Biomedical Engineering Reference
In-Depth Information
Teijlingen
et al
. 2003). These quite paradoxical accounts can however also
be understood as refl ecting the women's efforts to return to normality by
re-evaluating the worrying risk information as something 'good' that could
be integrated into the experience of their own pregnancy as, in the end,
normal. It is also possible that the Down syndrome screening is imbued with
meaning associated to routine antenatal care (just another test), and to an
understanding of the advantages of this care more generally (such as the
relationship to an empathic midwife), as discussed by Press and Browner
(1997) in their study of another prenatal diagnostic test, the maternal serum
alpha fetoprotein.
The initial sense of relief after confi rmation of normality has in other
studies of the psychological reactions in pregnant women been found to be
followed by residual feelings of worry and continued fears of abnormality,
and it has been pointed out that the longevity of these feelings are still not
known (Baillie
et al
. 2000). From a psychological perspective, Marteau
et
al
. (1992) discuss how residual anxiety could be attributed to a generalized
anxiety, or heightened awareness that 'something' could go wrong. The
diffi culties in reversing the belief that something is wrong observed by
Marteau
et al
. are thus in line with the observations in this study, that not
all women can make the transition from a high risk pregnancy back to an
'expectant' state of pregnancy (ibid.).
Third, the women in this study account not only for understanding of risk
scores but also how this risk is understood in the context of motherhood,
more precisely in the context of the moral responsibility for another being.
Of particular interest is how they in this process describe different scenarios:
that of the expected baby as normal and healthy, of a termination of the
pregnancy after confi rmation of abnormality, as well as the scenario of a
future life as the mother of a disabled child. The high risk information
confronts the women with scenarios of the abnormal, and the decisions they
will have to take themselves in the face of this information. For many of the
women, this immediately triggers refl ections on a future motherhood with
a disabled child. As Rapp argues, offers of a prenatal diagnosis turn women
into 'moral pioneers' (2000: 310) as they are forced into an engagement with
'disability consciousness'. The development of foetal diagnostic tests thus
mean that expectant parents increasingly are faced with the responsibility
of deciding whether to use tests to discover characteristics of their foetus,
and if something is discovered, the diffi culty of having to decide what to
do. Shakespeare (2003: 203) points out that 'This adds to the stress and
anxiety of pregnancy for everyone, not just the tiny proportion in whom a
genetic condition is diagnosed'. In this context he argues that the condition
of Down syndrome 'has moved from being an unfortunate piece of bad luck,
to being a blameworthy failure of surveillance and control' (ibid.: 205). This
also means that this reproductive technology not only opens the pregnant
body to control, but also the expected baby to be 'chosen' (Williams 1997:
1045).
