Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having an (...) intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

In this article, I argue that many women lack the epistemic resources that would allow them to recognise the practice of vaginal examinations during childbirth as violent or as unnecessary and potentially declinable. I address vaginal examinations during childbirth as a special case of obstetric violence, in which women frequently lack the epistemic resources necessary to recognise the practice as violent not only because of the inherent difficulty of recognising violence that happens in an ‘essentially benevolent’ setting such as the (...) medical one, but also, and mainly, due to the pervasive sexual reification of women under patriarchy and the pervasive shame to which women are subjected. My argument is that the practice of vaginal examinations is indeed experienced – bodily apprehended – as violent by many women, but that full epistemic recognition of this violence is frequently obstructed because the experience perfectly coincides with the normal phenomenological situation of women within patriarchy and thus cannot really be framed as violent. A phenomenological analysis presenting the embodied experience of women under patriarchy as always already essentially tied to sexual availability and commodification, and to shame, will explain this epistemological impairment. A phenomenological take on Judith Butler’s distinction between ‘recognition’ and ‘apprehension’ informs my analysis: I deploy it to provide a richer, more nuanced response to the question of why vaginal examinations are not fully recognised and expressed as violent – even when they are, frequently, apprehended as such. Furthermore, Butler’s ideas about the epistemic ‘framings’ through which we make sense of different kinds of lives (grievable versus ungrievable) will help me to explain how the patriarchal sexual reification of women in fact already frames sexual violence as not-violence – which ultimately also prevents labouring women (and obstetrics staff) from recognising vaginal examinations during labour as violence. (shrink)

In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining (...) the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process—and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used. (shrink)

This article explores post-cesarean shame to understand how normative birthing ideals are tied to neoliberal and popular feminist expectations of what it means to be a “good” mother. Drawing on narratives shared on motherhood blogs, we note that feelings of shame associated with cesareans are tied to social pressures for unmedicated, vaginal birth. Rather than critique nonmedical or “natural” birth, this article explores the affective implications of approaching birth as a curated and controllable process. We conclude with suggestions for practitioners, (...) moms, and their supporters on how to make room for births that are not good. (shrink)

Using the social interpretation of disability, Foucault's theory of disciplinary power, literary devices, and feminist literature, I write an affective narrative of mothering disabled children. In doing so I illustrate the ways in which the materiality of normalcy, surveillance, and embodiment can produce emotions that create docile mothers ashamed of their contribution to the world, conflicted mothers struggling with dissonant affects, and unruly, angry mothers battling against the architectures of their children's oppression.

I argue that public officials and health workers ought to respect and protect women’s rights to make risky choices during childbirth. Women’s rights to make treatment decisions ought to be respected even if their decisions expose their unborn children to unnecessary risks, and even if it is wrong to put unborn children at risk. I first defend a presumption of medical autonomy in the context of childbirth. I then draw on women’s birth stories to show that women’s medical autonomy is (...) often ignored during labor. Medical interventions are performed during childbirth without women’s consent. Childbirth is risky and some coercive medical interventions may be understood as attempts to protect children and to prevent mothers from acting impermissibly. However, even if it is wrong to make risky choices during childbirth, women have rights to do wrong in these cases. Therefore, coercive medical interventions are impermissible during childbirth and institutions should adopt specific protections for obstetric autonomy. (shrink)

This special issue explores the relevance of shame to feminist theory and practice. Across a number of contexts, theoretical frames, and disciplines, the articles collated here provide a stimulating engagement with shame, posing questions and developing analyses that have a direct bearing on feminism. For, the significance of shame to feminists lies in the complex and often troubling implications it holds as a feeling that may be experienced differently by people of certain genders (and none), and in its relation to (...) power. Indeed, as the contributions to this special issue highlight, shame may play a role in our moral development, but given its often readily acknowledged harmful effects, shame is frequently put to politically problematic and morally questionable ends. In patriarchal societies the outgrowths of this regularly entail gendered consequences, as gendered shame may form a disciplining device operating through structures of oppression, such as gender, but also class, race, ethnicity, sexuality, nationality, and related intersectional categories. The question of a politics of shame therefore arises in the context of a consideration of the social and political deployment and manipulation of shame, and the reported divergence in the shame experience itself, which feminists have attributed to its manifestation through, among others, gender. (shrink)

