This week’s readings differ from the topics we have covered thus far in class. While we’ve discussed the aspects of artificial reproductive technologies (ARTs) as they affect people of different faiths, this week’s readings branch off and detail a mostly female approach to options considered during an ongoing pregnancy.
Testing Women, Testing the Fetus is a full-length ethnography by Dr. Rayna Rapp. Her ethnography covered a spectrum of topics relating to the healthcare system, discussing the history of genetic testing, the current prenatal testing (amniocentesis), healthcare reform in the United States, and ethnic disparities in the healthcare industry. Her methodology involved qualitative interviews of patients receiving prenatal testing and genetic counselors, which provided her with a comprehensive evaluation of prenatal testing from both perspectives. Her background also provides a unique perspective to this ethnography, as she had gone through the procedure of prenatal testing, received a positive diagnosis of Down Syndrome for her fetus, and decided to terminate her pregnancy (pg. 3).
Throughout the discussion of ethnic differences in the female perspective to prenatal testing and pregnancy, Dr. Rapp talks about the cultural ideological differences that arose with genetic testing. One part of the ethnography that stood out to me was the disparity in understanding familial history. As Dr. Rapp points out, some research participants were adamant that the environment surrounding them was more likely to influence their child, as opposed to the family history of the parents (pg. 163). Similarly, I was intrigued to learn that parents who already had children found themselves more confident that their body would produce healthy babies, especially when compared to first-time parents of a higher socioeconomic status (pg. 69). This disparity was evident through prenatal testing, as the statistics showing a Down Syndrome occurrence of 3 in 1000 births were perceived differently in those two populations of parents. Another ethnic difference she discusses surrounds populations in which a male child is preferred to a female child, resulting in fetal femicide, a practice more common in Asian populations (pg. 94).
The other reading from this week was an article from Medicine Anthropology Theory, titled “Blessing Unintended Pregnancy,” written by Dr. Seeman and his colleagues. This article displayed results from their ethnographic research conducted at Naomi’s House, a homeless women’s shelter with a predominantly African American population. Many of the research subjects were women who decided to raise their children independently, with the exception of one woman who was living with her partner (pg. 39). Like the title suggests, this article examines the beliefs of women who were faced with an unplanned pregnancy, yet many of whom still deemed the pregnancy as a blessing. Many of the women interviewed indicated that their child was a strong reason to pursue a “better life,” and in cases of teenage pregnancies, continue their education or leave destructive familial situations.
In addition to questions regarding their pregnancy, these women were also approached with questions about their faith and spirituality. Although the shelter itself was non-denominational, there is a religious history to the center, even though a majority of its residents identified as “spiritual but not religious” (pg.41). A majority of the interview participants responded that their pregnancy was intended by “an agency that trumps human planning,” even if it was not intended by themselves (pg. 42).
While Dr. Rapp’s ethnography details the genetics of prenatal testing and the decisions parents have to make to choose the procedure, Dr. Seeman’s research discusses the choices left in the hands of (mostly) single, pregnant women. Despite the differences in ethnographies, both discuss the need to understand each other’s perspective of reproduction.
Dr. Rapp describes a divide/miscommunication between the patient and healthcare provider – do you believe this is accurate? Do you think this is limited to prenatal testing or do you think this is prevalent in other areas of the healthcare field?
How would you distinguish the differences between being religious and being spiritual and how do you think this affects women during pregnancy?
Dr. Rapp examines the implications of prenatal testing toeing the line between reproductive rights and disability rights. Based on what we’ve read this week, what are your opinions of this debate?
In Testing Women, Testing the Fetus, Dr. Rapp discusses the limitations to prenatal testing. She talks about how certain members may have access to the testing, but not have access to the subsequent procedures, such as selective termination – if this is the case, do you believe prenatal testing is still important?