Tangled Diagnoses

Since the late nineteenth century, medicine has sought to foster the birth of healthy children by attending to the bodies of pregnant women, through what we have come to call prenatal care. Women, and not their unborn children, were the initial focus of that medical attention, but prenatal diagnosis in its present form, which couples scrutiny of the fetus with the option to terminate pregnancy, came into being in the early 1970s. Tangled Diagnoses examines the multiple consequences of the widespread diffusion of this medical innovation. Prenatal testing, Ilana Löwy argues, has become mainly a risk-management technology—the goal of which is to prevent inborn impairments, ideally through the development of efficient therapies but in practice mainly through the prevention of the birth of children with such impairments. Using scholarship, interviews, and direct observation in France and Brazil of two groups of professionals who play an especially important role in the production of knowledge about fetal development—fetopathologists and clinical geneticists—to expose the real-life dilemmas prenatal testing creates, this book will be of interest to anyone concerned with the sociopolitical conditions of biomedical innovation, the politics of women’s bodies, disability, and the ethics of modern medicine.

How the monsters of nineteenth-century literature and science came to define us. “Was I then a monster, a blot upon the earth, from which all men fled and whom all men disowned?” In We Are All Monsters, Andrew Mangham offers a fresh interpretation of this question uttered by Frankenstein’s creature in Mary Shelley’s 1818 novel in an expansive exploration of how nineteenth-century literature and science recast the monster as vital to the workings of nature and key to unlocking the knowledge of all life-forms and processes. Even as gothic literature and freak shows exploited an abiding association between abnormal bodies and horror, amazement, or failure, the development of monsters in the ideas and writings of this period showed the world to be dynamic, varied, plentiful, transformative, and creative. In works ranging from Comte de Buffon’s interrogations of humanity within natural history to Hugo de Vries’s mutation theory, and from Shelley’s artificial man to fin de siècle notions of body difference, Mangham expertly traces a persistent attempt to understand modern subjectivity through a range of biological and imaginary monsters. In a world that hides monstrosity behind theoretical and cultural representations that reinscribe its otherness, this enlightened book shows how innovative nineteenth-century thinkers dismantled the fictive idea of normality and provided a means of thinking about life in ways that check the reflexive tendency to categorize and divide.

The history of pregnancy testing, and how it transformed from an esoteric laboratory tool to a commonplace of everyday life. Pregnancy testing has never been easier. Waiting on one side or the other of the bathroom door for a “positive” or “negative” result has become a modern ritual and rite of passage. Today, the ubiquitous home pregnancy test is implicated in personal decisions and public debates about all aspects of reproduction, from miscarriage and abortion to the “biological clock” and IVF. Yet, only three generations ago, women typically waited not minutes but months to find out whether they were pregnant. A Woman’s Right to Know tells, for the first time, the story of pregnancy testing—one of the most significant and least studied technologies of reproduction. Focusing on Britain from around 1900 to the present day, Jesse Olszynko-Gryn shows how demand shifted from doctors to women, and then goes further to explain the remarkable transformation of pregnancy testing from an obscure laboratory service to an easily accessible (though fraught) tool for every woman. Lastly, the book reflects on resources the past might contain for the present and future of sexual and reproductive health. Solidly researched and compellingly argued, Olszynko-Gryn demonstrates that the rise of pregnancy testing has had significant—and not always expected—impact and has led to changes in the ways in which we conceive of pregnancy itself.

Prenatal diagnosis, especially noninvasive prenatal testing (NIPT), has changed the experience of pregnancy, prenatal care and responsibilities in Israel and Germany in different ways. These differences reflect the countries' historical legacies, medico-legal policies, normative and cultural identities. Building on this observation, the contributors of this book present conversations between leading scholars from Israel and Germany based on an empirical bioethical perspective, analyses about the reshaping of 'life' by biomedicine, and philosophical reflections on socio-cultural claims and epistemic horizons of responsibilities. Practices and discussions of reproductive medicine transform the concepts of responsibility and irresponsibility.

