Health Care Analysis 9: 387400, 2001. 2001 Kluwer Academic Publishers. Printed in the Netherlands.

Foetal Images: The Power of Visual Technology inAntenatal Care and the Implications for WomensReproductive Freedom

INGRID ZECHMEISTERDepartment of Social Policy, Vienna University of Economics and Business Administration,Reithlegasse 16, 1190 Vienna, Austria (E-mail: ingrid.zechmeister@wu-wien.ac.at)

Abstract. Continuing medico-technical progress has led to an increasing medicalisation ofpregnancy and childbirth. One of the most common technologies in this context is ultra-sound. Based on some identified pro-technology feminist theories, notably the postmodernistfeminist discourse, the technology of ultrasound is analysed focusing mainly on social andpolitical rather than clinical issues. As empirical research suggests, ultrasound is welcomedby the majority of women. The analysis, however, shows that attitudes and decisions of womenare influenced by broader social aspects. Furthermore, it demonstrates how the visual techno-logy of ultrasound, in addition to other reproductive technology in maternity care, is linkedto the personification of the foetus and has therefore contributed to a new image of thefoetus. The exploration of these issues challenges some arguments of feminist discourse. Itdraws attention to possible adverse implications of the technology for womens reproductivefreedom and indicates the importance of the topic for political discussions.

Key words: abortion debate, biomedicine, feminist theories, foetal personhood, ultrasound,technology in antenatal care, visualisation

Continuing medical-technical progress has, over the last decades, led to arapid rise in the application of technology in antenatal care throughout thedeveloped countries of Western society. One of the most commonly usedtechniques which contributed considerably to an increasing medicalisationof pregnancy is ultrasound which has developed to a highly sophisticatedmethod allowing the detailed visualisation of the growing foetus. The tech-nique is used for a variety of reasons such as determining malformations, ormonitoring foetal growth to name just a few. Although clinical advantagesare debatable in certain cases (Baille and Mason, 1997; Enkin, 1995; Oakley,1984; Rudinow, 1996) ultrasound as well as other technology in antenatalcare, without doubt, also offer benefits (Waldenstrom et al., 1988). Thepurpose of the article is therefore by no means to condemn the technique as awhole. It is, however, the technique in a less clinical context but in its broader

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societal or even political context and the possible implications for women andreproduction which will be analysed critically. The analysis will be startedwith an identification of technology approving feminist arguments whichwill then be continued by a critical evaluation of those arguments taking intoaccount results from various pieces of empirical research conducted amongwomen.

The article continues with a debate about the concept of visualisation andthe reliance upon biomedical knowledge for the construction of personhoodin Western society. The possible implications of these issues for women willbe discussed and finally, the arguments will be related back to the feministdebate about reproductive technology.

Ultrasound: A Benefit for Mothers?

An obvious starting point might be to pay some attention to feministarguments about technology in antenatal care. As it has been stressed byAnnandale (1998), the feminist movement is not a coherent body of thoughtand, similar to other areas, attitudes and theories about women and repro-duction differ considerably between various feminists. Proponents of repro-ductive technology can be found in postmodernist/poststructuralist and someradical feminist theories.

Firstly, postmodernist/poststructuralist feminists argue that modernistbinaric thinking including the binary of gender can be regarded as the mainroot of oppression because this duality tends to associate men with whatis valued and women with what is devalued, it constructs a woman as themans complement (Annandale and Clarke, 1996). Technology in maternitycare, however, may deconstruct duality and therefore helps to supersede thegendered notion of a body.

High technology challenges dualism since it is no longer clear who makesand who is made in the relation between human and machine (Annandaleand Clarke, 1996: 38).

Using Donna Haraways (1991) image of the Cyborg to demonstrate thedisappearing demarcation between human and machine and the fusion ofnature and technology, they argue that technology in antenatal care wouldblur the distinction between dualisms. As a consequence, technology maycontribute to liberate women through deconstructing the male/female opposi-tion, resulting in a reconceptualisation of the female body as an anti-essentialist body that is in between nature and culture, (Matisons, 1998:11) in between nature and technique.

