Kukla Mearuing mothering

Measuring Mothering
Author(s): Rebecca Kukla
Reviewed work(s):
Source: International Journal of Feminist Approaches to Bioethics, Vol. 1, No. 1, Doing
Feminist Bioethics (Spring, 2008), pp. 67-90
Published by: Indiana University Press
Stable URL: http://www.jstor.org/stable/40339213 .
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MEASURING MOTHERING
Rebecca Kukla
Abstract
As a culture,
in termsofa setofsigwehavea tendency
to measuremotherhood
and anxiety;
nal moments
thathavebecomethefocusofspecialsocialattention
abilities.
we interpret
theseas emblematic
ofwomen'smothering
summations
can
seem
to
exhaust
the
Women'sperformances
these
moments
story
during
ofmothering,
and mothers
ofteninternalize
thesemeasuresand evaluatetheir
in termsofthem."Good"mothersarethosewho pass a series
ownmothering
oftests-theybondproperly
theydo
screening,
duringtheirroutineultrasound
birth
notleta sipofalcoholcrosstheirlipsduringpregnancy,
theygive
vaginally
without
theirchildan artificial
nippleduring
painmedication,
theydo notoffer
mealswith
thefirstsix months,theyfeedtheirchildrenmaximally
nutritious
and
of
has
so
on.
This
reductive
bite,
every
understandingmothering had counmeasures
effects
health
care
andpolicy,
terproductive upon
practice
encouraging
thatpenalizemothers
who do notliveup to culturalnormsduringsignalmoofhealthy
ments,whilefailingto promoteextendednarratives
mothering.
"Asmartwomanwholovesherunbornchildwillavoid havinga
c-sectionifat all possible.Onlya self-absorbed
wimpwouldchoose
toput herbabyin harm'swayso thatshe doesn'thave toalterher
THE INTERNATIONALJOURNALOKFEMINIST APPROACHES TO BIOETHICS
Vol. 1,No. 1 (SPRING2008).© 2008
68
TO <^&W*^L<
j7nte**™U*&*t€*£&*€*****£QRFEMINISTAPPROACHES
1:1
don tgetany
scheduleorfeelanypain. Thesewomendefinitely
respect
fromme"
ASHLEY, 2006
birthslovetheirbabies.Love is not
"Manymotherswhohave difficult
It's theopposite,
a contraction.
forme.A veryslowopening."
LAUREN, 2004
mothergavebirthto me at theendof 1969,aftera difficult
pregnancy
healthinsuranceallowedheronly
duringwhichhergraduate-student
care.1A hippywithdegreesinliterature,
minimalprenatal
drama,andeducation,
anda preschooler:
Shenourished
foran infant
shewasan idealmother
myevery
in mypersonality
food,and
quirks,fedmehealthy
delighted
sparkofcreativity,
did
thatgoodparenting
taughtmetoreadbythetimeI wastwo.Firmbelievers
becameintimately
sheandmyfather
notrequirea hiatusfromlifeandadventure,
familiarwiththeplaygrounds,
zoos, and ponyridesofEuropeand northern
motherofan olderchild.Shewas cona
was
she
Africa.However,
problematic
andderidedmydesires
whenI showedsignsofindependence
andfearful
trolling
for
tofitinwithmypeergroups.Myparentspulledmeoutofschoolrepeatedly
andschoolalmostevery
monthsata timeandmovedmetoa newneighborhood
ofhomeownertheresponsibilities
without
year,so thattheycouldtravelfreely
mymother
despitethesedisruptions,
ship.SeeingthatI excelledacademically
life.Later,
and
social
emotional
totheireffects
showedlittlesensitivity
uponmy
and myfailureto accepthervisionoflifeat facevalue
oncemyindependence
forme,leaving
shemoreorlessrelinquished
becameundeniable,
responsibility
on.Yetshehasturnedouttobe a wonfrommymid-teens
metosupportmyself
derfulmotherofan adultchild.Afterwe each settledintoacceptanceofour
ofmychoicesanda careshebecamea staunchsupporter
mutualindependence,
as wellas a devoted,
audienceformyaccomplishments,
fuland appreciative
she
mother
Thejuryis outonwhatkindofelderly
creative
grandmother.
playful,
in
turn.
her
children
willbecomelater,aftershebecomesdependent
upon
Aristotle
saidthata man'shappiness
So wasmymothera "goodmother"?
couldbe measuredonlyoncehe was dead;happinessand unhappinessreside
in hislifenarrative
onlytakenas a whole(1941,BookI, Chapter10).Similarly,
narrative.
an entireparenting
can
onlythrough
goodmothering be constituted
be
univocal.
will
it
ever
nor
is
not
narrative
mother's
yetcomplete,
My
REBECCA KUKLA
69
wehavea tendency
tomeasuremotherhood,
notinextended
Yetas a society
that
we
as
but
a
set
of
moments
emblematic
testsand
narratives, by
interpret
signal
ofwomen's
abilities.
Women's
summations
performances
mothering
duringthese
Mothersofteninternalize
moments
can seemtoexhaustthestoryofmothering.
intermsofthem.These"definandevaluatetheirownmothering
thesemeasures
- indeed,several
come
in
the
narrative
moments"
tend
to
veryearly
mothering
ing
orevenbeforeconception.
ofthemcomeduringpregnancy
ethics
hascometorefer
almostexcluConsiderhowthephrasereproductive
faced
or
of
discrete
choices
to
ethical
pregnancy evenearlier.
during
sively
analyses
in
ethics
include
abortion,
pre-implantation
geneticdiKeytopics reproductive
is
us as strange.
medicine.
Thisoughttostrike
Reproduction
agnosis,andfertility
Renewpeopleandbuildingfamiliesand communities.
theprocessofcreating
andcaringfornewgeneratotheethicsofcreating
ethicsoughttorefer
productive
ourundertions.Thisis a processthatextendsacrossthelifespan.Ifwerestrict
notonly
andpregnancy,
totheprocessesofconception
ofreproduction
standing
thecreation
andsociallaborthatconstitutes
willweignoremuchofthematerial
thesocialandethical
riskdistorting
ofnewpeople,butwesurely
andsustenance
it
would
be odd to think
That
of
meaningoftheseearlystages reproduction. is,
orconcepofpregnancy
theethicsorsocialsignificance
thatwecan understand
the
oflonger
first
and
foremost
as
them
tionwithout
beginnings
understanding
in
once
mothers
interest
lose
bioethicists
Yetmainstream
narratives.
consistently
to
bioethical
attention
no
We
little
or
is
over.
narrative
their
of
thebeginning
give
I
notto mentionolderchildren.
childrenafterinfancy,
theethicsofmothering
has
had
of
claimthatthisreductive
counterproductive
understandingmothering
measuresthatpenalize
effects
encouraging
uponhealthcarepracticeandpolicy,
whilefailing
norms
to
cultural
whodo notliveup
mothers
duringsignalmoments
ofhealthy
narratives
extended
toencourage
mothering.2
bioethicsis to turn
tasksforfeminist
I believethatone oftheimportant
notonlyhappensin
thebioethicalspotlightupon thefactthatreproduction
women'sbodies,butthroughwomen'songoing,richlytexturedlabor- labor
withmedicalinstituthat,afterall,does notescapea complicated
relationship
andlate-night
offices
From
ends.
tionsandspacesafter
pediatrician's
pregnancy
ofchildren's
medicalization
the
to
rooms
negotiating increasing
emergency
relationtheir
and
in
behaviorandbodies,womenmother
complicated
through
evenwhentheyresist
and possibilities,
judgment,
shipsto medicalauthority,
our
currentage ofinin
even
this
it
should
be
or
not
Whether
so.
way,
doing
a
bear
mothers
shared
duties,
responsibildisproportionate
parenting
creasingly
70
^,t^rnt*/^+i**/
TO 6&;*><*//*i<±i
1:1
<Z**+in*t/W FEMINISTAPPROACHES
contactwithprofessional
healthinstitutions,
ityformanagingtheirchildren's
their
health
at
the
domestic
level
maintaining
(throughfeedingand hygiene
practicesand thelike),and trainingthemin safetyand self-care.
