The Tentative Pregnancy: Prenatal Diagnosis and the Future of Motherhood/Reflections: On Hard Work
Reflections: On Hard Work B.K. Rothman (1986b). Qualitative Sociology 9(1), 48-53
Amniocentesis is a prenatal diagnostic technique used to detect genetic disorders in fetuses. Barbara Katz Rothman has written an evocative book, The Tentative Pregnancy: Prenatal Diagnosis and the Future of Motherhood, in which she discusses some of the ramifications of the procedure for women and society. She writes sensitively about women who have used the test. Rothman's fieldwork, which forms the back-bone of the project, includes extensive interviews with women and medical professionals. The voices of the interviewed women come forth strongly in the text, consequently bringing their seldom heard views into the arena of public discourse. Although amniocentesis gives women a certain freedom to choose the kind of parenting they will undertake, data presented by Rothman suggests that women's opinions and experiences have not been sufficiently considered in the use of this technology.
Amniocentesis involves an amniotic tap usually performed during the sixteenth week of pregnancy. The test results are available about four weeks later, in approximately the middle of the pregnancy. If the test results indicate a genetic defect in the fetus, then the parents may decide to have an abortion. A pregnancy, in which amniocentesis is performed, is tentative because it "is medically acknowledged, made socially real, but the fetus/baby is not" (1986a: 101). The woman follows social, medical and personal rituals associated with pregnancy but knows that she may not be carrying the baby to full term. These are wanted and often planned pregnancies. Rothman found that women were "having abortions but using the language of infanticide, because these are not 'accidental' pregnancies, but wanted babies" (1986b: 48).
Rothman found that the use of amniocentesis changed the way that women experienced several aspects of pregnancy. For example amniocentesis "changes the fundamental psychological and social meanings of quickening" (1986a: 107). For many women feeling fetal movement affirms their pregnancy. When amniocentesis was used quickening was not necessarily reassuring to the pregnant woman, while the amniocentesis results were (1986a: 107-108). Some women were "afraid to feel their baby move-because they may not be babies at all, but genetic mistakes" (1986b: 48). The author had anecdotal evidence of a mother who did not feel her baby kick until a half-hour after she received the test results reporting a genetically healthy baby (1986a: 104, and 1986b: 48). Other women are faced with the difficult decision to abort a baby whom they have felt moving and have become attached to (for example see 1986a: 106).
Rothman is deeply moved by many of the women's stories. She highlights her feelings in a related article 'Reflections: On Hard Work' published in Qualitative Sociology (1986b). Her passion, and compassion, infuses The Tentative Pregnancy. Rothman's writing enables the reader to witness the grief experienced by many of the women in the study (see 1986a Chapter 7, and 1986b: 53).
The author puts her concern to a pragmatic use by including an 'Appendix: Guidelines For Personal Decision-Making' (1986a: 245257). This section includes consumer guidelines which summarize the basic diagnostic techniques, the fetal conditions that can be diagnosed, suggestions for the possible ramifications of the decisions made, as well as suggestions for people who have already decided to use amniocentesis.
The book is well researched. In it the author combines theoretical and historical perspectives with an empirical base derived from a comprehensive literature search and interview data. Rothman includes footnotes as well as a selected bibliography. All of these components, combined with the author's notable writing skills, add up to a provocative book useful to health care consumers and professionals, as well as to academics.