Medical and Maternal Discourses on Amniocentesis
When we walked into the doctor's office, both my husband and I were crying. He looked up and said, "What's wrong? Why are you both in tears?""It's our baby, our baby is going to die," I said. "That isn't a baby," he said firmly. "It's a collection of cells that made a mistake." Leah Rubinstein, age thirty-nine
Late twentieth-century reproductive medicine offers both benefits and burdens. Its technologies are aimed at reducing maternal and infant mortality and helping assure normal, healthy outcomes. At the same time, however, it controls conditions of pregnancy, birth, and parenting in ways that scientize our most fundamental experiences. Being a woman, becoming a parent, experiencing birth, and sometimes confronting death are processes increasingly organized by reproductive medicine rather than by individuals, families, and communities. Indeed, many of the core experiences of sex, gender, and family formation are now culturally defined by medical science. The access people have to reproductive medicine, as well as its respected or coercive quality, in part defines their experience of pregnancy.
Examining prenatal diagnosis, especially the use of amniocentesis, reveals a great deal about the changing definitions and controls of pregnancy and birth. On this frontier of reproductive technology, medical services are transforming the experience of pregnancy, personhood, and parenthood for the women and their families who use prenatal diagnosis. In offering a test for chromosome anomalies and some other inherited disabilities, amniocentesis holds out the possibility of choosing to carry or not to carry to term a pregnancy in which a fetus will become a child with a genetic disability. That choice is part of the medical definition of what constitutes an acceptable or an unacceptable child in American culture. The choices people make around amniocentesis also reveal the similarities and differences between medical and maternal perceptions of what it means to have a child with a disability.
Rayna Rapp, "The Power of 'Positive' Diagnosis: Medical and Maternal Discourses on Amniocentesis," in Karen L. Michaelson, ed. Childbirth in America: Anthropological Perspectives (South Hadley, Mass.: Bergin & Garvey, 1988): 103-16. Reprinted by permission.