Correspondmothers
arehelddisproportionately
fortheirchildren's
physiresponsible
ingly,
cal andmentalhealthimperfections.3
Justas bioethicsmisrepresents
pregnancy
and conceptionwhenitseversthemfromtherestofmothering,
likewiseaccountsoftheethicsoffamilyrelationships
missa pressing
dimensionofmotheringiftheyfailtobringthetoolsofmedicalethicsto bear.
In thefollowing,
I explorethreeexamplesofsignalmomentsthatwe interpret
as displaysand testsofwomen'smaternaladequacy;I thenturnto thelarger
culturaland ethicalimpactofmeasuring
in theseways.
mothering
Respondingproperlyto ultrasoundimages
to
ritualsvaryfromcountry
Althoughtheritualsand theaccompanying
for
fetal
abnorMitchell
and
ultrasound
(cf.,
1997),
country
Georges
screening
malitiesduringapparently
routine
hasbecomecompletely
healthy
pregnancies
in manycountries.
In Canada and theUnitedStates,forinstance,itis standard
tohavesuchan ultrasound
aroundtheeighteenth
weekofpregnancy.
screening
The eighteenth-week
ultrasoundindeedhas becomeso routinethatcouples
oftenwaituntiltheyhavehadittoannouncethepregnancy
tofriends
andfamconsent,is
ily(Mitchell2001;Weir1998).Theprocedurerequiresno informed
rarelyrefusedbywomen,and is generally
precededbylittleorno discussionof
themedicalpurposesofthetest,itsprovenrisksorbenefits,
ortheoptionsthat
willbe availableifan anomalyis detected.(In fact,therehasbeenno persuasive
datashowingimproved
outcomesforindividual
mothers
orbabiesfromroutine
ultrasound
and
an
ultrasound
screening, although atypical
mayleadtoa recommendationformoretesting,
thereare almostno conditionsdetectableon the
ultrasound
screenthatcan be treated
ormanagedinutero.Reported
reductions
in neonatalmorbidity
and mortality
due to routineultrasoundscreeningare
basedon termination
canhardlybe countedas an option
rates,andtermination
thatimproves
thehealthofa fetus.)
themedicalexpectations
thetestmaybe vague,the
Although
surrounding
webofnormative
andsocialexpectations
inwhichitis embeddedis not."Good"
mothers
areexpectednotonlytohavetheultrasound,
buttobutlookforward
to
itas a keymoment
on thepathtomotherhood.
Theprimary
of
the
test,
purpose
as itis represented
in ourculture,
is notdiagnostic
butsocial.Pregnant
women
REBECCA KUKLA
71
momentduringwhichtheywill
totreattheeventas a treasured
areencouraged
withtheimageoftheirfetus,
time.Whenconfronted
"meetthebaby"forthefirst
manifest
loveandamazement
andreaffirm
thatthetesthashelped
"good"mothers
areaccompanied
tothe
the"reality"
ofthebaby.Goodmothers
themunderstand
The
husbands
and
fathers-to-be.
heterosexual
ultrasound
jointatbysupportive
screenas
motherand father,
directed
to theinscrutable
oftheexpectant
tention
and properties
ofthe"baby,"
theultrasoundtechnicianrattlesoffthefeatures
unit.Attheendof
thenormative
nuclearfamily
andforeshadow
servestoaffirm
a photototakehomewiththem,which,
thecoupleusuallyreceives
thescreening,
LisaMitchell
as medicalethnographer
(2001)hasshown,servessociallyas "babys
havetakena back
first
Indeed,themedicalpurposesoftheultrasound
picture."
seatto itssocialpurposesto suchan extentthatmanywomenfindthemselves
results
ultrasound
fortheemotional
impactofproblematic
unprepared
completely
(cf.,Yaqub2005).
is
thattheprimary
Lestweremainunconvinced
purposeoftheultrasound
clinics
ultrasound
weneedonlyturntothecommercial
thanmedical,
socialrather
in thepastdecade.Fora fee,
thathavesprungup in mallsacrossthecontinent
andprovide
a photoofyourbabyina cute
an ultrasound
theseclinicswillperform
decorated
frame.
Theyalso sellvariousothertypesofmerchandise
baby-themed
to
istheextent
formypurposes,
withyourultrasound
image.Whatis significant,
that
rhetoric
theirservices
clinicsadvertise
whichthesecommercial
sugthrough
theirultrawillwanttopreserve
thatgoodmothers
expectation
gestsa normative
an aptlynamed
toRemember,"
AnUltrasound
"FetalMoments:
soundexperience.
"customkeepsake
clinicin a suburbanAtlantamall,recommends
purchasing
photo(see fig.1).Accordingto their
yourbaby'sultrasound
jewelry"featuring
witha wonderful
to
is
here
Moments
Website,"Fetal
provide
youandyourfamily
foryears
thatyoucantreasure
a uniqueultrasound
through
bondingexperience
medicaladviceordiagnoses,
declinestooffer
Whiletheclinicexplicitly
tocome."4
ifrequested,"
determination,
alltheirpackagesincludea DVD andphotos,
"gender
friends."
and
to
and"room bringyourfamily
bonafidestothetest.
ritualservestoputwomen'smaternal
Theultrasound
We can seethismostclearly,
bylookingatwhathappenswhenwomen
perhaps,
"fail"thistest.For example,Lisa MitchellfoundthatCanadian ultrasound
towhat
whoreferred
mothers
corrected
andobstetricians
technicians
expectant
theysawon thescreenas a fetusinsteadofa baby.Whenwomendidnotmaniwiththe
festthe"proper"levelofemotionorthe"proper"formofengagement
to motherand
ultrasoundimage,techniciansweresuspiciousoftheirfitness
72
,J^rf^i#««/^^^/^#>#«^/()I
FEMINISTAPPROACHES
TO ^#/^*5<^L* 1:1
for"FetalMoments"ultrasoundstudio(www.fetalmoments.com)
Figure1. Advertisement
theircommitment
tothepregnancy.
Technicians
also weresuspiciousofwomen
whoshowedtoo muchor notenoughinterest
in thehealthofthefetusor too
muchornotenoughinterest
initssex.Theyweresometimes
directly
judgmental
towardexpectant
inthesex,tellingthemthat
parentswhowere"too"interested
outthesexisn'timportant.
Themostimportant
"finding
thingis thatthebaby
is healthy."
in
such
cases
and
when
thewomanwas
Occasionally,
particularly
notCaucasian,thetechnicians
wouldevenlie abouttheirabilityto detectthe
sexofthefetus(Mitchell2001,381).