As Palumbo (2000) points out:

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An instrument of this new continuity between surface and depth, themachine leads our eyes and our senses into our body . . . . From beingan instrument of alterity between nature and artifice, it has now becomethe tool for a new dialogue between men, and between man and matter,between man and nature.Secondly, some early radical feminists, represented most notably by Fire-

stone (1970), Rich (1977) or Piercy (1976), have argued that technology hasenabled women to gain more control over their bodies through liberating themfrom their biology and the burden of reproduction.

Cause as long as we were biologically enchained, wed never be equal(Piercy, quoted by Adams 1993: 274).

Research conducted among women suggests that the general tenor towardsultrasound among them is mainly positive (Davis-Floyd, 1994; Evans, 1985;Proud and Murphy-Black, 1995; Rapp, 1990; Tymstra et al., 1991). However,it is worth going one step further and trying to analyse why women may havea positive attitude.

In addition to receiving assurance of the babys health the enthusiasmamong the majority of women about having an ultrasound examination isexplained in their feelings of being closer and more attached to the baby(Kohn et al. cited by Baille and Mason, 1997; Petechsky, 1985; Rothman,1994). Seeing the foetus can therefore be described as triggering a process ofprenatal bonding. Not only obstetricians but also some women argue thatthis experience of bonding caused by ultrasound influences the motherscompliance and life-style. The most frequently used example is the apparentlypositive influence of ultrasound on a womans smoking behaviour once shesees the foetus on the screen (Waldenstrom et al., 1988).

Apart from the clinical point of view the experiences of women have to befurther analysed. To quote Petechsky (1987: 72):

We have to understand the market for . . . high-tech pregnancy monit-oring as a more complex phenomenon . . .

According to her, one reason why women experience the feeling of bondingpositively may be that the image of the foetus which she sees is in fact some-thing which she ought to see. In this sense meaning is shaped by social mythsabout bonding and mother-love. This is similar to the argument by Campbelland Porter (1997: 353) who make clear that the way we think is influencedby our social and material environment.

One explanation for womens positive attitudes not only towards ultra-sound but also towards other reproductive technologies could therefore lie inthe uncritical faith in medical expertise, inherent in the traditional doctorsknow best ideology, which influences womens attitudes. This ideology,

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according to Hunter (1994), implies a form of power which is described byLukes (1974) as the so-called third dimension of power. He explains that itis a form of power to get a person to do something or to accept the existingorder of things through shaping her/his wants. According to Foucault (1982),power is not necessarily coercion, domination and control but is the directionof the free will in that individuals are persuaded to act in the experts interests.In this context it may therefore be just another form of medical power anddominance and not the womans true interests which makes her acceptingthe technology.

Davis-Floyd (1994) provides a similar approach. In her view it is theuncontested faith in technology and the scientific model of nature, the tech-nocratic myth, which exists in Western society, that functions as a powerfulagent of social control, shaping and channelling individual values, beliefs andbehaviours (Davis-Floyd, 1994: 1125). According to her, women express apositive view of ultrasound and feel empowered by any reproductive tech-nology because they are a part of the societys core value system. This inturn influences their way of thinking, and therefore makes them believe inthe value of technology. In her study these are the professional women, whoshe describes as the agents of technocratic control (Davis-Floyd, 1994:1137), influenced by the status of technology which stands as a symbol forthe superiority of modern medical science (Mitchell and Georges, 1997) andby the cultural imperative of consumption offering women the pleasuresof reproduction construed as consumption (Taylor, 2000: 402 and 397).

Finally, another interesting issue is raised by Petechsky (1987). Shementions the womans traditional responsibility for the family photo-albumas an additional factor which may contribute to her positive response to ultra-sound. The foetus on the ultrasonic photo is already fully regarded as thecouples offspring. It shows their descendant, hence the continuation of thefamily lineage not only after birth but already before the child is born.

