Printer Friendly

OF SONOGRAMS AND BABY PRAMS: PRENATAL DIAGNOSIS, PREGNANCY, AND CONSUMPTION.

The transformation of any society should be revealed by the changing relations of persons to objects within it.

Jean Comaroff and John L. Comaroff, "Goodly Beasts and Beastly Goods: Cattle and Commodities in a South African Context, American Ethnologist, 1990

In the past twenty-odd years, in the United States, a number of different prenatal diagnosti technologies have, with startling rapidity, gone from highly experimental to virtually routine medical procedures. Ultrasound, alpha fetoprotein (AFP) blood screening, and amniocentesis, which may with varying degrees of accuracy detect a wide range of abnormalities and other health problems in the fetus, have become regular features of prenatal care for the majority of U.S. women who enjoy access to any form of health care. [1] In the context of ongoing conflicts over abortion, the routinization of prenatal diagnostic technologies has aroused concern from many quarters that embryos and fetuses are being reduced to the status of commodities. Feminists have voiced the further concern that women are, in the process, being reduced to the status of unskilled reproductive workers, who produce these valued commodities through their alienated labor.

In these responses to prenatal diagnostic technology, we may discern a number of related cultural anxieties about perceived threats to boundaries between persons and things-the intrusion of technology into the body, the incorporation of biological reproduction (of people) into the structures of industrial production (of things), and the specter of treating human beings as if they were mere commodities. These discussions are structured by two key assumptions: (1) that reproduction is best understood by analogy to production; and (2) that we can and should clearly distinguish persons from commodities.

In this article I draw upon an ethnographic study of obstetrical ultrasound (probably the single most widely used of all the prenatal diagnostic technologies) to question these assumptions. The case of obstetrical ultrasound shows, I argue, that in the contemporary United States (1) reproduction has increasingly come to-be constructed as a matter of consumption; and in the process (2) the fetus is constructed more and more as a "commodity" at the same time and through the same means that it is also constructed more and more as a "person." I shall first sketch out the argument by analogy to production, which is a compelling and influential strand within the feminist critique of reproductive medicine, and show how this line of analysis explains the advent of obstetrical ultrasound. I shall then discuss a number of other aspects of ultrasound that do not easily fit into this framework and which I believe are better understood in terms of consumption. There are at least four different (if interrelated and overlapping) ways in which reproduction has come to be construed in terms of consumption in the American context: (1) consuming on behalf of the fetus, (2) pregnancy as consumption, (3) consuming pregnancy as a commodified experience, and (4) consuming the fetus.

REPRODUCTION AND THE ANALOGY-TO PRODUCTION

The same span of time that has witnessed this proliferation of prenatal diagnostic tests and other new reproductive technologies has also seen the rise of compelling and influential feminist critiques of reproductive medicine. One important position staked out within these critiques turns on the analogy between reproduction and production, specifically identifying ways that the analogy to industrial factory production operates within medical discourse and shapes medical practice. Scholars such as Emily Martin, Ann Oakley, Dorothy Wertz and Richard Wertz, and Barbara Katz Rothman, among others, have argued that as pregnancy and childbirth have come under the aegis of the male-dominated medical profession, these natural processes have come to be represented and understood in terms of analogies drawn from the world of industrial production. Doctors have come to be positioned as "managers" relative to reproduction, fetuses appear as valuable "products," and women are like reproductive "workers." These metaphors o perate within medical discourse and structure the medical treatment of reproduction--with negative consequences for women. In this view, the routinization of ultrasound and other prenatal diagnostic technologies appears to further this process on every front: bolstering the power of doctors as managers, enhancing the value of fetuses as products, and further alienating the woman as reproductive laborer.

Doctors as Managers. Let's first consider the claim that doctors are like managers. In The Woman in the Body: A Cultural Analysis of Reproduction, Emily Martin shows how medical textbooks use imagery which likens labor to factory production: "Medical imagery juxtaposes two pictures: the uterus as a machine that produces the baby and the woman as laborer who produces the baby. Perhaps at times the two come together in a consistent form as the woman-laborer whose uterus-machine produces the baby. What role is the doctor given? I think it is clear that he is predominantly seen as the supervisor or foreman of the labor process." [2] She argues that such texts, by teaching doctors to view themselves as managers, encourage caesarean sections and other surgical and technological interventions--which are often alienating, dangerous, and unnecessary--whenever pregnancy or labor appear to deviate from a fixed, abstract schedule of production. From this perspective, the rapid routinization of prenatal diagnostic techno logies appears as merely the latest step in a long historical process by which doctors, via the culture of Fordist capitalist production, have established their power and authority over pregnant women.

And indeed, ultrasound technology as used in prenatal care can be seen as having this effect. Obstetricians have eagerly embraced ultrasound as a relatively inexpensive, noninvasive, and presumed safe means of obtaining a great deal of information not otherwise available, about the position, appearance, and activity of the fetus. The availability of such information does not, however, in and of itself explain why the information is considered valuable or useful. Ann Oakley has argued convincingly that a large part of ultrasound's appeal for doctors is that it allows them technologically to bypass pregnant women themselves as a source of knowledge about pregnancy. [3] For example, instead of asking a woman for the date of her last menstrual period (and having to rely upon her word), a doctor. may seek an ultrasound estimation of "gestational age." [4] In this regard, it does seem plausible to interpret the routinization of ultrasound as a strategic move by doctors to solidify their position as "managers" of r eproduction construed as analogous to industrial production.