Thustheultrasound
testisculturally
framed
notonlyas a socialritualduring
whichyoumeetyourbaby,butalso as an earlymomentat whichan expectant
mothersabilityto engageand bondwithherbabyand to arrangeforitsproper
socialreception
is measured.One ofMitchell's
interviewees
toldherthestoryof
howherownultrasound
had goneand thenasked,"Howdid I do?"(ibid.,epiOn
the
television
sitcomFriends,
RachelGreene-oneofthemain
graph).
popular
whois alreadymarkedas a nonstandard
motherwhenshebecomes
characters,
REBECCA KUKLA
73
whilesingleafterspendinga drunkennightwithherex-boyfriendpregnant
burstsintotearsduringherultrasound,
mother!"
because
wailing"I'ma terrible
the
on
when
shecannotsee fetus thescreen
thetechnician
pointsitout.5Although
theultrasound
areculturally
variantandrelatively
theritualssurrounding
recent,
forhowwomenwillactandfeelduringtheseritualsarealready
ourexpectations
in ourfolkculture.6
Itis acceptable
fora woman
quiterigidandwell-entrenched
the
about sexofthebaby,forexample,butonly
to refuseorto seekinformation
theinformation
becauseshewantsthesexto
fortherightreasons:shecan refuse
she
is
but
not
because
shecanfindout
be a wonderful
uninterested;
surprise,
just
thesexbecauseshewantstostartcontentedly
gender-coded
babygear,
purchasing
a childofonesex(although,
butnotbecauseshewouldgreatly
prefer
interestingly,
forfathers).
One can refuse
seemtobe moresociallyacceptable
suchpreferences
will
to
that
one
want
on
the
theultrasound
carrythebabyto
altogether
grounds
ofanyanomaliesand"loveitthesamewayno matter
termregardless
what,"but
in
thatthereis
notbecauseoneis simplyuninterested thetestand unconvinced
totheprocedure.
anymedicalbenefit
forulIn thefaceofthedearthofmedicalevidenceforconcretebenefits
has
been
that
for
its
routinization
thestandard
trasoundscreening,
justification
ithelpswomenbondwiththeirunbornchildren(cf.,Sedgmenetal. 2006).This
dubiousat best (cf.,
is scientifically
is so despitethefactthatsuchan effect
to
havethenormative
woman
who
fails
a
et
al.
2007).
Byimplication,
Lapaire
deficient.
reactionsto theultrasoundeventis maternally
whywe
Interestingly,
womenbondwiththeirfetuseshas gonemostly
or notpregnant
carewhether
It
is
a
assumption-and one forwhichI have
empirical
major
unquestioned.
-that bondingwithone'sfetusmakes
evidencewhatsoever
foundno scientific
one anymorelikelyto bondwithone'sactualbaby.Indeed,we mightimagine
thatbondingwithsomething
completely
portablethatwe havemetonlyvia an
infantthatmuchmoreofa
a
of
make
the
will
screaming
spitting,
reality
image
womenarealreadygoingto extreme
shock.Mostpregnant
lengthsto monitor
women
minimize
to
behavior
their
and discipline
risk;pregnant
obsessively
controltheirdiets,exerciseregimes,emotionalstates,haircareproductuse,
andjustabouteveryotheraspectofdailylife.We hardlyneeda toolsuchas the
thisalreadyexcessivephenomenon.
ultrasoundto heighten
Meanwhile,pregsuch
as
behaviors
in
who
women
nant
drugabuse are
engage seriouslyrisky
thana suggestive
morehelpful
someintervention
tostopwithout
image
unlikely
and a sternwarning.It seemsto me thatourvaluationofthematernal-fetal
intoa normative
affair
motherhood
bondstemsfromourdesiretostartturning
74
j£*2WW£»**<*/^«**#wf
OF FEMINISTAPPROACHES
TO {J&dvttf&o*1:1
as earlyas possibleand likewiseto startmeasuringa woman'smaternaladequacyas earlyas possible.
Birthas a maternalachievementtest
Laborand delivery
takelessthana day;somewomenlaborforas
typically
lastsformanydecades.Within
however,
longas a fewdays.Mothering,
typically
mostmothering
birthmakesupa tinyspeck.Adoptive
mothers
do not
narratives,
birth
to
their
children.
Yet
have
the
of
we
elevated
importance birth
give
symbolic
tothepointwhereitappearstoserveas a make-or-break
testofa woman'smotherIfshemanagesherbirth"successfully,"
risk-adverse,
ingabilities.
makingproper,
to doctorsand
bothproperdeference
choices,and maintaining
self-sacrificing
controloverherownbody,thensheproveshermaternal
bonafidesandinitiates
a lifetime
ofpropermothering.
If,ontheotherhand,shefailsatthesetasksduring
as selfish
orundisciplined
andrisksdeforming
herbaby's
labor,sherevealsherself
andemotional
whileputting
herbondwithherchild
character,
health,
well-being,
inpermanent
jeopardy.
toourculturalmythos,
delivervaginally
withAccording
"good"mothers
outpainmedication,
after
advanceplanningandappropriate
education.
prenatal
Second-best
mothers
submitregretfully
butdocilelytowhatever
medicalinterventionsthedoctorsrecommendto correctand controltheirunrulybodies.
"Bad"mothers
makeother,
"selfish"
choices,suchas givingbirthathome,seeka vaginalbirthaftera
ingoutan epiduralor a cesareansection,or attempting
"bad" mothersmayjustfailto demonstrate
previousc-section.Alternatively,
sufficient
control
overtheirbirths.
andthereby
Theymaylabor"unproductively"
"failto progress"or otherwisefailto proceedin a timelyfashiontowardan
birth.7
In somehospitals,
womenthatendup receiving
cesarean
uncomplicated
sectionsresulting
in healthy
babiesareroutinely
on
literature
givenunsolicited
to
them
their
of
failure
and
loss
at
not
grieving help
through
feelings
having
achieveda normative
birth.8
successfully
Whenwomenwerefirst
encouragedtodrawup birthplansin whichthey
theirpreferences
whowouldbe allowed
specified
concerning
painmedication,
in theirroomsduringlabor,and otherbasicaspectsoftheircare,thelaudable
ideawastohelpwomenbecomeatleastpartialagentsoftheirownbirths,
rather
thanpassively
tomedicalmanagement.
overtime,formuHowever,
submitting
latinga birthplanhas movedfroman empowering
optionto a socialduty.In
theadvice column,"AskAmy,"a recentletter-writer
was appalledthather
friend
was
not
childbirth
classes:
"She
saidthatsheandher
pregnant
attending
REBECCA KUKLA
75
husbandweregoingto"wingit"andthatthenursesknewwhattheyweredoing.
womanwouldhavesucha casual
I was a bitstunnedthatthiswell-educated
also
said
that
This
mom
attitude
theyweregoingto flipa cointo
expectant
These
decidewhetherto havean epidural.I thinkthisis veryirresponsible.
North
American
a
level
of
risk/'9
do
Contemporary
pregnant
procedures carry
womenare expectedto plan outtheirbirthswiththeelaborateprecisionand
brideplanningherweddingday,and theyareexpectedto
careofa traditional
"In thehappyhaze ofearly
recommends:
do itearly.One Web siteperversely
faroff-which
seem
and
birth
of
labor
...
the
extremely
may
reality
pregnancy
timeto startplanningforthearrivalofyourbabywith
makesthistheperfect
birthplan"
One fairly
a birthplanthatdetailsyourwishes."10
typical"interactive
is a seven-pageformthatasks
thatcan be downloadedfromchildbirth.org
and severalsubdifferent
to detailtheirchoicesin eighteen
mothers
categories
to thespecific
in
the
the
from
room,
lighting
coveringeverything
categories,
to
the
thatmaybe usedin caseofcomplications,
instruments
laboringpositions
thattheywill adopt.We can pushtheanalogybetweenbirthplanningand
as womenarecalleduponto planand designtheir
weddingplanningfarther:
as thefirst
to
think
ofbirth,notprimarily
invited
are
births,
dayoftherest
they
tenureas
their
which
oftheirchildren's
lives,butas their"specialday,"during
andputon display,
foreshadowed
willbe symbolically
mothers
justas weddings
atwhich
moment
areoftenframedas thebride'sspecialdayandas thesymbolic
a
as
is
the
of
theperfection
(orimperfection)
marriage performed spectacle.