The Concept of Visualisation

One of the most significant advances in antenatal care has been the intro-duction of ultrasound. This has allowed the visualisation of our secondpatient, the fetus (Kilby, 1998: 752).

Three words in this statement, made by a consultant, seem to be crucial: Thevisualisation of our patient. As has been argued by Franklin (1991), thedevelopment of human life has always been a fascinating area for scientists.The technology of ultrasound is therefore even more significant as it has,for the first time, enabled the medical profession to see the child before it is

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born, to watch and observe its growth from the stage of an embryo to that of amature foetus. As expressed by Overall (1987: 44), ultrasound is like putting awindow on the womb. The growing foetus which had always been hidden inthe uterus has become visible, a development which, without doubt, has madepregnancy much less mysterious for the medical profession. This, on theother hand, poses the danger that antenatal care no longer emphasises, as thename might suggest, caring but that the focus shifts from caring to technicalsurveillance. Hence, women become the object of medical surveillance.

What inevitably follows as another consequence is that because techniqueof visualisation opens up the new possibility of seeing the foetus, the focusof surveillance will be less on the mother but increasingly on the foetus. Forthe profession it becomes their patient rather than the mothers baby. Theremight be two patients in pregnancy, however, as Overall (1987: 60) suggests,the fetus is medically and technically by far the more interesting one.

Women solely function as environment and space to be explored inthe interests of science. That this is a legitimate concern already comesclear when observing an ultrasound examination described so remarkablyby Rothman (1994: 113), which also confirms my own experience as asonographer:

The woman on the table with the ultrasound scanner to her belly, and onthe other side of the technician or doctor, the fetus on the screen. Thedoctor sits between the mother and the fetus. He turns away from themother to examine her baby.In fact, it is no longer the mother but it is the foetus, which becomes the

important object whereas the mother herself becomes less important. This isadditionally expressed in the way the foetus is visualised in relation to itsmother. Looking at an ultrasound picture does provide information about thefoetus but little about its relation to the mother.

Picture to yourself the photos you have seen of fetuses in utero, wriggling,sucking their tiny fingers. Where did they lie in their mothers? Wherewas the fetus in relation to her body, to her navel, her heart, her pelvis? Itexisted as if in space . . . . But where is the mother in that metaphor? Shehas become empty space (Rothman, 1994: 114).

The pregnant body has become a kind of empty spaceship for the cosmo-naut foetus or as expressed more extremely by Annas, stated by Callahanand Knight (1992: 233), the mothers role is marginalized to being the foetalcontainer, a vessel. This metaphor is expressed more clearly in scientificphotographs of the foetus which have in common that they make the motherinvisible by simultaneously bestowing a status of independence upon thefoetus.

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The fetus is illuminated against a dark background flecked with floatingwhite particles, like stars against al night sky (Adams, 1993: 269).

In other words, picturing and visualising the foetus detaches and separates itfrom the mothers body. It conceals the relation of the foetus to the mothersbody or even denies the existence of a relation entirely. As it is the case inultrasound, it transfers the foetus from the mother on to the screen and createsa new image of the foetus.

What plays a significant role in this context is the importance and thepower of the visual in Western culture. Seeing has become the mostimportant of our senses (Keller and Grontkowski, 1983). Hence, the relianceon the information obtained through seeing is paramount and it is this infor-mation which is regarded as more likely to be true than information obtainedwith all other senses. Ultrasound is in fact nothing else than taking a picture ofthe foetus. It has therefore the same attributes as any other kind photography,most importantly in this context, it is linked with positivism (Petechsky, 1987)As Bazin (1980: 241) has pointed out:

The objective nature of photography confers on it a quality of credibility. . . . In spite of any objections our critical spirit may offer, we areforced to accept as real the existence of the object produced, actually,re-presented, set before us, that is to say, in time and space.

Furthermore, as argued by Keller and Grontkowski (1983: 207), the logic ofthe visual is a male logic and, according to Petechsky (1987), it has beenargued that discrediting other senses in favour of the visual is a specificmasculine attribute and implies the potential of putting the female bodyunder male surveillance. Addtionally, those analysts, through an emphasison visualisation, identify a form of voyeurism, which, according to them, is amascluinist form of looking.