Fetuses as Products. A second comparison through which the feminist argument by analogy to production proceeds is the claim that fetuses are like products. In this light, prenatal diagnostic testing represents a way in which doctor/managers try to make sure that fetuses, whose production they oversee, are of consistently high quality. Barbara Katz Rothman writes that "genetic counseling, screening and testing of fetuses-[serve] the function of 'quality control' on the assembly line of the products of conception, separating out those products we wish to develop from those we wish to discontinue. Once we see the products of conception as just that, as products, we begin to treat them as we do any other product, subject to similar scrutiny and standards." [5] Again, obstetrical ultrasound does seem to fit quite readily into this argument. An ultrasound exam can provide information about a variety of major and minor problems in the development and health of the fetus. However, with ultrasound as with other prena tal diagnostic tests, medicine has at present no treatment to offer for the majority of problems that can be detected, other than abortion-and indeed, one of the primary justifications given in the medical literature for offering ultrasound screening to all women on a routine basis is the expectation that fetuses exhibiting anomalies will be aborted. One article advocating routine ultrasound screening of all pregnancies concludes: "Long-term gains would include identification of a major anomaly and termination of pregnancy, thus avoiding the birth of a child with an anomaly who is likely to survive but with a poor quality of life...." [6] Certainly, such a statement, casting diagnosis of fetal anomaly followed by abortion as a "gain," does indeed seem to reflect a managerial view of the fetus as a product that must be subjected to "quality control," rather than any appreciation of the tenor of this experience for women who go through it. [7]

As this view of the fetus as a product takes hold among pregnant women themselves and in society at large, it is argued, respect for persons necessarily diminishes. In Rothman's words, the routinization of prenatal diagnostic testing is symptomatic of "the expansion of a way of thinking that treats people as objects, as commodities." [8] This assumes, of course, that commodification is directly corrosive of personhood and can only mean devaluation--so that, to the extent that we think of fetuses as commodities, we fail to regard children fully as persons. I shall return to this point later, to show how an ethnographic approach to obstetrical ultrasound may challenge this view.

Women as Workers. For the moment, however, let us first turn to the third crucial step in the feminist argument by analogy to production--the claim that women are like workers. When doctors act as managers and fetuses appear as products, then women come to be regarded as unskilled workers, alienated from their own reproductive labor. "As babies and children become products, mothers become producers, pregnant women the unskilled workers on a reproductive assembly line.... What are the causes of prematurity, fetal defects, damaged newborns--flawed products? Bad mothers, of course--inept workers." [9] In a similar vein, Emily Martin argues that with new reproductive technologies, "the possibility exists that the woman, the 'laborer,' will increasingly drop out of sight as doctor-managers focus on 'producing' perfect 'products.'" [10]

As deployed in medical practice, then, the analogy between reproduction and production appears clearly to work to women's detriment. However, the same analogy may also be used to analytically ground feminist demands for change and calls to action--on the logic that "women have control over the means of reproduction (at least for the present...) in the form of their own bodies...." [11] Or in Carol A. Stabile's words: "only women can carry out the work that is pregnancy...." [12]

FROM PRODUCTION TO CONSUMPTION

But is pregnancy really all work and no play, so to speak? My own ethnographic study of obstetrical ultrasound leads me to think not.

The argument by analogy to production represents an important strand within the broader feminist critique of medicine. This argument does hold considerable merit, and as I've tried to show, it can go some distance toward accounting for the routinization of ultrasound within obstetrics. This analysis, however, takes doctors perhaps a bit too much at their word, by assuming that obstetrical ultrasound really is about just what they say it is about-prenatal diagnosis and medical management. Indeed, the fact that obstetrical ultrasound has been so completely routinized for all pregnancies in this country despite medical professional guidelines, which have consistently recommended against routine screening of all pregnancies and for more limited usage only in the face of certain specified medical indications, should suggest to us that matters are in reality a bit more complicated. As with any technology, its use in social practice does not correspond exactly to any one set of intentions.

Indeed, it was precisely the strikingly diverse and apparently incompatible meanings and agendas that this technology was being drafted to serve that led me to pursue ethnographic research on obstetrical ultrasound. In anti-abortion materials, ultrasound imagery of the fetus has been used as evidence that the fetus is really a baby, a person-and that abortion is therefore murder. In medical practice, by contrast, ultrasound is used as a prenatal diagnostic technology to diagnose a variety of problems with the fetus-for most of which, medicine currently has no treatment to offer other than the option of selective abortion. In product advertisements and other mass-media representations, meanwhile, the ultrasound image of the fetus has been hitched to the imperative to consume, in ways that seem to tap into both sides of this apparent opposition. [13] This led me to ask, how do the diagnostic functions of ultrasound technology relate to the meanings attached to ultrasound imagery in the broader culture? And, mor e generally, how do the medicalized practices of reproduction relate to the politics of reproduction?

Seeking to answer these questions, I pursued ethnographic research on the topic of obstetrical ultrasound. The centerpiece of this project was research conducted in a hospital-based obstetrics/gynecology ultrasound clinic in Chicago, over a period of nearly a year, between January and December of 1994, consisting of observations of obstetrical ultrasound examinations and semistructured interviews with more than 100 women. This was supplemented by interviews with some thirty-odd women residing in the vicinity of the clinic conducted in their homes or in restaurants. I also sought to explore the "ultrasound world" [14] by visiting ultrasound manufacturing plants and sonography education programs in Chicago and elsewhere; attending the meetings of the sonographers' professional association; and interviewing more than a dozen sonographers, a few other medical professionals (midwives, radiologists, and obstetricians), and several engineers employed by a company that manufactures ultrasound equipment. I have supple mented these observations and interviews with readings of a number of relevant "texts" (including medical articles on ultrasound, popular pregnancy manuals, as well as anti-abortion materials and product advertisements that make use of ultrasound imagery). All names used here are pseudonyms.