Such elaboratebirthplans set up completelyunrealisticexpectations
howmuchcontrolone can possiblyhaveoverthelaboringprocess,
concerning
lackofconfidence,
offailure,
womenup forfeelings
disappointsetting
thereby
to
not
do
when
maternal
and
ment,
go according plan,even
things
inadequacy
whenmotherand babyend up healthy.
Theyalso givewomentheimpression
thatiftheydo nothavestrongopinionssevenmonthsin advanceconcerning
howtheywouldliketheirlaborroomlitand whether
theywishto availthemnot
are
then
foot
of
selves
engaged,consufficiently
they
pedalsduringlabor,
entire
the
cernedmothers-to-be.
Furthermore,
phenomenonofthe
although
all women
"birthplan"is pervadedbytherhetoricofchoiceand autonomy,
makesomechoicesbutnotothers.Forinstance,indiknowthatgoodmothers
attheearliestmedically
possiblemoment
catingthatonewantspainmedication
availableon the
it
is
a
choice
is nota sociallyacceptablechoice,eventhough
form.LaurenSlater(2004) writes,"Our [prenatal]teacherbelievedthatbirth
was fullofchoices.'You shouldwritea birthplanand giveittothenurses,'she
76
TO {jSd&ttf&c* 1:1
<7,tJeirva/t'o,*a/ &*€*****£OK FEMINISTAPPROACHES
said. 'You shouldrefuseall pain medication.Refusea heartmonitor.Refuse
'
Pitocin Our instructor
also informed
us thatbirthinterrupted
bytechnologyequalsa motherlessableto bondwithherbaby."
orriskfailTheideathatwomenhadbetter
managetheirbirthssuccessfully
of
motherhood
corto
bond
with
babiesand
risk
a
narrative
their
ing
thereby
atwith
the
from
the
momentis
tenacious.
first
ruptedirreparably
Beginning
tachment
movement
(1969,1983,and1988)
parenting
spearheaded
byJohn
Bowlby
fromboth
andWilliamandMarthaSears(1993)inthe1970sand 1980s,alarmists
have
medicalcommunity
thenaturalchildbirth
movement
and thetraditional
in
hour
will
not
the
first
that
mothers
who
do
not
breast-feed
for
argued, instance,
ofbirth
bondwiththeirbabies,thatmothers
whoarenotfully
lucidatthemoment
duetopainmedication
willnotbondwiththeirbabies,andso forth.11
Typically,
mothers
thenominalconcernofthosewhoraisesuchworries
istoprotect
against
interventions.
of
overzealous
medical
these
to
bond
because
losing
opportunities
infact,suchclaimsredoundagainstmothers
reason,
who,forwhatever
However,
do notmanagetoorchestrate
theirmaternal
thesefirst
moments
correctly,
putting
successintoquestionfromthestart.Forexample,notedbirthanthropologist
motherwhodoes nothearherbaby's
claims,"Asemi-conscious
Jordan
Brigitte
first
infant
whosereactions
areweakareofftoa badinteraccryanda narcotized
a birthinwhichthe
tionalstart"(1992,79).Shethentellsthestoryofwitnessing
terrorized
too
medical
much
intervention,
mother,
stoppedbeing
purportedly
by
and instead"gaveup"duringlabor.Hercontractions
stopped,her
"courageous"
laborwasartificially
andherbabywasbornwiththehelpofforceps.
restimulated,
endsthedramatic
talebycommenting
"I hopeshestilllovesherbaby"(ibid.
Jordan
ofmedicalizedbirthprac112-13).Thepassageis supposedtobe an indictment
ticesin theUnitedStates,butthenormative
languageoffailureaimedat the
motheris clear,as is Jordan's
beliefthatthiswoman'sfailedperformance
during
- however
themoment
ofbirth
muchitcanbe blamedonherdoctorsandtheinstitutionalized
ritualsofthehospital-portends
a lifetime
ofdeficient
maternity.
In popularculture,thedistasteformotherswhodo notbehaveproperly
andexplicit,
as istheimplication
thatthisbadbehavduringtheirbirthsisstrong
iorreflects
oftheirmothering.
Women'schoicestohaveornot
upontheentirety
tohavecesareansectionshaveparticularly
mobilizedthisdiscourse.
Notoriously
labeled"tooposhtopush,"mothers
whochooseelective
cesareans
fornon-medical
reasonsarevilified
In an articleentitled
bythemediaand in onlinediscussions.
"TooPoshtoPushMomsSetBadExampleforSociety,"
theVancouver
Suneditorializes,"PitypoorSeanPrestonSpearsFederline His momcouldn'tevenbe
REBECCA KUKLA
77
bothered
to suffer
a littlepainfora lotofgainon thedayofhiscelebrated
birth.
birth
the
old-fashioned
hurts.
to
Welcome
motherhood"
Yes,giving
(Fralic
way
c-section-which,
2005).Here,Britney
Spearsselective
giventhewaysofabdominalsurgery,
didinvolvemorethan"a littlepain"- is takenas reflecting
probably
her
entire
tomotherhood,
whereaspropermaternity
is
relationship
upon
directly
and a willingness
to bearpain.Meanwhile,on a
associatedwithself-sacrifice
theethicalacceptability
of
bulletinboarddiscussionconcerning
babycenter.com
similar
toAshley,
whowrites,
entries
sentiments
elective
c-sections,
express
typical
c-sections A smartwomanwholovesherunborn
"I amtotally
againstelective
childwillavoidhavinga c-sectionifat all possible.Onlya self-absorbed
wimp
wouldchooseto putherbabyin harm'swayso thatshedoesn'thaveto alterher
fromme."12
don'tgetanyrespect
orfeelanypain.Thesewomendefinitely
schedule
a global
birtharetakentoindicate
choicesconcerning
Hereagain,non-normative
and
love
ofmaternal
competence.
deficiency
liketheseis thecomplete
meaboutcomments
Partofwhatinterests
vaguewould
whatsortsofgainsandharmsareatstake.Whatexactly
nessconcerning
who
elect
mothers
how
are
and
a
birth,
exactly
Britney
gainbyattemptingvaginal
a
is
this
Of
"in
harms
their
babies
c-sections
complexsciway"? course,
putting
aimedatpinningdown
ofongoingresearch
entific
question,andthereis plenty
modes
andbabiesofdifferent
formothers
anddisadvantages
theexactadvantages
witha hostofothermundane
Whatwedo knowisthat,incomparison
ofdelivery.
allofthestandard
inhistory,
moments
toallprevious
andincomparison
activities,
vaginalbirthsafterceoptionsforbirthin developednations(cesareansections,
safeformotherandbabyalike.
waterbirths)areextremely
sarean,homebirths,
than
a c-section
chanceswithherbabybyscheduling
surelytakesfewer
Britney
walk
than
a
ride
rather
a
car
is
that
whochoosesa preschool
doesa mother
away
fromherhome.13
we castcesareansectionsorvaginalbirthsas therisky,
In fact,whether
selfishoptionvariesin accordancewithcontext,notin accordancewiththe
womenwhohave
actualrisksinvolved.Not onlyhavesome(mostlyindigent)
cesareansectionsoccasionallybeen served
resistedmedicallyrecommended
withcourtorders(orin thecase ofMelissaRowlandin SaltLakeCityin 2004,
an elective
butevenwomenwhowishtoattempt
withhomicidecharges),
vaginal
withdraconian
faced
are
birthaftera previouscesareansection increasingly
(Schneider2005; Grady2004) and thesame chargesof
hospitalrestrictions
thattheirpeerswhoseekelectivecesareansections
and risk-taking
selfishness
womenfromattempting
forpreventing
standard
The
face.
vaginal
justification
78
iW FEMINISTAPPROACHES
TO (J&iottf&c* 1:1
<y,tJ&i+t<*&o,t<*/<7*>t***t<*/
birthsaftera cesareanis based on theriskofcatastrophicoutcomesdue to
uterine
Notonlyis theriskofuterine
but- ironically-this
rupture.