Both the importance of the visual in general and the resulting associationwith a womens feeling as the less valued female sense might be one explana-tion for the fact that, as Hubbard (1989) argues, in contrast to the trueinformation on the screen, the mothers feelings are often regarded as of littleimportant. Ultrasound as a visual technology represents a visual realism withthe consequence that a womans subjective feelings loose credibility. Truth isonly what can be seen on the screen (Krieger, 1995).

In summary the significance of ultrasound in obstetrics can be regarded asthree-fold. On the clinical level it provides medical information and evidence;on the second level, it is linked with surveillance and on the third level itbecomes a tool for creating a new myth; the foetus as image. Any one ofthese meanings has an effect on the woman and her experience of pregnancy.Further consequences which may follow will be analysed below.

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The Foetus: A Patient and a Person Implications and Consequences

As outlined above, ultrasound has contributed to the creation of the patientfoetus. It has even created a particular image of this patient; it bestowsupon the foetus the image of a tiny little person. The more sophisticatedthe technology and the better the quality of the equipment and the printing,the more it becomes this person. This image is particularly powerful in therecently developed 3-D ultrasound technique. Additionally, the foetus can beobserved via real time mode when it kicks, excretes and yawns. This humanbehaviour reinforces its image of a person.

The visual technique of ultrasound does, in addition to other medicalscientific techniques, provide the source of information Western society relieson as a basis for the construction of personhood. Hence, ontology in Westernculture is based on biological facts. This is expressed by Franklin (1997: 487):

. . . The biological facts of conception, pregnancy and fetal life are . . .the key cultural resources in the construction of personhood.This concept which implies faith in technology, already described earlier

as the technocratic model, at the same time maintains the valorisation of thebiomedical model as it is the individual scientific expert who is relied on andwhose knowledge is regarded as legitimate (Franklin, 1997) Consequently, asDavis-Floyd (1994: 1126) remarks, it constitutes the separation of humansfrom nature, of mind from body, of mother from child.

Further more, Franklin (1997) has pointed out that the reliance on medicalscience and visual technology not only separates the fetus from the mother italso separates the social from the biological. In this context she states:

The ontology of fetal being is entirely asocial. It is a definition ofpersonhood constructed entirely out of natural facts (Franklin, 1997:489).

Therefore non-biological dimensions of human life, like societal aspects,become less important in favour of the biological aspect of life. Askey cultural resources, however, these biological and scientific facts haveconsiderable power. What has already been outlined in context with ultra-sound is also valid for other scientific knowledge of the foetus. It implies thepotential to create an independent foetal personhood. Through science, ratherthan being passive and weak, the foetus has gained a more dominant rolein pregnancy including the ability to control its mother. A quote from twomedical scientists might underpin the argument. They remark that

[t]he fetus is not a quiescent, passively-growing product of concep-tion tucked neatly away in its protected uterine environment. Whileundoubtedly depending on the mothers nutrient supplies for its growth

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and survival, it nonetheless enjoys considerable independence in the regu-lation of its own development. Indeed, the fetus exerts profound effectson maternal physiology via hormones secreted by the fetal part of theplacenta. These, in part, determine the mothers ability to meet metabolicrequirements (Johnson and Everitt, 1995: 190).

What additionally contributes to this status of independence is that scientificprogress has enabled the shift of gestational age after which a foetus is ableto survive outside the uterus to an increasingly earlier one (Morris, 1991).

Two important consequences which follow on from this analysis needto be addressed because of their considerable potential to influence bothwomens reproductive freedom and their possibility of free choice overreproductive decisions.

Firstly, the whole process of separation of mother and foetus, the medicalfocus on the patient foetus, the construction of a foetal personhood and a newimage of the foetus inevitably raise the issue of foetal rights. Constructing afoetal personhood implies the possibility of creating a legal person with civilrights already before the baby is born. The foetus is an idealised infant and apotential adult, a future person (Callahan and Knight, 1992). By implication,this creates a conflict between the legal rights of the mother versus the legalrights of the foetus (Wertz and Fletcher, 1993). Fetal citizenship contradictsthe citizenship of women (Franklin, 1997: 490).

