Preparing appropriately

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The moral context in whichmothering occurs is hard to escape, its influences

being felt for some even before conception. It clearly shapes the antenatal

period, that is the medically defined stages, which pregnant women pass

through. In theUKand theUSthere is a cultural expectation that allwomen

expecting a child will take up and use antenatal services ‘appropriately’ and

this involves regu lar in teracti on s w ith h ealth care profess ionals (M iller, 1995;

Browner a n d Pre ss, 1997). Mos t of t he women i n thi s s tudy purchased h ome

test kits from the pharmacy to establish whether they were pregnant.

However, all presented themselves to their general practitioners (GPs) to

confirm their pregnancy. Also, many spoke of the now routine ultrasound

scan providing absolute certainty of their pregnancy and reassurance:

That was really reassuring because up till then I hadn’t really sort of believed in it

you know. (Peggy)

I suppose I didn’t actually feel that pregnant until you actually see that baby on the

scan, then yes, it becomes more real. (Linda)

Engagement with health professionals and associated practices were

openly undertaken at an early stage by all the women. This was regarded

as the appropriate thing to do when expecting a child. As noted in earlier

chapters, how ‘choices’ are perceived and made is bound up with dominant

ideologies about appropriate behaviours. These in turn are

reinforced and perpetuated through interactions and mediated by social

class. Thus ‘all participants come to see the current social order as a

natural order, that is, the way things (obviously) are’ (Davis-Floyd and

Sargent , 1997 :56). This extends to place of birth, with the hospita l

regarded as the appropriate, ‘natural’ setting for birth. In the following

extract, Felicity talks about her reasons for not contemplating a home

birth and recognises the contradictions in her account:

The one thing about birth that really worries me is the mess. The mess and the

smell . . . and yes, OK, I slag off the medical profession but I’m going to be

damned glad that they’ll be there if anything goes wrong.

Kathryn too emphasises her perception of the hospital as being the safest

place to give birth, and her responsibility for her unborn child:

I would just never forgive myself if something went wrong and I could have saved

the baby.

These extracts resonate with others in the study and indeed other

research findings in theUKand US, which show engagement with, rather

than resistanc e to, a (potent ially) med icalised birth (Lazar us, 1997 ). The

uncertainty of what giving birth will involve, especially when expecting a

first child, leads the women to engage with those they perceive as expert,

and to demonstrate through their accounts and actions that they are

preparing responsibly. Birth should occur where both expert professionals

and expert equipment are located: the hospital. Greater interaction

with the medical profession was also regarded as evidence of better

care, and experienced as reassuring. The expert and reassuring nature of

the relationship was summed up by Sarah:

. . . goes to the hospital and the woman there was brilliant, she was really nice. And

there was a midwife there and a . . . some guy who deals with genes, and a trainee

doctor who just nodded a lot, and somebody else, some other kind of expert . . . as

well as the ultrasound person and . . . and they were brilliant. The fact is that all of

those women and men, they know exactly what they’re doing, it’s their job . . .

Stories of engagement with the experts, through contact with G.P.s and/or

midwives, or health visitors at parent-craft classes, provided a central part

of the plot in the women’s anticipatory narratives. Whilst the women all

spoke of getting information from other sources, for example, relatives,

friends and books, these were regarded as less reliable, less expert, than that

provided by health professionals, as the following extract shows:

I don’t like getting information from other people because it’s always so subjective

and they always want to harp on about their little story, and so I have actually

avoided other people . . . I’ve steered away from those, those are the most unhelpful,

personal experiences that I’ve steered away from. But I think the books, and

the midwives and my doctor, my doctor’s been good. (Rebecca)

Information from friends was seen as either ‘unhelpful’ or as in the extract

below, potentially ‘wrong’. Ironically, the cautious silence on the part of

friends who were already mothers helped to perpetuate particular myths

of motherhood:

Well, a lot of the friends that have had babies say that they don’t like to say too

much because they could say the wrong thing. (Faye)

Information from experts, those in whom cultural authority is vested, is

ordered as being a better source of knowledge. Information giving could

also act as a catalyst leading to greater reflexivity. Gillian describes her

experiences of attending parent-craft classes:

they’ve been useful in that they’ve prompted me . . . it’s just made you think or it’s

made you think in order . . .