rupture
tiny,
riskturnsout to be roughlyequivalentto theriskofuterineruptureduring
(Smithetal. 2002).Meanwhile,repeatcesareansare,
primary
vaginaldelivery
ofcourse,no saferthanprimary
cesareans;indeed,quitetheopposite.In other
or an attempted
whether
a
scheduled
cesarean
words,
vaginalbirthis thesomaternal"choicedependson whetheror notthe
ciallysanctioned,"properly
motherhada previouscesareanornot.Butthefactofa previouscesareanin no
hereour social
wayreversestherelativeriskofthesetwooptions.Therefore,
attitudestowardpropermaternalchoiceare cutfreeofanybasisin objective
relative
risks.14
to
Butinanycase,therealrisksandtheirsizesdo notseemtobe ofinterest
withhand-wavwhoappearquitecontent
thelaycritics
birthchoices,
ofmothers'
arenotreto gainsand harms.Especially
becausethesecritiques
ingreferences
toanyspecific,
sizablerisks,itishardnottoconcludethatthemainnorsponsive
that
mativestandards
atplayareideological,
notmedical:Ourculturalinsistence
overtheirbirthnarrawomenmake"proper"
birthchoicesandmaintaincontrol
ourdesiretomeasure
tivesis notaboutminimizing
realrisks;rather,
itsupports
exercised
in termsofwomen'spersonalchoicesand ofself-discipline
mothering
an image
but
What
is
at
stake
is
not
the
health
of
babies
moments.
duringsignal
as a
ofpropermotherhood,
combinedwiththeideathatbirthshouldfunction
of
motherhood.
such
spectacle
symbolic
Even
moments.
Wemustremember
thatmothering
isnotdennedbyitsfirst
is
a
a mother
thebestbondbetween
andhertwenty-minute-old
meaningless
baby
shadow of a genuine mother-childbond of the sort that sustains good
mothering.
You are whatyourchild eats
to childrenand eatingwellduring
Providing
high-quality
earlynutrition
ofgoodmothering.
Children's
areundeniably
important
components
pregnancy
nutritional
statusdependson eatinghabitsthatareestablished
overtime.Howthatpurportedly
ever,our cultureis repletewithimagesoffeedingmoments
both
children
and
in
mothers
some
corrupt
permanent
way.
Thelogicofthesinglecorrupting
biteshowsvividlyin a recentarticleby
"MemotoNanny:No JuiceBoxes."
JodiKantorin theNewYorkTimesentitled
Kantorwrites,apparently
"Thecurrent
wisdomsays
withoutirony,
nutritional
thatwhatchildreneatmaysettheirtastesin placepermanently.
In thisview,a
REBECCA KUKLA
79
hotdog is neverjust a singletubeofmeat,becauseitwilllead to thousandsof
lunchesto come."Heretheseemingly
salty,processed,who-knows-what-filled
and encapbeyonditself,
determining
singlehotdog is picturedas extending
ofpooreatinghabitsratherthanremaining
singular.Byalsulatinga lifetime
lowinga hotdogto slipintoherchildin a momentofweakness,a mothercan
thechild'stastesand eatingpracticesforever,
thereby
undoingmonths
pervert
oryearsofdevotionto purchasing
organicfood,avoidingtransfats,and planforherchildoutoffreshingredients.
balanced
meals
and
preparing
ning
andI havearguedthat
testsandbirthareidiosyncratic
Ultrasound
events,
events.Thelogicof
these
mothersare measuredbytheirperformance
during
one mustfeedone'schildoverand overagain,and
different:
feedingis slightly
thereis no discretemomentat whichone can proveone'spropermaternality
a mother
On theotherhand,atanymoment
mayproveherself
feeding.
through
Hence
this
is
a
testthatone can
an
act
of
mother
an improper
feeding.
through
hundreds
ofonKantor's
articlereceived
neverpassbutis alwaysatriskoffailing.
in
favor
of
more
of
them
from
linecomments
mothers,
many
arguing
immediately
One
mother
comrules.
and stricter
anddiscipline
surveillance
maternal
eating
to a
How can parentsgivesuchdiscretion
mented,"Thisarticleis frightening.
thanrelying
theirjobsrather
described
Commentators
upon
quitting
babysitter?"
toavoidhotdogs,refined
be trusted
whocouldn't
nanniesandgrandparents
flour,
in hercomments
whoadmitted
withtracesofpeanuts.One mother
orproducts
flamedby
was
infant
formula
of
one
bottle
at
least
to owning
immediately
others.15
testveryearlyon. Manyparenting
Indeed,one can failthefeeding
guides
artificial
suck
on
an
one
her
that
or
claim
outright allowing baby single
suggest
relationchancesfora successful
a mother's
breast-feeding
nipplemaywelldestroy
isathighriskforfailure
(andinturn,thata babywhoisnotbreast-fed
shipforever
andhealthproblems).16
behavioral
lowIQ, andmultiple
tobondwithitsmother,
materials
NorthAmericanbreast-feeding
emphasize
consistently
promotional
as opposedtothemoreproductive
exclusive
messagethatthemore
breast-feeding,
makethatmuch
"Doesonebottleofformula
thebetter.
breastmilkbabiesreceive,
statesLa LecheLeague,rather
We wishwe couldsaythatitdoesn't,"
difference?
intheirbreast-feeding
guide,"butwecan't"(1997,90).According
disingenuously,
and
can trigger
of
formula
tothisguide,a singlebottle
life-threatening
allergies,
cancausenippleconfusion,
withartificial
nipples(bottlesorpacifiers)
anycontact
In fact,
onto
a breast.
to
latch
or
able
thebabyisnolonger
wherein
although
willing
fedfroma bottlemayrejectthebreastorlose
itistruethata babywhois regularly
80
^t^trt^/t^ri^/
^etrri^/
TO (£irx<>//ii<*1:1
AW FEMINISTAPPROACHES
from
theskilloflatching
ontoit,thereisnoevidence
fornippleconfusion
resulting
Lawand
Inch
1996
theoccasionaluseofartificial
Fisher
and
Neifert,
nipples(cf.
outinbreast-feeding
rence,and Seacat1995).A 1992studyfoundno difference
andthosewho
breast-fed
whowereexclusively
comesbetweennewborninfants
received
onebottledaily(Cronenwett,
Stukel,and Kearney1992).Thepervasive
cultivated
fearofinstantnippleconfusion
bythemedical
amongnewmothers,
Nations
the
United
WorldHealthOrganization
establishment/the
(WHO) and
ofthepowerofthe
is itself
indicative
Children's
Fund(UNICEF),amongothers,
of
the
moment.17
singlecorrupting
logic
morethanjustan infant's
Artificial
as corrupting
nipplesareportrayed
as a whole.In WhattoExpect:
theirstaincan infect
practices;
mothering
feeding
TheFirstYear(thesequelto theubiquitousand unforgiving
queen ofguidebooks, Whatto ExpectWhenYou'reExpecting),we findout how,despitea
ofan artificial
mother's
thatfirst
offer
bestintentions,
nipplecan initiatea processthatcorrodesnearlyall aspectsofmothering:
abuse.Whatstartsoutas
Be awarethatpacifier
use easilyslipsintopacifier
s. Thereis theever-present
thebaby'scrutchcan easilybecomethemother
fortheattention
substitute
to use thepacifieras a convenient
temptation
motherwho
to herchild.Thewell-meaning
sheherself
shouldbe providing
offers
thepacifier. . . maysoon findherselfpoppingin a pacifierthemoto determine
thereason
insteadof trying
ment[herbaby]becomesfussy,
forthefussingor iftheremaybe otherwaysofplacatinghim.She mayuse
to ensurequiet
itto getthebabyoffto sleepinsteadofreadinghima story,
whileshe'son thephoneinsteadofpickinghimup and consolinghimwhile
she'schatting,
to buyhis silencewhileshe'spickingouta pairofnewshoes
Theresultis oftena babywhocan
himintheinteraction.
insteadofinvolving
in
his
be
with
mouth,and who is unableto comfort
something
only happy
and
or
to sleep.(Murkoff,
entertain
himself
himself,
himself, get
Hathaway,
2003,117)
Eisenberg
Afterherinitialofferof thepacifier,
themotherin thispassageis sweptpasofbad mothering
overwhichshehas littleor no control;
sivelydowna current
forherown
thepacifier
led intotemptation,
shesoon findsherself
substituting
activities
withmarkedly
activities
ofmothering.