Several examples exemplify that it is increasingly the mothers right whichdeclines in favour of the foetus rights. The most obvious one is the debateabout caesareans. In this context Overall (1987: 44) quotes a lawyer whostates that where the need to preserve the unborn childs life or healthconflicts with the mothers wish for vaginal delivery, the childs interestsshould take priority. Similar cases have also been described by Europeanauthors (De Jong and Kemmler, 1999).

Furthermore, because of the emphasis on child protection the woman isincreasingly seen as being a dangerous influence on the foetus be it throughsmoking or some other kind of unhealthy life-style. Referring back to theidea of bonding it becomes clear that in this context bonding, although posi-tively expressed by women, may suddenly be used against the woman in thatultrasound may be used to create a feeling of guilt through monitoring themothers shortcomings and failures to be good mothers, as shown in a studyconducted by Mitchell and Georges (1997: 381). To quote Lupton (1994:155):

Those women who choose to ignore . . . advice [giving up smoking,loosing weight . . .], or who simply cannot, for one reason or another, giveup cigarettes or alcohol, are routinely portrayed as selfish, irresponsible

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and uncaring. Once again, the primary emphasis of such discourse is uponthe health and well-being of the foetus.

Lupton criticises that instead of addressing the underlying causes of theseproblems the professionals focus on the well being of the child from a merelymedical point of view and accuse mothers of neglecting their child.

The second important implication of reproductive technology used inantenatal care and prenatal diagnosis which is closely related to the issueof the foetus rights is that its development has given pro-life movements,scientists and politicians new opportunities to re-open the abortion debate.For example, only recently this happened in Austria (Der Standard, 2000).

Alongside with scientific photography, mentioned earlier, any other foetalimages which have emerged as a result of scientific knowledge are madepublic in all kinds of media and have even entered private homes (Rapp,1990). For anti- abortionists they are a useful tool. To quote Petechsky (1987:58):

The strategy of anti-abortionists to make foetal personhood a self-fulfilling prophecy by making the foetus a public presence addresses avisually oriented culture.

After the traditionally religious based defence of life the rhetoric changesnow from a religious to a medical-technical one (The Science and TechnologySubgroup, 1991). Pro-life activists refer to scientific facts which suggest thatfrom the beginning of conception the growing child is a unique individualand medical knowledge about foetal teleology is used to emphasise on themiracle of life (Franklin, 1991).

Apart from these implications another issue is worth mentioning.According to Franklin (1991: 202), the construction of the foetus as an indi-vidual and citizen and its visual representation affirms a patriarchal modelwhich, according to her, is evident in the language used to describe the foetus.She mentions statements like the foetus must overcome barriers, conquerthreats or spends nine month preparing for live outside the uterus like anastronaut who prepares for the environment of space. All of which areused in anti-abortion rhetoric, which bestow upon the foetus a masculinehero/adventurer image. Furthermore, the male image is not only apparent inthe language used but, according to Krieger (1995), it is also mainly malefoetuses which are depicted in photographs of anti-abortionist brochures.

Drawing Together the Issues of Discourse

Having outlined some implications of ultrasound the aim is now to relate thearguments to the feminist theories stated at the beginning of the paper.

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To start with a re-discussion of the postmodernist deconstruction theorythe analysis makes clear that it is debatable whether reproductive technologyleads to the deconstruction of duality. Firstly, addressing the issue of gender-deconstruction several examples contest the postmodernist argument. Onecontradiction seems to lie in the fact that technology has not only enabledus to visualises the foetus as a person in a neutral sense but it also allowsthe determination of the foetus sex. Consequently, as Rothman (1994: 119)argues,

[this] knowledge changes things, because with sex comes gender . . . .Gender goes beyond the X and Y chromosomes, beyond genitalia, to ourideas about the kind of person the fetus will become (original emphasis).