This article theorises a group of mothers’ experiences of shame as a result of feeding infant formula to their children. Drawing on interviews with formula and breastfeeding mothers, the author brings together insights from scholarship on shame, feminist scholarship on reproductive labour and the Marxist notion of estranged labour to demonstrate that shame causes the formula-feeding mothers in this study, who initially wanted to breastfeed, to be estranged in their labour as mothers. The article addresses a gap in qualitative infant-feeding (...) scholarship, which focuses primarily on breastfeeding. It provides an empathic account framing breastfeeding and formula-feeding mothers as potential allies against ‘controlling images’ of motherhood who face different facets of the same pressure to fulfil idealised roles. Both scholarly work on reproductive labour, and public programmes supporting new mothers, should account more seriously for the experiences of formula feeding mothers. (shrink)

Obstetric violence—violence in the labor room—has been described in terms not only of violence in general but specifically of gender violence. We offer a philosophical analysis of obstetric violence, focused on the central role of gendered shame for construing and perpetuating such violence. Gendered shame in labor derives both from the reifying gaze that transforms women's laboring bodies into dirty, overly sexual, and “not‐feminine‐enough” dysfunctional bodies and from a structural tendency to relate to laboring women mainly as mothers‐to‐be, from whom (...) “good motherhood” is demanded. We show that women who desire a humane birth are thus easily made to feel ashamed of wanting to be respected and cared for as subjects, rather than caring exclusively for the baby's well‐being as a good altruistic mother supposedly should. We explore how obstetric violence is perpetuated and expanded through shaming mechanisms that paralyze women, rendering them passive and barely able to face and fight against this violence. Gendered shame has a crucial role in returning women to “femininity” and construing them as “fit mothers.” To stand against gendered shame, to resist it, on the other hand, is to clearly challenge obstetric violence and its oppressive power. (shrink)

Traditional western conceptions of pain have commonly associated pain with the inability to communicate and with the absence of the self. Thus pain, it seems, must be avoided, since it is to blame for alienating the body from subjectivity and the self from others. Recent work on pain, however, has began to challenge these assumptions, mainly by discerning between different kinds of pain and by pointing out how some forms of pain might even constitute a crucial element in the production (...) of subjectivity. This article deals with the specific form of pain that is labour pain. Pain in labour has been investigated in medicine and lately, copiously, within the social sciences. Analyses from a more philosophical perspective are still very much missing, however, and in developing such analyses, de Beauvoir’s ideas on subjectivity as inherently embodied, as situated, and as profoundly ambiguous when authentically lived, appear to be of significant use. (shrink)

Drawing on sociological and anthropological studies, the aim of this article is to reconstruct how obstetric technologies contribute to a moral conception of pregnancy and motherhood, and to evaluate that conception from a normative point of view. Obstetrics and midwifery, so the assumption, are value-laden, value-producing and value-reproducing practices, values that shape the social perception of what it means to be a “good” pregnant woman and to be a “good” mother. Activities in the medical field of reproduction contribute to “kinning”, (...) that is the making of particular social relationships marked by closeness and special moral obligations. Three technologies, which belong to standard procedures in prenatal care in postmodern societies, are presently investigated: informed consent in prenatal care, obstetric sonogram, and birth plan. Their widespread application issupposed to serve the moral goal of effecting patient autonomy. A reconstruction of the actual moral implications of these technologies, however, reveals that this goal is missed in multiple ways. Informed consent situations are marked by involuntariness and blindness to social dimensions of decision-making; obstetric sonograms construct moral subjectivity and agency in a way that attribute inconsistent and unreasonable moral responsibilities to the pregnant woman; and birth plans obscure the need for a healthcare environment that reflects a shared-decision-making model, rather than a rational-choice-framework. (shrink)