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.
Discussion Questions
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?
Sai-I really liked the questions you posed at the end of this article as they were some of the same issues and thoughts I had when doing the reading this week. Your question considering reproductive rights and disability rights was very interesting to me. I had studied abroad in Denmark last semester and I remember speaking to a young doctor who was telling me that when doing the neck crest exam to screen for down syndrome, Danish doctors are told to recommend to the mother to have an abortion if the test is positive. Something about this really stuck with me and I felt a similar feeling while reading this weeks reading. I think that testing is a really, really important option that should be available for all pregnant mothers, if only to have information about the health status of the fetus. However, I think that not placing any type of “recommendation” or suggestion is important for disability rights. In my opinion, mothers should have the choice to make for their future child and doctors should be there to provide support and information to the mother, no matter what the decision is.
Do you think that the freedom to choose you propound here should be linked in some way to people’s ability (financial and otherwise) to care for a child with a disability? Or is it simply society’s responsibility to help care for such children when they are born?
Hi Greeshma,
I really like the questions at the end of your blogpost – most of which I think are really hard to answer.
One part of the reading “Blessing Unintended Pregnancies” was the following: “I needed to start over; I needed to better myself for my
children. I needed to stop and break the pattern, so I went there’. Starting over was part of a complex set of meanings associated with pregnancy and blessing…”.
First of all I was really surprised to learn that unintended pregnancies could come with such positive effects. I guess from the standpoint of someone who would be considered as socioeconomically privileged and as someone who is mostly surrounded by such people, unwanted pregnancies have always seemed like something negative, like an unwanted change in life which one is not prepared for. It was really interesting to look at unwanted pregnancies from a standpoint of making a life of a woman in an underserved and underprivileged community better. Before reading this text I thought and unwanted pregnancy for a woman in an underserved community would be the opposite of a blessing, as it would come with a financial burden as well as possibly many social issues. I think it is amazing to read how these women used pregnancy as an inspiration to better their lives and change them in so many ways.
As for your last question “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?” – I think this is a great question! From a perspective of someone who wants to pursue medicine/science I think it is important to have such testing, even if procedures like termination of pregnancy are not available. In my opinion it is important to have access to all the information (as far as reasonable medical procedures go) during the pregnancy, so one can prepare for any possible disabilities of the child by learning about them. One can do so by talking to other parents whose children are affected by similar disabilities, talking to doctors and other professionals, and preparing for maybe an added financial burden due to the disability because their child might need more care than able-bodied children.
Thanks, I appreciated your honesty here.
Most of the time, I believe that there is a divide or miscommunication between the patient and the healthcare provider because sometimes the healthcare provider does not take the opinion and thoughts of the patient into account. The healthcare provider just wants to only use their expertise to provide advice. This is prevalent in other areas of the healthcare field as well such as, from personal experience, regular check-ups and dermatology appointments.
Furthermore, to answer the question on religious and spiritual, being religious is identifying with one or more religions and following their traditions whereas being spiritual is not identifying with one specific religion but still believing in a higher power or entity. One’s religion or spirituality will help guide women in what they should or should not be doing during pregnancy. It will also affect how the woman thinks of the baby, whether the baby is a gift from God or a product of her choices.
I like how you compared this week’s reading to other week’s reading by starting off with a small introduction. It help to set up the premise of this week’s readings. I wish I saw more integration between the readings, to see how they all fit together. Other than that, you had clear and concise writing!
This was a good, helpeful comment.
Unit 5 Blog Response
Hi Greeshma! I really liked your analysis on the two readings and how they approached perspective son reproductions from various angles. I was also very intrigued by the Dr. Rapp’s description of the difficulty in understanding family history. Along the lines you discussed, Dr. Rapp mentioned how “silence or ‘no’ in response to familial health questions from a counselor may result in one of a number of misinterpretations (page 81)” This showed the importance of language and cultural barriers that exist in the medical world. I had the opportunity to volunteer at an Islamic free clinic in Atlanta this past summer that caters to all religions. I got to take vitals and do the initial family history and I noticed similar issues such as being a female communicating with conservative Muslim men or finding words that make sense to the patient though I wasn’t completely fluent in Hindi. The director of the clinic presented these issues during our orientation as “issues that will always arise with any free clinic, especially one founded by an Muslim organization.”
This also segues into the question you posed about the role of religion versus spirituality during pregnancy. Just like the free clinic I volunteered at, Naomi’s House was founded with religious roots but caters to all religions and requires religious-neutral counseling. I thought this was interesting because as you mentioned most women at the shelter identified as “spiritual,” but it was stated, “local religious institutions and religious ideas did contribute to the ethos of the shelter (page 32).” Thus to me, it almost seems like being religious in aspect to this topic has gained a negative connotation and more people choose to be spiritual about it. It got me questioning to what extent that the current political climate around unplanned pregnancies and abortion plays a role in this connotation and how the women at Naomi’s House took it into consideration when presenting their views on abortion laws?
Do you accept the religion/spirituality distinction raised in this article? One of my arguments is that it is a problematic one. I would like to hear more about your experiences.
Thanks for this. These are good summaries of the reading, with good use of citation. In the future, it would also be a good idea in the future to be a bit more detailed in critical reading– not just what questions you have but also how you think we might resolve them. You asked whether people agreed with one of Rapp’s conclusions. Well, what do you think?
Hi, Dr. Seeman – Thank you for your feedback.
It has been difficult for me to come to a conclusion regarding the debate between disability rights and reproductive rights. I see both sides to the conversation, but I am struggling to find my stance on this issue, so I wanted to see how some of my peers felt about it.
Regarding the miscommunication between patients and healthcare providers, I do think that this is a problem that can be generalized to more areas of healthcare, other than reproductive medicine. For the past three years, I have been working in the Sickle Cell Disease department at Emory, and our goal is to publish a website to inform patients and family members so they can make the most informed decision while figuring out what’s best for them. While transcribing the interviews, I learned how common it is for patients to not fully understand their own bodies and potential treatment options available. Knowing this is prevalent in other areas of the healthcare industry, I can understand Dr. Rapp’s discussion regarding this issue in reproductive care.