Philippa comments on her early interactions with the health services and professionals:

К оглавлению
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 

I did feel very confused to start with because I think they assumed . . . There was

also, there was kind of confusion over just very silly things like, I remember where

you had to sort of take your notes with you and they kind of assumed things like you

knew you had to take a urine sample with you and stuff and there was a bit of kind

of . . . and I didn’t on the first occasion and they said, oh I can tell it’s your first

baby, and I thought, no one ever told me. I don’t know, there were just little things

like that that I just found irritating, this kind of assumption that it was . . . you were

kind of stepping in to something and you’d automatically know where to go and

who to see, and what sort of . . . And I got a note from [hospital] saying come for

your booking in, and I thought, what’s a booking in? And I had no idea. So there

was, I think that was, there was a lack of kind of explanation of the process that I’d

be going through in terms of the health care I’d be receiving, but once I kind of got

my head round it and asked questions, that was fine. And actually the health care

itself was not the problem, it was more kind of procedural.

This extract captures the ambiguities and contradictions in the relationship

between those in whomauthoritative knowledge is vested and women

beginning their journeys into motherhood. It also illuminates the assumptions

made about what women should instinctively know. Once again,

different professional and lay frames of reference are operationalised.

Interestingly, whilst Philippa challenges the assumptions that are made

about her level of knowledge as a pregnant woman, and what is perceived

as expert terminology for example ‘booking in’, she concludes that it was not

the health care itself, but the procedures that were ambiguous. Philippa,

however, is also tentative in her criticisms: ‘so there was, I think that was,

there was a lack of kind of explanation of the process’. The differing perspectives

on what pregnant women know, or are expected to know, are

interwoven with essentialist assumptions around women’s abilities to

naturally mother. Although this is more apparent during the early postnatal

perio d (see chapt er 5) such assum ptions cl early underpi n aspe cts of

antenatal care, which paradoxically occur within an increasingly medicalised

context. This contradictory position has also been recognised in other

work. For example, Lazarus notes from her extensive research on childbirth

in the US that women ‘regardless of social class or ethnicity . . . spoke

about childbirth as a natural process, but at least to some degree, they

accepted the medical view of birth: that any number of things could go

wrong and that ultimately they had to rely on authoritative knowledge and

concomitant technological expertise of their physician to ensure that they

h ad d on e e ve ry th in g p os si bl e t o h av e a h eal th y b ab y’ ( 1 9 9 7 :1 33 ).

The women’s narratives throughout the antenatal period can be seen as

tentatively constructed. They draw on both essentialist assumptions of

women’s abilities to naturally become mothers and the need for expert

medical guidance and to be seen to act responsibly. As noted in the

previous chapter, the experiences of previous generations have become

less relevant. This is because technological developments have changed

the contours of pregnancy and so other experts are increasingly looked to

for guidance. Rather than a demise in reliance or trust being placed in

expert bodies of knowledge in late modernity, as some theorists have

suggested (Beck, 199 2), within the arena of reproduction and childbirth

there is continued and even increased engagement with expert bodies of

knowledge and practices. The women in the study considered the procedures

involved in their antenatal care to be ultimately reassuring, helping to

allay fears around perceived risks. Even so, they found the ways in which

information was given and the availability of tests (to confirm absence of

possible risks) to be at times inadequate. They wanted their pregnancies to

be monitored by the experts. They wanted more information not less, and

whilst aspects of monitoring could involve some anxiety, ultimately

engagement was perceived as reassuring, as illustrated by Clare:

I think it’s been quite adequate. I mean, I had quite an easy pregnancy and there’s

never been any . . . well there was one . . . I had to have another scan because they

thought the baby might be a bit small, which . . . worried for a week until I had the

scan and it was perfectly normal . . . because it’s been so normal I think I’ve never

had to really ask many questions. They’ve always done all the checks all the time

so I’m quite confident that everything’s been monitored.

A focus on how women make sense of this period of embodied, physical

change reveals that some narratives are more complex than others,

challenging – whilst engaging with – the medical profession. Felicity

(bravely) challenges the expectations she perceives to surround her

pregnancy and begins to stray into the largely uncharted area of what

can and cannot be said in relation to our (even unborn) children:

It’s almost as if you have to play along with this game, you have to be really pleased

in order to be a proper mum.

Later she talks about the midwife giving her a book on pregnancy, which

contained pictures of the birth:

which just made me burst into tears, I don’t want to do it.

Felicity feels that those with authoritative knowledge could provide more

helpful parameters to help her think about the birth:

I’d be much happier if they actually said, you know, well I expect it’s going to hurt

like hell, how long it’s going to take, sort of maximum and minimum, what they’re

going to do, but they haven’t.

Yet, although she constructs an account with elements of resistance,

Felicity does not challenge the medicalisation of childbearing, but rather

finds that she must be responsible for privately purchasing further tests for

Downs Syndrome, which she thinks are necessary:

The National Health Service has been awful in terms of . . . we actually went to

see a genetic counsellor to allay any fears [of Downs Syndrome] and she, the

counsellor, was very patronising, ‘don’t worry, dear, go away and enjoy your

pregnancy’.

Diana also talks of her needs not being met in the way she thinks they

should have been:

You really need to make informed choices and not many people in the medical

profession I’ve found tell you very much about it . . . in fact I found my GP to be

less than forward with any information, they just don’t want to tell you anything.

The complexities of the relationship between health professionals and

women are drawn out in the previous extract, and show competing frames

of reference being used. Health professionals can be seen to assume some

level of instinctive knowledge on the part of the women, whilst at the same

time giving only that information which they deem necessary for the

women to have. It could be that the profoundly embodied experience of

pregnancy leads the experts to assume some level of instinctive, bodily

knowledge. But this needs to be set against the ways in which women’s

knowledge of their own bodies has been shaped over generations. Barbara

Katz Rothman has spoken of ‘the history of Western obstetrics (as) the

history of technologies of separation’ (cited in Davis-Floyd and Davies,

1997 :315) an d here is an other cont ext in whic h the effect of sepa ration is

played out. The women are unclear about their needs, both wanting and

resisting information that they are given or believe is being withheld.