Shereplacespropermothering
the
trivialtasks:chatting
on thephoneand shoeshopping.
Although
gendered,
first
suckmaybe bothtempting
andfleeting,
itsconsequence
is an orallyfixated,
child.18
emotionally
crippled
REBECCA KUKLA
81
a pivotalchoicebetweenrisk
Theideathateachfeedingmomentpresents
WhattoExpect
extends
into
backwards
andmaternal
pregnancy.
responsibility
bite
counts:
Before
close
WhenYoureExpecting
warns,"Every
you
yourmouth
'Is thisthebestbiteI can givemybaby?'Ifitwill
offood,consider,
on a forkful
Ifit'llonlybenefit
chew
benefit
yoursweettoothor appease
baby,
away.
your
and Hathaway2002,
down"
fork
(Murkoff,
Eisenberg,
putyour
yourappetite,
of
womenin chat
the
wrath
incurs
which
This
80).
pregnant
regularly
passage
roomsand on bulletinboards- demandsthatmothersdisciplinetheireating
selfish
bitethatis not
withliterally
everybiteoffood,avoidingthecorrupting,
is
because
one
Here,
("to
hungry appeaseyour
eatingsimply
baby-directed.
betrayal.
appetite")is akinto maternal
economic
thatarisefrommothers'
Therisksandbenefits
ongoinglifestyle,
benefits
risks
and
the
far
foods
to
and
access
outweigh
high-quality
security,
offeeding
orsuck.Ourfocuson theimportance
thatattachtoanysingleforkful
momentsratherthanon long-term
eatingpatternsbetraysour entrapment
ratherthan
maternalperformance,
withinan ideologicalpictureofnormative
a reasonableconcernwithchildren's
well-being.
in moments
ofmeasuring
Theeffects
mothering
a routine
activitiesthreematernal
ultrasound,
I havedescribed
undergoing
I
that
have
or
fetus
one's
and
child)arguedserve
baby(or
givingbirth, feeding
In each
are
measured.
bona
maternal
women's
testsduringwhich
as cultural
fides
colludeinassessing
themselves
themedia,andmothers
case,medicalinstitutions,
The
howmothers
signalmoments.
normatively-regulated
duringheavily,
perform
will
that
one
on
the
moments
these
hand,
rhetoric
they desuggests,
surrounding
the
narrative
thesuccessofthefuture
termine
(whether motherwill
mothering
ofsecure
thebabywilldevelopa lifetime
withherbaby;whether
bondproperly
the
reveal
that
on
the
other
and
and
hand,
habits)
they
eating
relationships healthy
selfis
she
tomother
truthabouta woman'sfitness
(whether
engaged,
sufficiently
risk-adverse,
etc.).
disciplined,
sacrificing,
behaviorduringthesetestsarenot
Ourculturalimagesofpropermaternal
withrespect
to
a
woman's
neutral.
Rather,
"properly"
ability perform
politically
andethnic
status
socioeconomic
marked
are
and
toprenatal
care,birth, feeding
by
Consider:
identity.
womeninCanadawere,notsurprisfoundthatimmigrant
(1)LisaMitchell
Nothavingbeen
the
follow
to
less
scriptduringtheirultrasounds.
ingly, likely
the
rituals
cultural
trainedon thecontingent
surrounding event,oftencoming
APPROACHES
TO(/i<«<>//t«^1:1
82 ,7, t/*i,,«/<«,i« /</„„<, i«/ <>\FEMINIST
or
fromcountries
wherethereis no routinescreening
pregnancy,
duringhealthy
is treatedas a clinicalratherthana social
fromcountries
wherethescreening
theimageon thescreen,bringalong
event,theywerelessinclinedto personify
ultrasound
theirspouses,expectkeepsakephotos,and so forth.Accordingly,
thantheir
thesewomenless medicalinformation
technicianstendedto offer
socialized
and
the
technicians
followed
ultrasound
who
etiquette,
counterparts
insuffiwomen
seemed
thatthe
lesswiththesefetalimages.Later,theyreported
withandexcitedabouttheirbabies(Mitchell
concerned
2001,185).
ciently
to
birth
that
(2) An unmedicated
goesaccording a predetermined
vaginal
I argued.Buta woman'schances
birthplanistakenas thematernal
goldstandard,
ofhavingsucha birthdependheavilyuponherownhealth,heraccessto highwithherpreferwhois familiar
continuous
healthcarewitha provider
quality,
will
herwishesin a waythathealthprofessionals
ences,herabilityto articulate
or
birth
an
of
her
center),
understand, mastery English(in Anglophone
hospital
andherlevelofsupport
tohirean advocatesuchas a doulaormidwife,
herability
fromfamilymembersand otherswhocan speakforherduringthebirth.The
evenwhenmeditoinsistthata birthplanbe respected
staff,
bythehospital
ability
andperof
a
confidence,
requires highdegree education,
normally
callypossible,
variesbysocioeconomic
ceivedsocialauthority.
position.
Everyoneofthesefactors
Womenwhomanageto havea "natural"birthmayfeelthattheyaresomehow
butinfact,theynormally
withtheirmythical
sisters,
pre-industrial
communing
accessto state-ofand theirimmediate
drawheavilyupontheirsocialprivilege
inenacting
theirbirthnarratives.
the-art
interventions
technological
diversefoods,andlesstime
(3) Poorwomenhavelessaccesstohigh-quality,
women
to preparemealsforthemselves
and theirchildren.Poorand minority
Weknow
thanfinancially
securewhitewomen.19
havelowerratesofbreast-feeding
of
in women'sknowledgeofthebenefits
thatthisis notbecauseofdifferences
facother
and
Zimmerman
2000).
(Guttman
determining
Among
breast-feeding
womenarelesslikelyto havejobs thatprovideenough
tors,poorand minority
or privatespacesin whichto nurse.
leave
to
establish
maternity
breast-feeding
Theyaremorelikelytobe singleparentsandtoworklonghours.20
Thustotheextent
thatwetake"proper"
maternal
performance
duringthese
a
a
we
will
re-inscribe
social
moments
as
measure
of
as
whole,
key
mothering
We
will
read
deficient
maternal
character
into
the
bodies
and
actions
a
privilege.
women
ofunderprivileged
andsociallymarginalized
women,whereasprivileged
withsociallynormative
homeandworkliveswilltendto serveas ourmodelsof
tests
character.