What such an ethnographic approach reveals (among other things) is that the medical practice of obstetrical ultrasound is significantly shaped by the ways that ultrasound imagery of the fetus has been valued and appropriated outside the clinical context. In the United States, the medical task of obtaining certain views and measurements of the fetus and placenta is combined with a number of other practices that respond to the meanings the ultrasound examination has acquired as an opportunity to "see the baby," to "bond" with it emotionally, to learn its sex, to be "reassured" that it is normal, to get a "picture" to take home. Thus, a pregnant woman is usually allowed to bring a companion (often her husband or boyfriend) into the examining room; and the sonographer usually shows them the screen, points out certain features of the fetus, offers the pregnant woman the option of finding out fetal sex if it can be visualized, and gives her an image to take home. [15] Although it is true that the exam is often fra ught with anxiety over the possibility of a "positive" diagnosis of fetal anomaly or death, it is also true that many women look forward to and enjoy ultrasound, and even actively seek it out.

What are we to make of women's acceptance, or even embrace, of ultrasound? In terms of the analogy to production, we might ask: If prenatal diagnostic technologies help reduce women to the position of unskilled laborers in the reproductive process and expand the power exercised over them by doctor/managers, then why do more women not actively resist? This, of course, is a version of the old question: Why don't the workers revolt?

I would like to suggest that perhaps part of the reason is because the same transformations that have positioned women as "workers" relative to reproduction have also offered up to them the pleasures of reproduction construed as consumption. The seeds of this approach already lie within the feminist critique by analogy to production. For if women are the unskilled workers on the reproductive assembly line, and doctors are the foremen supervising their work, and the fetus is the valuable commodity being produced, then it seems only natural to ask: Who are the consumers? What do they consume, and how? In the discussion to follow, I shall suggest several ways in which reproduction has come to be construed in terms of consumption.

AN ALL CONSUMING EXPERIENCE

Consuming on Behalf of the Fetus. It began to dawn on me that ultrasound has a lot to do with consumption, only after many months of listening to women tell me so. Among the questions that I asked women about ultrasound, was whether they were interested in finding out the sex of the fetus if it could be visualized--and if so, why. Time and time again, women told me that they were looking forward to the ultrasound exam because they were hoping to learn the sex, so that they could start buying things for the baby.

"I'm just curious, and I want to shop."

"I hope it's a girl; I'll get dresses."

"I'd rather know, to see what type of clothes to buy."

This type of response seemed so banal that I kept looking for deeper or more interesting answers. It was only after some time that I began to recognize that there were deeper and more interesting issues at stake in the relationship between ultrasound technology and women's desire to purchase pink or blue baby clothes--namely, the whole question of how reproduction has come to be constructed as a matter of consumption. [16]

The purchase, during pregnancy, of mass-produced consumer goods intended for the anticipated child is, on one level, simply a rather unremarkable extension to the period before birth of the phenomenon of parents buying stuff for their kids. In the early part of this century, attempts to target children's needs as a potential marketing opportunity seemed to threaten an intrusion of the profane world of business into the sacred space of the home, as Daniel Thomas Cook has demonstrated in his historical study of the children's apparel industry. This potential conflict was resolved, according to Cook, "by recasting the expression of motherhood as consumer practice. ..." [17] By now, eighty years later, Americans take for granted that consuming on behalf of one's children is an important parental responsibility. Indeed, the challenge of becoming a competent consumer of the ever-increasing array of goods aimed at children appears to at least some women as a (rather daunting) test of their capabilities as a parent i n general: "We went to these childbirth classes, and they were telling us all about all these different things you have to buy, and it just seemed really intimidating. I mean, there's the baby carrier and the breast pump and the stroller and two different kinds of car seats, and I don't know how to even use them. It makes you start to wonder, am I really going to be able to take care of a child?" The material trappings of middle-class childhood in contemporary America are legion indeed, including not only baby carriers, breast pumps, strollers, and car seats, but much else besides. Just how much else is perhaps best illustrated by reference to one of the many self-help sources to which women may turn for advice and information about pregnancy. One of the features of "Stork Site," an Internet website geared toward pregnant women and their "pregnant partners," [18] is its collection of "babygrams," a series of one-page bulletins tailored to each week of pregnancy, containing advice and information, including an illustration of "how your baby is growing." The babygram for week twenty-nine of pregnancy (which features not a line drawing, like most other babygrams, but a "twenty-nine-week sonogram") offers expectant parents a list of no less than sixty-one mass-produced, commercially available items they will "need" upon their return from the hospital. Of course, not all women are equally well positioned to meet all of these "needs," nor to command the forms of knowledge and the resources involved in this kind of consumption (including those required to surf the Internet in search of such information). They may be painfully aware of their inability to provide these things, however; indeed, the inability to engage in such consumption on behalf of the fetus may now figure as one part of the experience of poverty as relative deprivation in contemporary U.S. society.

Many women who might be able to engage in consumption of baby goods during pregnancy resist doing so out of a sense of caution that something might go wrong, preferring instead to wait until just before the birth and then to buy only what are considered basic necessities. In the context of American society, where ubiquitous advertisements endlessly promise sex, happiness, and success through the purchase of goods, the notion that consumption during pregnancy could be seen as unwise or even dangerous ("tempting fate") might seem to be a curious superstition, a holdover from premodern systems of religious beliefs. Certainly, religious reasons do come into play for some women. For example, Susanna, a thirty -three-year-old marketing consultant who had two children and had previously lost one pregnancy at four months, attributed to her religion her reluctance to learn fetal sex via ultrasound or to buy things before the birth: "I guess I kind of feel like some things are meant to be veiled from you until their ti me to be revealed has come.... Part of it is religious, I guess. I'm Jewish. I'm not Orthodox, but--you always think, 'Well, it's great having a baby,' but you never know if it's gonna work out or not. And in my case, in one case it did not work out."