Hence, if there was a process of deconstructing gender-dualism through afusion of mother and machine this would be reversed when the technologyis applied, thereby maintaining and strengthening existing gender stereotypesand attributes (already before birth) rather than helping to eliminate them.

Another issue in this context has been raised by Rudinow (1996). In herstudy she has drawn attention to ultrasound as a technology that affects theconception of feminitiy and masculinity. Her empirical data confirms thatthrough social process technology itself is genderized (all technologieshave gender) and vice versa gender is technologized (e.g. masculinityis technophilic) (Rudinow, 1996: 69). Thus, within science and technologygendering is renegotiated rather than deconstructed. Can then techno-logy which has itself gender-specific attributes lead to deconstruction ofduality?

Secondly, some other forms of the binary logic are maintained throughtechnology, as one can see in the inherently strong valorisation of thebiomedical model which implies the Cartesian model of mind/body dualism.

Thirdly, new separate entities are created opposing each other such as theduality of mother and child or the separation of biological and social issues.

As has been argued by Derrida (1981) dualities have to be seen as hier-archies where one of the two terms governs the other. By implication,ultrasound maintains existing and creates new power relations with the dangerof eliminating women through externalising the foetus, visualising it inde-pendently and bestowing more human rights upon it. The unity of motherand foetus has been transformed into a mother versus foetus duality withthe foetus becoming the dominant pole.

It remains debatable whether the increasing elimination of women fromthe scene of reproduction can be described as deconstruction of gender asit could also be regarded as a sole deconstruction of femaleness leavingmaleness in the dominant and monopolist position.

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It remains also debatable whether the separation and unequal prioritisa-tion of social and biological issues will be for womens benefit, since thisincreasingly results in depolitisation and medicalisation of social issues.

Moreover, it is questionable in the first place whether deconstructingduality should be an aim at all. In postmodernist philosophy the way outof the roots of oppression inherent in the constructed modernist dualities isseen in replacing duality with plurality and heterogenity (Annandale, 1998).However, this process would hardly be of benefit for the former subordinateparty, which, in our case, is the woman. As stated by Bell and Klein, quotedby Roseneil (1999: 162), this would [decline] to identify domination ingeneral and male domination in particular. As a consequence, it would makeit impossible to address and contest power relations politically.

Continuing the discussion with the feminist argument about the libera-tion of women through a technological liberation of biology it is undeniablethat the technology has given women new opportunities. Most importantly, itallows women more freedom from biological constraints and it enables themto work towards a new general concept of motherhood. Hence, its significancelies in its potential to achieve social changes. However, as Rothman (1994: 3)states, technological change in reproduction . . . does not necessarily meansocial change. The sole existence of the technology is, firstly, not enoughto challenge existing social and patriarchal structures and, secondly, can alsolead to new unequal power relations and forms of de-liberation.

Conclusion

The analysis has provided an example to demonstrate that the technologiesin antenatal should not simply be valued as promising medico- technologicaldiagnostic tools, as it has become clear that they also bear some danger ofcontributing to the restriction of womens reproductive freedom. Data fromresearch conducted so far to evaluate womens attitudes towards reproductivetechnology have to be treated cautiously as these attitudes exist within a socialcontext, within existing power relations, social obligations, constraints andtraditions. By consequence, further research would be required and shouldtake those issues into account.

Rather than regarding technology as a means to deconstruct dualitywhich, according to postmodernist feminist theories, should liberate womenfrom oppression, duality is being maintained and even constructed in newforms. Consequently, the sole deconstruction of gender, though the possi-bility of such a process and its benefits are debatable themselves, doeshardly contribute to more equality if, through technology, women continue torepresent the subordinate poles within newly created dualisms or oppositions.

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Apart from its positive effects, technology also contributes to the establish-ment of new power relations with womens continuing elimination from thescene of reproduction whilst lawyers and medical professionals take controlover the visualised commodity foetus.

It is therefore not the technology itself that creates the danger but itsinherent capacity to exert control over womens bodies, to render themsubordinate to medicine, science or even the state.