Yetitis likelythatwomenpassthesemothering
propermaternal
REBECCA KUKLA
83
lessbydintoftheirinherently
maternal
character
andtheirresponsible
commitmenttotheirchildren
thanbecausetheyhavetheright
kindofeducation,
financial
and
healthinsurance
structure, jobs.
resources,
plans,family
at signalmomentsis partofa larger
Our focuson howmothersperform
in
America
atleast,publicethicaldiscourse
cultural
North
and
Britain,
sensibility:
andwill-power
tendstofocusheavilyon personalresponsibility
as itis displayed
on
fails
to
be
at
discrete
rather
than
thestructural
(or
choice-points,
displayed)
conditions
thatenableorundermine
peoples abilityto makegoodchoicesover
to turnpublicattention
to theenvironmental,
thelongterm.It is difficult
ecothatcanmakevariouschoicesandbehaviors
difficult
nomic,andsocialconditions
madeup ofnotions
oreasy;insteadwe tendtoemploya conceptualrepertoirethatinherently
isolates
suchas character,
choice,andresponsibilitywill-power,
determinants.
individuals
as ethicalagentsandoccludessuchcontextual
thatfocuson inThisindividualist
policiesandinitiatives
logicencourages
ratherthanon
makeatparticular
thechoicesthatmothers
moments,
fluencing
narratives
ofhealthy
motherthatfoster
extended
conditions
structural
creating
States
for
the
United
service
announcements
the
For
Departing. example, public
"Babieswereborn
mentofHealthandHumanServicesbreast-feeding
campaign,
in absurdly
womenengaging
launchedin 2005,showpregnant
tobe breast-fed,"
followed
andbull-riding,
suchas log-rolling
activities
bythetext,
riskyone-time
exBreast-feed
start
after?
born.
takerisksbefore
"Youwouldn't
Why
yourbaby's
from
exclusive
breast-feedfor
six
months."21
Here,anysingledeparture
clusively
I have
choice.Elsewhere,
self-indulgent
risky,
ingis equatedwitha dramatically
on mothers'
choices,usingthe
pointedoutthatthiscampaignfocusesentirely
toadvocatefor
andblame,without
rhetoric
ofpersonalresponsibility
anyattempt
of
or
forbreast-feeding
tolerance
members, members
family
amongemployers,
thepublic,orforstructural
leave,orurban
rules,maternity
changesinworkplace
viable
for
morewomen
exclusive
make
such
that
would
breast-feeding
planning
(Kukla2006).
whenitcomesto alcohol
Consideralso our emphasison zero-tolerance
toldthatthatthereis
Womenare repeatedly
consumption
duringpregnancy.
"noprovensafelevel"ofalcoholconsumption
indeed,inthe
duringpregnancy;
is
that
General
of
the
UnitedStates,theofficial
anyalcohol
position
Surgeon
number
ofother
and
a
is
growing
consumption
duringpregnancy unacceptable,
countriesare adoptingsimilarpositions.22
Althoughextensiveresearchhas
on fetusesfromwomen'slight
effects
failedtoturnup anyevidenceofnegative
theideathata singledrink
as partofa healthy
tomoderatedrinking
lifestyle,23
84
,j£««fe*««/l«««/^«i#*«/<>K
FKMINISTAPPROACHES
TO (£;<><>//ti<yl
1:1
SPECIALTY SECTION: Critical Care
One DrinkCan Last a
Lifetime
Womenwhoconsumealcohol duringpregnancy
puttheirbabiesat riskfora
multitude
of lifelongproblems
APRN
ByCarolNelkeDimbar,
April11,2005
Figure2. FromNurseWeek,April11,2005
bothrevealsmaternalirresponsibility
influand can havea lifelong
corrupting
enceis pervasive.
In a publicserviceannouncement
the
Ad
Counproducedby
a hipyoungblackwomantellsheraudience,"Ifyoudrinkalcoholwhile
cil,24
you'repregnant,
youmaybe ruining
yourbaby'schancesofeverhavinga normal
In figure2, a headlesspregnantbellyappearsto be gearingup to suck
life!"25
backa giantglassofwinedirectly
intothewomb.Thearticleheaderemploys
thelanguageofriskand blame("women. . . puttheirbabiesat risk"),while
thescientifically
inaccurateideathata singledrinkcan undermine
reinforcing
an entiremothering
narrative
(onedrinkcan "lasta lifetime").
RKBKCCA KIKLA
85
Ourdetermination
toprevent
womenfromeverdrinking
duringpregnancy,
andourdemonization
ofthosewhodo,hascomeatthecostofeducating
pregnant
toalcohol
womenaboutthedifference
betweenhealthy
andabusiverelationships
The
and thedifference
betweentheoretically
and substantially
riskybehaviors.
avoidanceofalcoholhasnotbeenaccompublichealthemphasisuponcomplete
women.Theimplicit
forpregnant
assumppaniedbysubstanceabuseprograms
zerotionwouldappearto be thatgood motherswillfollowtheno-safe-level,
tolerance
rule,whereaswomenwhoviolatethisrulealreadyhaveproventhemselvesto be bad motherswhoarebeyondsaving.Epidemiologically
speaking,
are
much
risk
factors
for
social
and
stress,
havinga baby
poverty,
smoking
bigger
withFetalAlcoholSyndrome
thanis occasionaldrinking
2003),but
(Armstrong
ourfocuson momentsofmaternalchoiceoccludesthesesocialdeterminants.
andperScaretacticsunderscored
character,
bythelanguageofchoice,maternal
not
at
riskfor
sonalresponsibility
women
who
are
convince
many
pointlessly
of
an
occasional
with
Fetal
Alcohol
to
the
babies
having
Syndrome forgo pleasure
glassofwine,whilesurelyinducinglittleotherthanguiltin alcoholicwomen
whosebabiesareatseriousrisk.
As a culture,then,we privilegeearly,discretemomentsofchoiceas the
relationmeasuresofmothers,
as opposedto ongoingpatterns
and developing
chances
at
if
in
or
secure
our
child's
ships as we can bond a moment,
destroy
ina moment,
ina moment.
Andyet,whilethereis
orfailatmothering
well-being
will
to
have
the
that
a
decision
turn
out
always possibility poor
tragicconsequences
decisiontoleavethreetoddlers
McCann'smuch-discussed
(suchas KateandGerry
- a decisionthathas been
alonein a hotelroomwhiletheywentoutfordinner
castbythemediaas Katesrather
thanthecouple's),
singleeventsrarely
universally
andsucin
will
turn
or
how
a
role
how
a
child
out,
healthy
play large
determining
cessfula mothering
narrativewillbe. My suggestionis thatwe need to view
as a workinprogress
untiltheveryend.Whenitcomestohealthpromothering
motionandpolicy,
weshouldshift
ourattention
performances
awayfrommothers'
at keymoments,
and ontoproviding
familieswiththesystematic
supportthat
Such
ofgoodmothering.
wouldenablewomento engagein ongoingnarratives
full
access
decent
leave;
maternity
supportwouldincludefoodandjob security;
accesstodecenteducation
to family
universal
planning;a cleanerenvironment;
aroundtheassumpandhealthcare;workplaces
andlaborlawsthatarestructured
tionthatmanyworkers
willhavesubstantial
commitments,
including
parental
APPROACHES
TO(/^/^/At'^i 1:1
86 ^£x*t*a****€*lj&>*4*n**lw FEMINIST
accessibleinterventions
for
and to fathering;
to breast-feeding
commitments
and a
mentalillness,or othersocialstresses;
withaddiction,
womenstruggling
forall children.
safe,competent,
publicschoolsystem
junk-food-free
a decades-long
is typically
theideathatreproduction
Ifwe takeseriously
a biologicaleventinvolving
socialand materiallaboroflove,and nevermerely
andthebioethical
rights,
eggs,sperm,andwombs;thentheseareall reproductive
and
limits
is
ethics.
consideration
oftheircontours
reproductive Hencethereoriwoulddramatically
thatI havebeenurging
entation
ofattention
changethescope
ethics
ethics.In thefirstinstance,reproductive
and methodsofreproductive
and
medicalchoicesmadebefore
wouldnolongerconcernparticular
conception
wouldbe largerquestionsofsocial,
Itsprimary
subjectmatter
duringpregnancy.