This sort of ambivalence toward consumption on behalf of the fetus is perhaps best understood, however, as (also) a tacit recognition of the extent to which consumption of commodities functions to construct identity in contemporary U.S. society. Buying things for the fetus on some level amounts to recognizing it as an individual consumer, a baby, a person. A woman might not wish to grant such recognition, or she might wish to embrace and proclaim it, depending upon a number of factors, including how far along she is in her pregnancy. [19] Thus Susanna, elaborating further upon her comments, segued from religious reasons to her sense that consumption serves to construct the fetus as a "baby," inappropriately early on in pregnancy: "So I think sometimes it's better not to make too many preparations and get too involved until the baby's really there, because the baby might not come, and then the parents have to face all of these material things they don't have any use for, and it brings that much more pain....B efore the baby's born, it's hidden, maybe it's not completed yet, maybe the deal isn't done yet, and I guess that gave me a sense of--you know, slow down."

Most women who carry their pregnancies to term usually do end up engaging in some consumption of goods "on behalf of the fetus," however, if only passively, thanks to the American ritual of the baby shower. The baby shower--which has evolved over time from a ritual passing on of knowledge between women (though it remains that too) to become more an example of what Leigh Eric Schmidt has called "consumer rites" in American culture [20]--conventionally takes place in the last month or two of pregnancy. One item that family and friends often like to buy as a shower gift (and that prospective parents like to buy too) is clothing for the baby; convention dictates that girls should wear pink clothes and boys should wear blue (although this convention itself is relatively recent, dating back only to the 1940s). [21] To state what should be obvious, objects are used to construct identities and relationships, in contemporary U.S. society no less than in the Melanesian gift-exchange systems long familiar to anthropolo gists, although in somewhat novel and distinctive ways. In this context, given the fact that women undergoing prenatal diagnostic tests in this country are commonly offered the option of finding out fetal sex, it is easy to see that women's attitudes toward, and experience of, ultrasound and other prenatal diagnostic technologies might be shaped by cultural imperatives of consumption.

Pregnancy as Consumption. Not only do women engage in consumption during pregnancy, however, but consumption itself to a significant degree constitutes the experience of pregnancy, especially in its early stages. Arjun Appadurai has suggested that "consumption creates time and does not simply respond to it.... Where repetition in consumption seems to be determined by natural or universal seasonalities of passage, always consider the reverse causal chain, in which consumption seasonalities might determine the style and significance of 'natural' passages." [22] Building upon this insight, I would like to consider here the ways in which transformations in consumption in fact serve to create the "time" of early pregnancy and determine the significance of the "natural" passage into pregnancy. Specifically, consumption constitutes the chief avenue of control for middle-class women, who are just beginning to conceptualize themselves as mothers, and also the chief performative arena where they may exemplify their mo thering skills for others.

As Faye Ginsburg has pointed out in her ethnographic study of the American abortion debate, women's relationship to reproduction has been transformed in recent decades, such that even conservative defenders of traditional values now frame motherhood not as women's biological destiny but rather as the result of a conscious decision to embrace their reproductive potential. [23] For a great many middie-class women of all political persuasions, the decision to embrace their reproductive potential, and to enter a state of being possibly-pregnant, follows a long period of engaging in sexual activity while using birth control. This transition is often both marked and effected by a transformation in the meaning and practice of consumption. Long before it becomes possible to feel the fetus moving or to see the belly bulging, often before pregnancy is confirmed or even attempted, the transition to hoped-for motherhood may be experienced as a transition to a new, more highly disciplined regime of consumption-it is the movement from being an individual consumer to a mother-as-consumer.

This change concerns, in the first place, consumption in its most literal meaning-eating and drinking. Indeed, for many women, a change in patterns of consuming food, drink, and drugs both precedes pregnancy and in some sense "causes" it. The daily ritual of swallowing oral contraceptives, for example, gives way to the swallowing of special vitamins high in folic acid, special foods full of nutrients, and special waters labeled and sold as free of contaminants. Many women temporarily forswear (or try to) some of the daily pleasures of consumption, giving up alcohol, tobacco, caffeine, and other substances thought to be harmful, as well as avoiding over-the-counter drugs. For many, the knowledge that one is pregnant comes as early as several days after a missed period, in the form of a mass-produced, disposable, over-the-counter device a woman must go buy in her local drugstore: the home pregnancy test. And one watches for early symptoms of pregnancy to manifest themselves as disturbances in normal patterns o f consumption of food: nausea and cravings.

Nor is it only patterns of consumption that change when it begins to be "on behalf of' the fetus but so too does the meaning of consumption itself. Suddenly, consumption itself is invested with new levels of moral significance-consumption is cast as an act of maternal love, and an expression of a woman's strength of character and powers of self-discipline, even as consumption is also seen to literally create the fetal body. As a popular book on diet during pregnancy advises women: "Not only are you what you eat, but your baby is, too." [24] Do you love your future child enough to give up coffee? Are you dedicated enough to resist sweets? How diligent are you in reading the labels of everything you eat and drink? A woman's first maternal duty, it would seem, is to act as an intelligent and effective filter between the fetus within her and the world outside, letting in the good and keeping out the bad, and the primary locus of this responsibility is her choice of what substances to consume. [25]

To transform one's patterns of consumption in this way is difficult, of course, demanding constant vigilance and self-denial. It is perhaps not surprising, therefore, that many women whose experience of early pregnancy is defined in large part by the burdens of newly significant consumption might welcome the prospect of an ultrasound examination as providing tangible evidence that (as so many women put it), "there really is a baby in there"--a baby whose existence gives meaning to the sacrifice of all those passed-up (or thrown-up!) desserts, cigarettes, cups of coffee, and glasses of wine. [26] By the same token, however, if any problems are detected or questions raised during the ultrasound examination, women all too readily attribute them to their own failure to consume properly.

