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.