ratherthanjustas an afeconomic,and environmental
justice,and inevitablytreats
ethicsgenerally
reproductive
equity.Contemporary
terthought-gender
sourcesofgeneticmaterialand gestational
mothersas fleeting
environments,
toa handfulof
is summedupbyandconfined
whoseethicalroleinreproduction
we must
lives.As feminists,
choicesmadeatorbeforethestartofourchildren's
tobe whole,sociallysituated
takemothers
insistthatbioethicists
peoplewithendecades
of
several
tirelifenarratives,
mothering.
including
typically
Notes
attheAmericanSocietyforBioethics
ofthispaperwerepresented
1.Earlyversions
and theHumanitiesannual meetingin Denver,Colorado in October2006 and as a
in theAgeofIntensiveParParents:Childrearing
keynoteaddressat the"Monitoring
Forwonderful
in
2007.
of
Kent
the
at
conference
June,
supportand
University
enting"
Ellie
Colleen
to
Lee,MereI
Fulton,
am
Charles,
conversations,
Sonya
grateful
helpful
and especiallythemembersof
dithMichaels,TriciaShivas,an anonymousreviewer,
Lisa
RiskResearchGroup:ElizabethM. Armstrong,
theObstetricsand Gynecology
Lisa
Mitchell.
and
Anne
Miriam
Little,
Harris,
DrapkinLyerly,
Margaret
Kuppermann,
Research
wassupported
Thisresearch
bya grantfromtheSocialScienceandHumanities
CouncilofCanada.
referee
2. As an anonymous
pointedout,1do notmakeanyseriousattempt
rightly
in
this
to definegoodorhealthy
paper.Surelywomencan be betterorworse
mothering
criticaldistancefrom(whatI seeas) one
is
in
here
interest
mothers.
However,
gaining
my
and deratherthanwithforging
mothering,
wayofmeasuring
hegemonic
problematic,
moral
serious
is
of
ethics
of
the
alternative
a specific
Mothering
mothering.
picture
fending
mother
takes
to
what
it
however,
consider
to
need
well;
we
do
hence
and
hopefully,
work,
canbe measuredinanyuniform
theideathatmothering
wecan transcend
way.
3. 1 elaborateand defendtheclaimthatmothersplaysucha crucialrolein the
healthcaresystemin Kukla2006.
4. www.fetalmoments.com
15,2007).
(accessedSeptember
REBECCAKUKLA 87
5. "TheOne WhereRachelTells.. .",first
airedOctober11,2001.
6. 1 cannot,in anyformalsense,provideempiricalevidencethattheseattitudes
are entrenched
in our folkculture;itis oftenin thenatureoffolkattitudesnotto be
documented
or articulated.
formally
7. Severalfeminist
scholarshavepointedouthowthelanguageoffailingand defective
women'sbodiespervadesourdiscussions
ofbirth.Cf.Harrison1982;Davis-Floyd
2006.
1994;and Lyerly
8. ThiswasthepracticeatOttawaCivicHospital,whereI gavebirthtomyperfectly
sonbycesareansection.I do notknowhowmanyhospitalsdo this,however
itis
healthy
easytofindpamphlets
designedforthispurposeonline.See forinstancewww.birthrites.
(accessedNovember12,2007). See www.plus-size-pregnancy.
org/Bookletlndex.html
(accessedNovember12,2007)for
org/CSANDVBAC/csemotionalrecov.htm#References
a largeclearinghouseofliterature
designedto aid emotionalrecoveryaftercesarean
section.
A recentNew
9."AskAmy,"
August29,2007,accessedatwww.chicagotribune.com.
theconcernaboutwomen
YorkTimesarticle,"TheEndofChildbirth
101?",underscores
thatsuch
classesexpressedbythisletter-writer,
whodo nottakechildbirth
worrying
whoexplainedeach
ofhavinghada teacher
womenwillnotbe ableto"reapthedividends
possibleintervention."
10.www.kidshealth.org.
studies(e.g.,Kennel,
scientific
11.Bowlby's
programspawnedvarioussympathetic
to debunkhim(inbacklashattempting
Trause,and Klaus 1975),as wellas a scientific
Lozoff
1983).
cluding
PostedSeptember
12.www.babycenter.com.
28,2006.
13. 1 could notpossiblydocumentor compareall thepossiblerisksofroutine
andofbeingbornbyscheduledcesareansection.Butforpurposesofillustration,
driving
the2003rateofautomobile
considerthataccordingtotheNationalCenterforStatistics,
fatalities
in theUnitedStateswas 8.34/1000population,whereasthe
accident-related
rateofperinataldeathassociatedwithscheduledcesareansectionsin theUnitedStates
is 1.3/1000
population(Landonetal. 2004).
in
14.Theargumentofthisparagraph,differently
worded,appearedpreviously
al.
2007.
et
Lyerly
15.News.blogs.nytimes.com/2006/09/28/memo-to-nanny-no-juice-boxes.
lactation
16.Cf.,e.g.,La Leche1997andTamaro1998,as wellas thestandard
nursing
thisadvice.
Lawrence1994,whichrecommends
textbook,
givingnewmothers
17.Cf.,e.g.,AmericanAcademyofFamilyPhysicians2000. UNICEF and the
whichexplicitly
WHO jointlysponsortheBabyFriendly
promotes
HospitalsInitiative,
thetotalavoidanceofartificial
nippleconfusion.Cf.www.
nipplesin orderto prevent
(accessedNovember13,2007).
babyfriendlyusa.org
suck,as it
18.In Kukla2005,Chapter5, 1 documentthislogicofthecorrupting
journalarticles,in quitea bitof
appearsin popularmedia,guidebooks,and scientific
detail.
accessedNovem19.www.cdc.gov/MMWR/preview/mmwrhtml/mm5512a3.htm,
ber13,2007.
88 j£**S^Wi»##«/^*4*Wr0F
1:1
FEMINIST
TO(/><«<>//t«,i
APPROACHES
20. Fordetaileddiscussionsofwhypoorand minority
womenbreast-feed
atlower
rates,cf.Blum2000,and Kukla2006.
21. PSAs available at www.4women.gov/breastfeeding/index.
cfm?page=
adcouncil.
lawsthatwould
22. AustraliaandNewZealandareintheprocessofimplementing
labelssimilarto thoseused in theUnitedStates(www.amavic.
requirezero-tolerance
its
com.au,accessedNovemberl3,
2007),and New Zealand has recently
strengthened
of
alof
Health
which
avoidance
have
from
Ministry
guidelines,
recommending
gone
coholduringpregnancyto urging"totalabstinence"duringpregnancy(www.otago.
accessedNovember13,2007).
ac.nz/news/news/2006/13-07-06_press_release.html,
womenshouldavoid
SomeCanadianprovincesrequirewarningsstatingthatpregnant
of
all alcoholto be postedin licensedestablishments.
In May 2007,thegovernment
their
Britainand theRoyalCollegeofObstetricians
and Gynecologists
"strengthened"
ofalcoholconsumption
Whereastheformer
warningsconcerning
duringpregnancy.
toone
ficialBritish
recommendation
wasthatpregnant
womenlimittheirconsumption
to twodrinksperweek,thenewguidelinesadvisethatwomenshould"stopdrinking
(Bennett2007).
duringpregnancy
altogether"
2003.
23. Foran exhaustivereviewoftheevidence,cf.Armstrong
24. Inventors
ofMcGruff
theCrimeDog, SmokeytheBear,and the Babieswere
Bornto be Breastfed"
materials.
campaign,amongothersocialmarketing
25. PSA availableatwww.nofas.org/MediaFiles/PSA/PSA.wmv.
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American
ofFamilyPhysicians.
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Academy
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