Difficult as it is to achieve, then, perfectly conscientious and careful consumption of food even appears to promise a means by which the individual woman (and her fetus) may transcend the effects of environmental damage-damage wrought, in large part, as a by-product of existing societal and global patterns of consumption. One popular book on diet during pregnancy advises women: Even with so much in our environment out of our control...today, having a healthy baby is, most of the time, more up to us than up to chance....Eating ... is an area in which there are enormous possibilities for control." [27]

Consumption of food, in other words, is presented as the way to deal with the problems caused by consumption of energy and goods. Women engaged in reproducing the next generation are thus encouraged to regard their scope of effective action as limited to the realm of consumer choices, which do not challenge broader social and economic structures-which, if anything, serve only to reproduce them. [28]

We may see here one example of how "reproduction, in its biological and social senses, is inextricably bound up with the production of culture." [29] We may also see how consuming "on behalf of" the fetus reprises long-standing cultural associations between consumption and gender. The idea that consumption generally, and consumption of food in particular, are avenues through which middle-class women may exercise "control" has, of course, a long history in American society; the conscientious pregnant woman of today is treading a path already well worn by women shoppers and dieters through the years.

Consuming Pregnancy as a Commodified Experience. The sense that consumption carries heightened significance during pregnancy is not, however, limited to the physical consumption of food and other substances. The experience of pregnancy itself has come to be a more or less standardized product, available (to those who command the resources) in a range of different varieties to suit individual consumer preferences-and this despite the fact that untold numbers of women, in this country and elsewhere in the world, still go through pregnancy and bear children without reliable access to food, shelter, or basic medical care.

Women in this country who enjoy good medical coverage may now choose from among a range of options, what kind of care to seek during pregnancy, and from whom, and what kind of education or preparation, and where and how to plan on giving birth. Robbie Davis-Floyd points out: "At present in our society, the culturally recognized spectrum of possible beliefs about pregnancy and birth is encompassed by two basic opposing models, or paradigms, which are available to pregnant women for the perception and interpretation of their pregnancy and birth experiences-the technocratic and wholistic models." [30] Although most women still seek care from doctors and give birth in hospitals, growing numbers also choose to seek prenatal care from nurse-midwives, and a small but significant minority give birth at home under the care of lay midwives.

As with the choice of the provider and setting for prenatal care and birth, educational classes for pregnant women may also range widely along the ideological spectrum, from those which hew closer to the "technocratic" model of birth to those which reflect more "wholistic" models. In addition to childbirth-education classes, women may attend a variety of other classes and groups, on topics ranging from exercise during pregnancy to breastfeeding to infant massage, and many more. Pregnant women or women who are trying to become pregnant have also been discovered as a large and very lucrative market for educational or "self-help" books offering information and advice on pregnancy, conception, childbirth, and infant care, again written from many different positions between the "technocratic" and "wholistic" ideological poles. A recent glance at the "Pregnancy" section of a local branch of Borders, the national bookstore chain, for example, turned up no fewer than 114 different titles.

The image of Spiritual Midwifery cozily nestled up to Which Tests for My Unborn Baby? on the bookstore shelf hints at the extent to which reproduction itself has come to be construed in terms of consumption. Women who pursue a "wholistic" approach to pregnancy and childbirth might be regarded, in terms of the feminist argument by analogy to production, as "workers in revolt"; I suggest, however, that we must (also) recognize them as consumers in action. The ideological opposition between "wholistic" and "technocratic" models of pregnancy and childbirth plays itself out against the backdrop of a consumer culture and a class structure that remain fundamentally unchallenged.

When a woman plans and contracts for a particular kind of prenatal care, for a particular kind of birth, she is (to the extent that such a thing is possible) engaging to purchase a particular kind of pregnancy experience. Women who choose a "high-tech" approach and those who choose a "natural" approach may find each other's decisions incomprehensible, unenlightened, or simply silly; but the differences that separate them are perhaps ultimately less significant than the commonalities--namely, that a woman demonstrates her powers and her talents as a consumer, and engages in the construction of her identity, by the manner in which she consumes her pregnancy and birth.

In this context, as part of the consumption of pregnancy as a commodified experience, women's demand for ultrasound is perhaps more comprehensible. Middle-class women from many different positions along the ideological spectrum have come to regard ultrasound as an important standard feature of the larger package deal, if not always for the same reasons. As a glitzy hightech medical procedure, ultrasound may seem to be evidence that one is receiving the best of modem medical attention, with the "reassurance" that this seems to promise. Libby, a thirty-five-year-old lawyer, noted:

I was an infertility patient, so I was having ultrasound like every other day while I was taking infertility treatments, and then when I got pregnant I had [an ultrasound exam] every week, for about the first eight weeks.... Then there was this lull... until I had amnio which was at fourteen weeks. So there was about six weeks where I didn't have any ultrasounds at all. ... I can't imagine waiting until the sixth month, or even the fourth month, I just can't. You [see the ultrasound and you] know he's there, and he's safe, and it was kind of odd to go even those six or eight weeks between my last infertility ultrasound and the amnio one.

Given that usually no problems are detected, however, the ultrasound exam also seems to promise an emotionally gratifying moment of "reassurance" and "bonding" that has itself come to be regarded by many as a not-to-be-missed part of the experience of pregnancy. Amy, a twenty-five-year-old African-American college student, explained: "I feel a lot happier now since I know the heart is okay. ... Every time I get ultrasound it relaxes me, it's reassuring." And Jane, a thirty-five-year-old white psychologist, noted that her husband "was just very anxious about the whole thing, just wondering whether he could handle it. And it wasn't until the ultrasound, when he saw it moving, and he completely changed his attitude about the pregnancy-I was so happy! I didn't care why we were there!"