But this opportunity to ‘think’ was of course bounded by the medical

context in which particular ideological messages are conveyed. The interplay

between acting responsibly and being seen to do the right thing is

emphasised in the ways in which the women spoke about their feeding

intentions. This involved seeking guidance and reassurance from the

experts that their intended actions were appropriate. In the following

extract Angela talks of her intentions, but within the context of having

to seek confirmation from the expert, the midwife:

There’s things like . . . ’cos I can’t make up my mind whether I’m breastfeeding or

bottle feeding. So, I’d like to have a go at breastfeeding but you’ve got to know all

the bits and bobs that go with it, like I didn’t find out until the other day that,

I want to go half and half so that my husband will be involved, and what I was

going to do was do half formula and half breast, but I found out that if you’ve got

eczema or asthma in the family, they don’t like you doing a mixture, well, I only

found that out Monday . . . so looks like I’m going to do totally breast but I can’t

confirm that with the midwife until I see her.

Similarly, Wendy talks of not getting the permission she had sought in

regard to the feeding practice she had planned. But she is apparently

happy to be told what to do:

I’m going for the breast first to see how I get on. I did actually say to the midwife

that I wanted to do both, I wanted the bottle and . . . but she said you can’t

actually do that . . . (but) it’s been good. They just tell you everything.

Perceptions of the dimensions of expert knowledge are implicit within the

extract: ‘they don’t like you doing a mixture’. Wanting experts to give

guidance was expressed by many of the participants who, at times, resisted

being drawn into decision-making interactions, wanting to be told what to

do and emphasising their non-expert status, as Peggy remarked:

Don’t keep giving me decisions to make, I don’t know, I’ve not done this before.

As I have previously noted, professional care in the postnatal period in the

UK is organised under the National Health Service. It involves a number

of home visits made by the midwife and then health visitor in the period

following discharge from the hospital. This is a practice whichmay be less

culturally acceptable in the US. In the following extract, Gillian talks in

terms of establishing a relationship with the health professionals who will

be ‘responsible’ for her following the birth of her baby:

It also gives you a chance to get to know the health visitor . . . I mean I know

which one will be mine afterwards . . . just to sound out a few of their ideas and

things and how you . . . they’re going to handle you afterwards, that type of thing.

Establishing a relationship with members of the health care team was

seen as an important part of antenatal preparation. Anticipating and

preparing to become a mother in culturally appropriate ways was not a

solitary endeavour. Rather, it was expected that it would involve regular,

formal interactions with different experts, who would monitor progress.

The women produced accounts which showed their particular constructions

of the relationship, although their expectations were not always

met, as Rebecca comments:

The midwife came round the very first time when I’d just found out I was

pregnant and I was very, as I said, confused and very unsettled and she was not

that interested. They’re very good now, they’re very interested and they keep a tab

on everything, but at the very beginning, I suppose because people miscarry in the

first three months so they don’t spend a lot of time with you then in case it’s all for

no reason. But I did feel very left on my own. They saw me once and then they

didn’t see me for a month and I didn’t know when I was supposed to book up for

classes, the antenatal parent classes, and I didn’t know when I was meant to see

them and how often and what I was supposed to be doing, and that kind of thing,

and I just felt at the beginning I could have done with more support because

I really needed it then. Not so much physically, but emotionally.

Here we see different frames of reference being operationalised in

terms of lay expectations and professional, expert practices. Having

anticipated interaction with the midwife once her pregnancy had been

confirmed, Rebecca describes her confusion when this is not forthcoming

in the ways she had anticipated, and said that without them she didn’t

know ‘what [she] was supposed to be doing’. The uncertainties which

surround the process of becoming a mother for the women in this study

were discernible to varying degrees in all the accounts collected. The

women had all experienced dimensions of agency within the context of

being working women with some control over their lives. Yet uncertainties,

together with ideas about preparing appropriately, led to dependence

on authoritative expert knowledge and related practices. Through

engagement with the medical profession and the regular monitoring of

their pregnancies the women could be seen to be preparing to become

mothers, in appropriate ways, reducing risk and acting responsibly. And

whilst the participants said they did not have expectations of what pregnancy

would be like, once again reinforcing the consequences of broader

social changes, the narratives they produced were clearly shaped in relation

to cultural messages, for example:

I didn’t have any expectations whatsoever . . . It wasn’t really in my scope of

thinking . . . I’m just doing what you’re meant to do. (Sarah, emphasis added)

I wanted to just carry on as much as I could as normally as possible. . . . I didn’t

want it to sort of take over or anything. (Diana)

Although implicit references to expectations of pregnancy were apparent

amongst the women, their non-expert stance in relation to other

experts was acknowledged in all the accounts. In the following extract