There remains the question of how this context might be changed? AsPetechsky (1987: 78) suggests:

We have to restore women to a central place in the pregnancy scene. Todo this, we must create new images that recontextualize the foetus: thatplace it back into the uterus, and the uterus back into the womans bodyand her body into its social space.

At the same time it has, however, to be clearly avoided to reduce women toa maternal essence (Petechsky, 1987: 79).

Most importantly, the analysis should have made clear that from a feministpoint of view the issues addressed should not be left out from gender-political discussions. It should also have demonstrated the danger whenbasing political decisions solely on biomedical experts knowledge leadingto a depolitisation through a simultaneously increasing medicalisation. Thisprocess does not only exclude lay women from participation in decisionmaking but it also results in victim blaming and individualisation of socialproblems to be solved by the medical profession and, most importantly, itleaves existing power relations unchallenged.

References

Adams, A. (1993) Out of the Womb: The Future of the Uterine Metaphor. Feminist Studies19, 269289.

Annandale, E. and Clark, J. (1996) What Is Gender? Feminist Theory and the Sociology ofHuman Reproduction. Sociology of Health & Illness 18(1), 1744.

Annandale, E. (1998) The Sociology of Health and Medicine: A Critical Introduction.Cambridge: Polity Press.

Baille, C. and Mason, G. (1997) The psychological impact of obstetric ultrasound scans andsoft marker screening. Imaging 9, 117.

Bazin, A. (1980) The Ontology of the Photographic Image. In: A. Trachtenberg (Ed.), ClassicEssays on Photography. New Haven: Leetes Island Books.

Callahan J.C. and Knight, J.W. (1992) Women, Fetuses, Medicine and the Law. In: H.B.Holmes and L.M Purdy (Eds.), Feminist Perspectives in Medical Ethics. Indianapolis:Indiana University Press.

Campbell R. and Porter, S. (1997) Feminist Theory and the Sociology of Childbirth: AResponse to Ellen Annandale and Judith Clark. Sociology of Health & Illness 19(3), 353.

399

Davis-Floyd, R.E. (1994) The Technocratic Body: American Childbirth as Cultural Expres-sion. Social Science and Medicine 38(8), 11251140.

De Jong, M. and Kemmler, G. (1999) Kaiserschnitt- Narben an Seele und Bauch. Ein Ratgeberfr Kaiserschnittmtter, 3rd ed. Frankfurt am Main: Fischer.

Der Standard (2000) Abreibungsdebatte nicht den Ideologen berlassen. Der Standard 12December 2000, 30.

Derrida, J. (1981) Positions. Chicago, IL: The University of Chicago Press.Enkin, M. et al. (1995) A Guide to Effective Care in Pregnancy & Childbirth, 2nd edn. Oxford:

University Press.Evans, F. (1985) Managers and Labourers: Womens Attitudes to Reproductive Technology.

In: W. Faulkner et al. (Eds.), Smothered by Intervention. London: Pluto Press.Firestone, S. (1970) The Dialectic of Sex. New York: Bantom Books.Foucault, M. (1982) The Subject and Power. In: Dreyfus/Rabinow (Eds.), Michael Foucault:

Beyond Structuralism and Hermeneutics.Franklin, S. (1991) Fetal fascinations: New Dimensions to the Medical-Scientific Construc-

tion of Fetal Personhood. In: S. Franklin et al. (Eds.), Off-Centre. Feminism and CulturalStudies. London: Harper Collins Academic.

Franklin, S. (1997) Fetal Fascinations: New Dimensions to the Medical-Scientific Construc-tion of Fetal Personhood. In: S. Kamp and J. Squires (Eds.), Feminism. Oxford: UniversityPress.

Harraway, D. (1991) Simians, Cyborgs and Women: The Reinvention of Nature. New York:Routledge.

Hubbard, R. (1989) Personal Courage Is not Enough: Some Hazards of Childbearing inthe 1980s. In: R. Arditti et al. (Eds.), Test-Tube Women. What Future for Motherhood?.London: Pandora-Press.