Nor is it only middle-class women who demand ultrasound. Among the women I spoke with in the course of my research were "clinic" patients (i.e., poor women relying upon publicly subsidized programs and clinics for prenatal care, as opposed to "private" patients who have private medical insurance) who sought out ultrasound both because it is understood to be a Standard of good medical care and because they too wanted to partake of the pleasures it may offer. Charlotte, a thirty-nine-year-old African American woman expecting her first child, previously employed as a nurse's aide, told me:

I requested [an ultrasound]. I explained my fears, about me being over thirty-five years old, and [the doctor] said it's rare now a woman goes through a full pregnancy without....A woman in the waiting room showed me her ultrasound picture. And I got disappointed because I didn't have one....People kept asking me, "What is it? What is it?" Everybody kept asking me, "Did you have your ultrasound yet?" I felt cheated. I wanted to see that it was normal and also I didn't want to miss out on that experience. [31]

Consuming the Fetus. I have suggested a number of different ways in which I believe reproduction has come to be constructed not only in terms of production but also as a matter of consumption. Women engage in consumption of baby clothes and other mass-produced goods on behalf of the fetus during pregnancy; consumption (especially of food) to a considerable extent constitutes the experience of pregnancy, especially in its early stages; and women approach prenatal medical care and education as the consumption of a commodified pregnancy experience. At this point I would like to return to the most obvious, but also the most distinctly unsettling, implication of this argument-namely, the suggestion that women "consume" their fetuses. What might it mean to say that the fetus is a commodity? In what sense does one consume such a commodity?

Much of the theoretical literature on commodities turns upon the distinction between use value and exchange value-commodities are items that are produced not in order to be used directly but, rather, in order to be exchanged for money (which may then be used to purchase other commodities) in a capitalist market. Arjun Appadurai, in an important departure from this traditional definition, has proposed that we understand the commodity not as something that belongs to a certain class of objects (objects produced for exchange) but rather as something which occupies, even temporarily, the "commodity situation-the situation in which its exchangeability is its socially relevant feature." [32] In the case of the fetus, however, both of these approaches seem somewhat inadequate.

First of all, in the case of the fetus, exchange cannot be neatly separated from or opposed to consumption. Ultrasound (along with other prenatal diagnostic technologies) objectifies the fetus in ways that not only make possible certain sorts of exchanges but also make the fetus available for the pregnant woman herself to possess and enjoy in new ways. An ultrasound examination produces visual imagery and medically authorized information about the fetus-its size, sex, appearance, heart rate, position, activities, and so forth-which endow it with a sort of objectified existence. In this form, the fetus may be "consumed" by a pregnant woman, who may take considerable pleasure in not only being able to feel its presence within her body but also see it, name it, show it around to others, and construct for it the rudiments of a personal and social identity (a point to which we shall return in a moment). At the same time, the fetus as objectified in this form may in certain contexts be said to have an "exchange val ue." For example, a fetus displaying some particularly rare and interesting anomaly may have considerable value within the obstetrician's professional world, leading to publications and research presentations and other professional rewards. The pregnant woman carrying that same fetus, on the other hand, would be compelled first to either accept or reject the equivalence being made between the fetus within her and the fetus as externalized through ultrasound diagnosis and imagery, and then to weigh the value of this fetus against the possible futures (or the possible future fetuses) for which it might be exchanged.

And, in cases where no problems are detected, the fetus may be said to have other sorts of exchange values, in the context of a pregnant woman's social world. The image itself, and other bits of information gleaned from the ultrasound examination, are exchanged with others and valued as tangible evidence of the presence of the fetus as a new "person" to be incorporated into networks of family and kin. The vast majority of women I spoke with planned to show the ultrasound "picture" they were given during the examination to the baby's father, and/or their older children and their own parents or other family members. A good number said they planned to show it to friends, coworkers, or "anyone who will let me." A few couples told me that they had faxed their ultrasound images to family members living in other parts of the country or planned to do so. Sometimes, control over the image and its circulation was contested (with varying degrees of seriousness). For example, one young couple, nineteen-year-old secretary LaToya and her boyfriend Andre, who were dearly excited about the impending birth of their first child and delighted at seeing the image on the ultrasound screen, got into a good-natured argument when I asked LaToya what she would do with the "picture" that the sonographer had given her.

Andre: I', gonna keep it!

LaToya: (laughing), I know, he's not gonna let anyone have it. 'Cause I can't even see it, he keeps taking it away!

Janelle (to Andre): Okay, so what are you gonna do with it?

Andre: Oh, I'm gonna show it off, you know. I don't know if this can be framed or not, but I'm gonna take it to work. I'll explain it to them, you know, how this is his spine right here, and that's his stomach, his head, he has a big head like mine.

Clearly, just as exchange is entangled with consumption in the case of the fetus, so too is commoditization inextricably bound up with personification. The visual image of the fetus on the screen, the take-home Polaroid snapshot, the diagnosis, the medically certified knowledge that it is a girl or a boy, the narrative descriptions provided by the sonographer in the course of the ultrasound exam-all contribute to the process by which a pregnant woman and the people around her construct for her fetus a more specific social identity. Lisa Meryn Mitchell, drawing upon ethnographic fieldwork conducted in an ultrasound clinic in Montreal, has detailed the ways in which "sonographers' accounts of the fetal image for parents describe the fetus as a social being, with a specific social identity, and possessing intention, consciousness, emotion and communicative ability." [33] In the course of my research, I regularly observed how, during an examination, visible physical features or movements of the fetus were transla ted into terms that served to create for it a personality and a social identity. For example, consider an exam performed by Sondra, a sonographer who occasionally filled in at the clinic, on Audrey, a young African American woman pregnant with her first child:

Audrey: Are you gonna be able to tell me what it is today?

Sondra: Maybe. If the baby lets us, put it that way....Look, there's the legs, you see how they're stretching out?

Audrey: Yeah! Look at that, looks like he's clowning....

Sondra: Now I can't see for sure, but it looks like it might be a girl.... That's the heart.... That's the jawbone. See all the little teeth that's in there? ... Here, here's a picture for you ... and here's another one.

Audrey: I'll show these to my Mama, she'll say, "I can't see what it is! What is it?" (To the pictures): You are too active! I think you are a boy. Are you a boy? I wanna know so I can go buy clothes!

