Both Testing Women, Testing the Fetus and “Blessing Unplanned Pregnancy: Religion and the Discourse of Women’s Agency in Public Health” shed light on the social and moral view regarding mothers and their babies. Even though this weeks stance may be slightly different from previous weeks discussions regarding Assisted Reproductive Technologies, the decision about whether to continue with a pregnancy still plays a critical role in understanding the medical ethics, laws, and societal viewpoints that exist in modern-day.
Rayna Rapp wrote Testing Women, Testing the Fetus following her decision to have an abortion once prenatal diagnosis (PND) confirmed her fetus had Down Syndrome. Her decision to write the book led her to conduct fifteen years of extensive research on PND and analyze interactions between doctors and patients (Rapp 5). In her book, she mentions that miscommunication between patient and doctor are not just caused by differences in language, but also because of differences in philosophy. The branch of philosophy she mentions includes beliefs about what makes up a supportive parent and beliefs about the moral standing of a fetus. Another argument Rapp makes is that full cooperation between patients and physicians can never be accomplished because of two main reasons: lack of objectivity on the side of the physician and the complexity of a patients belief structure. She continues to mention that common social indicators such as race and gender are not enough to fuel this mutual cooperation (Rapp 79). With regards to PND, the above issues exercise a huge burden on the pregnant mother; if PND confirms Down Syndrome or some other disease, the mother faces a decision regarding her future if she were to continue with the pregnancy. This entails more commitment to the child, which involves less occupational opportunities and more emphasis regarding health standards of the child (Rapp 165).
Rayna Rapp’s book ties in well with the first week’s discussion regarding if abortions should be allowed in circumstances affecting the health of the mother/fetus. Numerous women take this question into account when finding out that their fetus has Down Syndrome or some other disease. Arguments over whether abortion should be allowed in this matter still exists, but the book by Rapp sheds light on reasons why abortions do take place in these circumstances; they include the belief systems of a patient and the risk measures in play (Rapp 53).
“Blessing Unplanned Pregnancy: Religion and the Discourse of Women’s Agency in Public Health” is an article which discusses “unintended blessings” and contraception in Naomi’s house. Naomi’s house is a shelter located in the southeastern portion of the United States and specializes in providing clients with childcare and educational resources to make them more economically and emotionally independent (31). The “unintended blessings” in this article refers to women becoming pregnant without intentions to do so. Even though numerous women at Naomi’s house agreed the “unintended blessings” came as a shock/scare at first thought, they admitted that it provided them with the opportunity to begin a fresh start in life (34). A example can be seen through the following quote: “Naomi’s house residents frequently described pregnancy or motherhood as effectively beyond their control…that motherhood provided the context for them to start over, receive blessings, or triumph over adversity” (35). Eva, one of the residents, decided to go back and finish high school, not allowing two unplanned pregnancies deter her from receiving a diploma. With regards to contraception, the issues of poverty and access to contraceptives play an important role. An example is seen when a resident named Regina became pregnant when her local pharmacy stopped carrying the birth control pills she used (39-40).
“Blessing Unplanned Pregnancy: Religion and the Discourse of Women’s Agency in Public Health” is an article which has a focus on a mother’s outlook on an unplanned pregnancy. The article reminded me of week three’s class discussion where it was brought up that the needs of pregnant mothers and hospital patients are sometimes not discovered because the question of what issues surround the individual at hand are never asked. While reading, I felt that the researchers that went to Naomi’s house kept this question in mind and it helped them better understand the residents. Examples include asking Regina why she stopped using contraceptive methods and what determined patients such as Eva and Demetria to go back to school to receive a diploma (35,40).
Overall, both readings provided a detailed analysis of the situations pregnant mothers face. The complex intertwine of differing ideologies and moral obligations still continue to cause conflicting feelings among individuals, but they play an important role in revealing the beliefs of people, which ultimately help progress the discussion of medical ethics in society.
Questions to Consider:
What connection do you see between the two readings?
Why do you think there exists a lack of connection between physicians and patients?
What steps can be taken to improve physician-patient interaction?
How do you interpret the word “blessing” when it refers to unplanned pregnancies?
This post offered a nice connection to the readings and an insightful reflection on women’s ideas toward their reproductive decisions. The idea of miscommunication between doctors and patients stood out to me as well as something worth discussing farther. Rapp describes how doctors and researchers used to dominate genetic counseling services. But the genetic counselor developed as a kind of middle-man between the doctor and the patient. Typically female, she could connect with patients and understand their anxieties about pregnancy more than the male-dominated field of medicine. I would argue that genetic counselors are important to conveying concerns about these issues, but that doctors are equally important in these matters. Indirect communication through genetic counselors would sever the doctor-patient relationship and encourage doctors to become even more objective. Rapp describes the inherent distance between medical professionals and patients. This is a problem that is complicated to overcome, but changes must be made in the field so genetic counselors, patients, doctors, and the geneticists who determine the test results can work together effectively. Cultural sensitivity is an important aspect of healthcare that should be emphasized and understood.
I agree that miscommunication is worth communicating about! What, besides cultural sensitivity training, would you recommend?
Unit Five:
Rachel, thanks for your response. I agree with you that a female genetic counselor would be extremely beneficial due to them being able to better understand the situation the pregnant mother is facing. When you mention changes should be made so all parties can work effectively, you are correct. It is a complicated task to complete, but am curious on how you feel it could be accomplished?
I feel one way to achieve the goal is for doctors, patients, and counselors to get together and talk about any disagreements they might have. Once they are outlined, they can progress in satisfying the needs of the mother and ultimately make the best decision regarding the baby.
Thank you for your commentary on the blog post. You really integrated them well with each other, allowing me to see how they relate to one another. You also connected this week’s readings to other readings we had in the class in previous weeks. This is great because I am now starting to tie some of the content together instead of thinking of them as separate topics. I wish I heard some of your voice within this blog post. What did you think of the readings? Would you have done some of the same things if you were in their shoes?
Lastly, do not forget to proofread. Although it did not completely steer my attention away from the reading, it would have been more fluent with correct punctuation. Great job on the blog post. You had very detailed writing!
In response to your questions, I think physicians can be more open-minded and can take the time to ask questions that will help the physician learn more about their moral values. This will help to get an insight on their complex moral structure. If one cannot know everything, it is worth it to try to learn at least a little bit of it.
Thanks Giang. You are getting good at offering comments for improvement.
Hi Petar. This was a good summary of the readings, but I would like to see more of your own critical engagement with the texts. How about suggesting some of your own answers to the questions raised? or methodological critiques? Try to push yourself from reporting on the readings to also commenting on them.
Dr. Seeman,
I would like to offer some insight on one of the questions I proposed: “How do you interpret the word ‘blessing’ when it refers to unplanned pregnancies?”. I feel it is referring to how the pregnant mothers view their pregnancy as a chance to get a fresh start in life, leaving some dark parts of their past life behind.
I do also want to point out how this meaning of “blessing” differs from the meaning we saw in Genesis 1, where it meant an “instruction”. It serves to show how the same word can mean something vastly different when used in a separate context. If there is more behind the meaning with regards to its contextual use in this week’s article, I would be more than happy to learn more about it.