms to a general societal view that women in general, and pregnant women in particular, are emotionally and physically unstable. The film’s trailer features one of the pregnant women crying on a television show, saying ‘I have no control over my body or my emotions’, something that clearly distresses her. Control over one’s embodied self is a central dimension of contemporary western societies. The contained, tightly controlled body is privileged over what is viewed culturally as the unregulated, uncontained, excessive body. Pregnant women and women in childbirth are the archetypal uncontained bodies, leaking and permeable both literally and symbolically. Pregnancy is a highly culturally ambiguous state. The pregnant women is an anomaly because of the ways her body transgresses boundaries between self and other. She is, for a time, two bodies in one, a state experienced by no other human body.

Women often experience pregnancy as a time in which their bodies no longer seem to belong to them. Pregnant bodies are seen by others as no longer private: they become public bodies, viewed as public property. Other people constantly make observations about pregnant women’s size and monitor pregnant women for their behaviour to ensure that they follow what is deemed to be appropriate for their own health and that of their baby. Pregnant women also express concern that their bodies will let them down in public places by leaking inappropriate body fluids: vomit due to morning sickness, for example, or their ‘waters’ (amniotic fluids) breaking. They all too aware of the public censure and disgust which accompanies such loss of control. Many feel as if they should withdraw from public space because of self-consciousness about their bodies, physical discomfort, concerns about losing control over their bodies and the difficulty of conforming to expectations of how a ‘proper’ pregnant woman should comport herself (Longhurst, 2005).

The age of the first-time pregnant woman can make a difference to how she feels about her pregnant body. British research (Thompson et al., 2011) using interviews with women from a wide range of age groups found that for younger women (aged under 25) pregnancy was seen by many as part of their youthful capacities, the body as taken-for-granted youthful femininity, part of their physical capital. Their pregnant bodies may also have been viewed as a source of shame, however, something that others judged them about because they were pregnant so young. For women in the age group 25 to 35, the body and maternity was a more self-conscious project. They were often aware of their lessening capacity to become pregnant and of the need to juggle career imperatives with maternity, involving much forward planning. Older women (those aged over 35) still sometimes viewed their bodies anxiously as vulnerable, unruly and likely to let them down, particularly if they had previously experienced fertility problems or miscarriage.

Interestingly, at a time in which the pregnant body is viewed as deviating from the norm in its inability to contain and regulate itself, it is also portrayed in popular culture as valuable, precious and a state to be aspired to: the apotheosis of true womanhood. This is particularly the case for celebrities who are pregnant and for the models who feature on pregnancy magazines and websites, glowing with health and radiating ‘natural’ beauty. These pregnant women are positioned as ideal-type pregnant women, with nary a varicose vein, stretch-mark or morning-sickness vomit stain in sight. Such women seem to have contained their permeability, their tendency towards bodily uncontainment, through sheer will-power. They are particularly esteemed if they have managed to control excessive weight gain during their pregnancy, suggesting their ability to exert power over any pregnancy-related cravings or appetites (Gentile, 2011). Such pregnant women are viewed as especially virtuous because they have managed to tame their unruly bodies at a time when it is expected that the body is very much in control of the self.

References

Gentile, K. (2011) What about the baby? The new cult of domesticity and media images of pregnancy. Studies in Gender and Sexuality, 12(1), 38–58.

Longhurst, R. (2005) Maternities: Gender, Bodies and Space. London: Routledge.

Lupton, D. (2012) Configuring Maternal, Preborn and Infant Embodiment. Sydney Health & Society Group Working Paper No. 2. Sydney: Sydney Health & Society Group. Available at http://hdl.handle.net/2123/8363.

Thomson, R., Kehily, M.J., Hadfield, L. and Sharpe, S. (2011) Making Modern Mothers. Bristol: The Policy Press.