Yet the commoditization and the singularization of the fetus around and through obstetrical ultrasound takes place in ways structured by the intersecting ideologies of motherhood, medicine, race, and class. Some sonographers I observed at work seemed to dispense "nonmedical" extras (showing the baby, giving a picture, informing of fetal sex) most readily to women whom they perceived as already having demonstrated a certain seriousness about the "medical" aspects of the procedure (prenatal diagnosis) and who more generally were seen as taking a responsible attitude toward their health and their pregnancy. [35] Not surprisingly, perhaps, some also displayed cultural attitudes widely shared in this country (and deeply entrenched in public policy and social theory alike), in regarding the pregnancies of young, poor, unmarried African American women in their care as symptomatic of their failure to be "serious" and "responsible" about reproduction-and regarding these young women as therefore less deserving of such "extras" than mature, middle-class, married (often white) women.

The "baby" is constructed as someone with the power to provide or deny the information its mother wants, someone who "clowns around"; and because it is "active," Audrey thinks it must be a boy, despite Sondra's informed guess that it's probably a girl. Through obstetrical ultrasound as it is practiced in the United States, then, the fetus is commoditized and personified, "produced" as an object for exchange and for consumption. To adopt the terminology proposed by Igor Kopytoff, ultrasound commoditizes the fetus (i.e., makes it exchangeable) in the same movement that it also singularizes it (i.e., endows it with a singular social identity). [34]

For example, after one examination, I stepped into the hail for a moment with the sonographer, Linda, while the patient, a seventeen-year-old African American woman named Talia who was seven months into her first pregnancy, rearranged her clothes. As we stood in the hallway, Linda complained to me, "I can't stand the people that just want to get a picture!" Confused, I asked: "I thought she was here because she had had chicken pox?" (Chicken pox contracted during pregnancy can lead to serious subsequent health problems for an affected fetus.) Linda replied: "Yeah, the doctor has his reasons for ordering it, but... certain types of people, all they care about is getting a picture and knowing what sex it is. They say, 'Oh, my girlfriend's having a boy; I wanna know what I'm having,' like it's a big contest or something." When I followed Linda back in, Talia asked, "Can I get a picture?" Linda answered breezily, "I'm sorry; I didn't take an extra one! All the pictures I have I need for the file."

Or, to take another example, Rasheeda, a young African American woman from the Woodlawn neighborhood of Chicago, eighteen years old and six months pregnant with her first child, came to her ultrasound examination accompanied by one of her girlfriends. There was some confusion at the start of the exam, because she had apparently not brought with her certain forms from her doctor that she was expected to provide. Rasheeda's examination proceeded:

Camilla: Do you want to know the sex of the baby?

Rasheeda: Yeah.

Friend: It's a male!

Rasheeda: (to friend, with some irritation)... Girl!

Camilla: Look at your baby.... That's the baby's head, there's the spine, there's the baby's heart. Do you want to know? Are you sure you want to know?

Friend: It's a boy! I can tell, it looks like a boy!

Rasheeda: What is it?

Camilla: You're going to have to wait until the baby is born.

After the examination was finished, I followed Camilla out into the hail while Rasheeda got dressed. I asked her, "So you really couldn't see what it was?" She responded: "I could tell, but then she started on about it being a boy, I got annoyed. I decided not to tell her; she can wait until the baby is born. It annoys me; they don't appreciate it. I let her come in, she doesn't have her papers or anything, she probably never got them. ...." The way in which Camilla thus conflated Rasheeda with her friend (she herself had, after all, said nothing about the baby being a boy) might be seen as hinting at the way in which both of them were, in Camilla's mind, conflated with a broader category of women, "certain types of people," who care altogether too much about "extras" such as knowledge of fetal sex and don't take the medical aspects of ultrasound seriously, just as they don't take pregnancy itself (or sexual activity) seriously enough. There are, in other words, conventions of discourse at work in the practic e of ultrasound which both presume and produce a "pathological" pregnant subject, in tandem with a "normal" pregnant subject formed in the image of bourgeois ideals of the kind of reproduction that is considered good (mature, married, financially stable, planned pregnancy, early prenatal care attendance, etc). And, as pregnant women are thus "produced," so too are their fetuses; in social practice some fetuses are clearly treated as "more equal" than others. What sonographers think and say and do does not, of course, determine how their pregnant patients think or feel about and value their own pregnancies and fetuses. It nonetheless seems worth noting, that if, as I have argued, obstetrical ultrasound as practiced in the United States both commoditizes and singularizes the fetus, it does so in ways that also serve to communicate to already disempowered groups of women a view that their children are less valued as commodities and regarded as less fully persons.

MIXED METAPHORS: THE HUNGRY CONSUMER AND THE PREGNANT WOMAN

To consider the fetus in terms of questions about commodification and consumption might seem an obvious enough move to make. Consumption practices are involved in the experience of pregnancy in a number of ways, as I have discussed. Furthermore, popular debates about abortion and new reproductive technologies, like theoretical discussions of consumption and commodification, both tend to revolve around the question of how best to understand and adjudicate the relationship between "persons" and "things." However, applying notions of consumption and commodification to the topic of reproduction turns out to be somewhat tricky, as we have seen. I would like to suggest here that this difficulty emerges, at least in part, out of the way in which implicit metaphors operate in social theory (no less than in medical practice!). Specifically, body metaphors of eating and digesting food remain implicit in theories of consumption, which mix rather badly with the metaphorical associations of procreation, making it difficul t (or at least quite counterintuitive) to bring theories of consumption to bear upon reproduction.