Hunter, D. (1994) From Tribalism to Corporatism: The Managerial Challenge to MedicalDominance. In: J. Gabe et al. (Eds.), Challenging Medicine. London: Routledge.

Johnson, M.H. and Everitt, B.J. (1995) Essential Reproduction, 4th ed. Oxford: Blackwell.Keller E.F. and Grontkowski, C.R. (1983) The Minds Eye. In: S.G. Harding and M.B.

Hintikka (Eds.), Discovering Reality. Dordrecht: Reidel.Kilby, M.D. (1998) Prenatal Diagnosis. The Way Ahead? Hospital Medicine 59(10), 752.Krieger, V. (1995) Der Kosmos-Ftus. Neue Schwangerschaftssthetik und die Elimination

der Frau. Feministische Studien 2, 824.Lukes, S. (1974) Power: A Radical View. London: Macmillan.Lupton, D. (1994) Medicine as Culture. Illness, Disease and the Body in Western Societies.

London: Sage.Matisons, M.R. (1997) The New Feminist Philosophy of the Body. The European Journal of

Womens Studies 5, 934.Mitchell, L.M. and Georges, E. (1997) Cross-Cultural Cyborgs: Greek and Canadian Womens

Discourses on Fetal Ultrasound. Feminist Studies 23, 373401.Morris, J. (1991) Pride Against Prejudices. Transforming Attitudes to Disability. London:

Womens Press.Oakley, A. (1984) The Captured Womb. Oxford: Blackwell.Overall, Ch. (1987) Ethics and Human Reproduction. A Feminist Analysis. London: Allen &

Unwin.Palumbo, M.L. (2000) New Wombs: Electronic Bodies and Architectrual Disorders. Basel:

Birkhuser.

400

Petechsky, R. (1987) Foetal Images. The Power of Visual Culture in the Politics of Repro-duction. In: M. Stanworth (Ed.), Reproductive Technologies, Gender, Motherhood andMedicine. Cambridge: Polity Press.

Piercy, M. (1976). Women on the Edge of Time. New York: Fawcett Crest Books.Proud, J. and Murphy-Black, T. (1997) Choice of a Scan: How Much Info Do Women Receive

before Ultrasound. British Journal of Midwifery 5(3), 144147.Rapp, R. (1990) Constructing Amniocentesis. Maternal and Medical Discourses. In: F.

Ginsburg and A.L. Tsing (Eds.), Uncertain Terms. Boston: Beacon Press.Rich, A. (1977) Of Women Born. Motherhood as Institution. London: Virago.Roseneil, S. (1999) Postmodern Feminist Politics. The Art of the (Im)possible? The European

Journal of Women Studies 6, 161182.Rothman, B.K. (1994) The Tentative Pregnancy. Amniocentesis and the Sexual Politics of

Motherhood, 2nd ed. London: Pandora.Rudinow S.A. (1997) Ultrasound Discourse. Contested Meanings of Gender and Techno-

logy in the Norwegion Ultrasound Screening Debate. The European Journal of WomensStudies 3, 5575.

Taylor, J.S. (2000) Of Sonograms and Baby Prams: Prenatal Diagnosis, Pregnancy andConsumption. Feminist Studies 26, 391418.

The Science and Technology Subgroup (1991) Feminism and Abortion: Past, Present andFutures. In: S. Franklin et al. (Eds.), Off-Centre. Feminism and Cultural Studies. London:Harper Collins Academic.

Tymstra, T.J. et al. (1991) Womens opinions on the offer and use of prenatal diagnosis.Prenatal Diagnosis 11, 893898.

Waldenstrom, U. et al. (1988) Effects of Routine One-Stage Ultrasound Screening inPregnancy: A Randomised Control Trial. The Lancet 2, 585588.

Wertz, D.C. and Fletcher, J.C. (1993) A Critique of Some Feminist Challenges to PrenatalDiagnosis. Journal of Womens Health bf 2(2), 173188.