In health and medicine, imagining the future is essential in giving meaning to the past and the present and for propelling people into action. This is true not only at the level of individuals as they envision and carry out everyday activities and long-term plans but also for institutional practices framed by and unfolding within various socio-political ecologies and transfigurations. Hope and uncertainty are critical affective and knowledge-related modalities of such imaginations and assume vital meanings in policing, managing, and experiencing health, illness, and well-being. This volume brings together contributions from medical anthropologists who address this theme across various medical spheres, including the pragmatics of hope and uncertainty, the techno-sphere, health management, and individual and socially distributed emotions.

Brazil's Zika outbreak revealed extreme health disparities and reproductive injustice across racial and socioeconomic lines. Brazil's 2015 Zika outbreak led to severe illnesses for many and the birth of several thousands of children with severe brain damage. Even though mosquito-borne diseases such as the Zika virus affect people across society, these children were born almost exclusively to poor, and usually non-white, women. In Viruses and Reproductive Injustice, Ilana Löwy explores the complicated health disparities and reproductive injustice that led to these cases of congenital Zika syndrome. Löwy examines the history of the outbreak in Brazil and connects it to broader questions concerning reproductive rights, the medical science behind understanding new pathogens, and the role of international health organizations in battling—or ignoring—public health crises. The explanation behind the strongly skewed distribution of cases among social classes was far from straightforward or obvious during the Zika outbreak. Löwy argues that the disproportionate effect of Zika on births among the poor is primarily a function of dramatic disparities in access to contraception and prenatal care, as well as Brazil's anti-abortion laws: only wealthier women have access to safe abortions. This is a book about the changing meaning of an infectious disease outbreak and a haunting demonstration that an epidemic is both a biological and a political event produced by the complicated entanglement of humans, viruses, and mosquitoes.

Since the defeat of the Nazi Third Reich and the end of its horrific eugenics policies, battles over the politics of life, sex, and death have continued and evolved. Dagmar Herzog documents how reproductive rights and disability rights, both latecomers to the postwar human rights canon, came to be seen as competing--with unexpected consequences. Bringing together the latest findings in Holocaust studies, the history of religion, and the history of sexuality in postwar--and now also postcommunist--Europe, Unlearning Eugenics shows how central the controversies over sexuality, reproduction, and disability have been to broader processes of secularization and religious renewal. Herzog also restores to the historical record a revelatory array of activists: from Catholic and Protestant theologians who defended abortion rights in the 1960s-70s to historians in the 1980s-90s who uncovered the long-suppressed connections between the mass murder of the disabled and the Holocaust of European Jewry; from feminists involved in the militant "cripple movement" of the 1980s to lawyers working for right-wing NGOs in the 2000s; and from a handful of pioneers in the 1940s-60s committed to living in intentional community with individuals with cognitive disability to present-day disability self-advocates.

This book places the intimate experience of fertility control at the heart of political and social approaches toward women’s bodies. Across the globe, women have always controlled their fertility through intimate efforts ultimately tied to larger political processes and gendered power dynamics. Women’s biological reproductive capabilities have been contested sites of power struggles, shaping the formation, rule, and dissolution of political regimes throughout history. Yet these intersections between the intimate and the political remain understudied in the historical literature. This book explores these questions from the perspective of multiple time periods, geographic locations, actors, and methods. Chapters analyze how women’s individual practices of fertility control, including contraception, abortion, and infanticide, alongside methods for achieving conception and birth, intersected with larger political, economic, and cultural trends. Others problematize the ideas of ‘control’ in history. What did it mean to ‘control one’s fertility’ in different historical periods and geographical regions? How did historical actors understand and practise what we now call fertility control? How can we expand conventional definitions of fertility control to interrogate ideas related to infertility, menstruation, and heteronormativity? Contributors also highlight how race, ethnicity, and class intersect with gender to shape if, and how, women and men approached fertility control. This book will be of great value to students and scholars of history including the history of the body, women’s rights, and health equity, as well as the intersectionality of gender and health. The chapters in this book were originally published as a special issue of Women’s History Review.