The concept of consumption, now taken within social theory to refer to all kinds of uses of goods and services, still retains heavy traces of its older association with eating. Indeed, Webster's defines "consumer" as: "one that consumes: as a: one that utilizes economic goods b: an organism requiring complex organic compounds for food which it obtains by preying on other organisms or by eating particles of organic matter." [36] This association between the consumption (i.e., purchase and use) of commodities and the consumption (i.e., ingestion) of food has, of course, deep historical roots. Sidney Mintz has traced an important part of this history in his account of the rise of sugar, arguing that the development of a taste for sucrose among the British poor was a crucial first step in their historical transformation into modem industrial workers and consumers. [37] As Marshall Sahlins has pointed out, this linkage has also left its mark upon the theoretical literature on consumption. Modem economic theory pr esumes a view of the individual as a creature driven by needs which are construed as bodily hungers:

In the world's richest societies, the subjective experience of lack increases in proportion to the objective output of wealth. Encompassed in an international division of labor, individual needs were seemingly inexhaustible. Felt, moreover, as physiological pangs, as deprivations like hunger and thirst, these needs seem to come from within, as dispositions of the body. The bourgeois economy made a fetish of human needs in the sense that needs, which are always social in character and origin and in that way objective, had to be assumed as subjective experiences of pain. [38]

Mintz and Sablins are, of course, two among many anthropologists whose work has enriched discussions of consumption with a critical focus on the social and cultural dimensions of goods and commodities, their exchange and their use, and the "needs" they are taken to satisfy. A particularly vibrant literature is also emerging within anthropology which focuses specifically on the intersections between changing regimes of consumption and processes of commodification of bodies and persons, primarily in non-Western contexts. [39] Too often, however, consumption continues to be defined exclusively as the purchase and use of (mass-produced) material things. For example, Daniel Miller's recent ethnographic study of shopping in North London [40] draws fascinating connections between consumption and kinship, especially the mother-child relationship, but proceeds from an understanding of consumption as having to do only with material things; indeed, in Miller's recent review article on the anthropology of consumption and commodities, "almost all of the cited literature ... consists of studies in anthropology and material culture." [4] Too much of the anthropological literature on consumption thus still tends to preserve largely intact the image of a restless, hungry subject inhabiting a world of needed-and-desired objects external to himself.

Indeed, hunger is inscribed as the paradigm for consumption already within Marx's definition of the "very queer thing" that is the commodity: "A commodity is, in the first place, an object outside us, a thing that by its properties satisfies human wants of some sort or another. The nature of such wants, whether, for instance, they spring from the stomach or from fancy, makes no difference..." [42] Wants that "spring from the stomach" stand here for real physical need (to the extent that any such unmediated needs might be said to exist), while other sorts of desires, wants that spring "from fancy," are refigured as a sort of mental or spiritual hunger. The consumer, then, is a metaphysically hungry individual, a person whose desires are oriented toward some "object outside," whether food or some other material object symbolically standing in its place.

All of this makes it rather difficult to conceptualize reproduction in terms of consumption. The consumer of social theory inhabits a body which, if not necessarily male (for after all, women too eat and feel hunger), is at least not easily imagined as a specifically pregnant body. The fetus is, after all, emphatically not "an object outside us," and although I would argue that it may nonetheless satisfy "human wants of some sort or another," it is difficult to imagine these wants as springing "from the stomach." How can the bearing of children be likened to the ingestion of food? The very suggestion seems to invoke that most frightening of all monsters, the mother who eats her own children. But if the awkwardness of looking at reproduction in terms of consumption serves thus to "wake up sleeping metaphors," [43] then the attempt may perhaps bring to light unexamined aspects of the theoretical apparatus with which we approach the topic of consumption. Specifically, it raises questions about how the implicit metaphor of the hungry consumer may shape or hinder our critical understanding of ongoing transformations--at once technological, social, cultural, and political--in the meaning and practice of reproduction.

CONCLUSIONS

As I have tried to show, obstetrical ultrasound plays a part in constructing the fetus more and more as a commodity at the same time and through the same means that it is also constructed more and more as a person. The experience of pregnancy and indeed the fetus itself are, as we have seen, in a variety of ways increasingly firmly embedded within U.S. consumer-capitalist society and culture, as commodities available for consumption like any others--but, in the same motion, the fetus is also increasingly construed as a baby, a person, from the earliest moments. By the same token, pregnant women are positioned as "consumers" through the same processes that they are positioned as reproductive "laborers." The feminist argument by analogy to production cannot easily account for the ways that obstetrical ultrasound technology has come to figure in the experience of pregnancy in contemporary U.S. society. I have argued that we must therefore consider reproduction in light of questions of commodification and consump tion, even if doing so requires that we struggle against gendered body metaphors implicit within these theoretical constructs themselves. My aim, in doing so, is not to replace one analogy with another, much less to argue that consumption is liberating or free-nor, indeed, do I concede that "producer" and "consumer" are the only possible subject positions from which to approach reproduction. Rather, my aim is simply to try to see things from another angle and to fill out the explanation-because I believe that in order to effectively engage as feminists with ultrasound and the panoply of other technologies now brought to bear upon reproduction, we will need to begin by recognizing that in this society at this moment, pregnancy is both a labor of production and an "all-consuming" experience.

Janelle S. Taylor teaches anthropology at the University of Washington. Her writings on obstetrical ultrasound have also appeared in Public Culture, Science as Culture, Techniques et culture, and the Journal of Diagnostic Medical Sonography, as well as in two edited volumes, Reproducing Reproduction: Kinship, Power, and Technological Innovation, ed. Sarah Franklin and Helena Ragone (University of Pennsylvania Press, 1998), and Biotechnology and Culture: Bodies, Anxieties, Ethics, ed. Paul Brodwin (Indiana University Press, forthcoming).

NOTES

The research upon which this article draws was supported in part by a Jacob K. Javits Graduate Fellowship. I am especially grateful to the women and the medical professionals whose generosity and cooperation made this research possible. This article originated as a presentation for the conference "Biotechnology, Culture, and the Body," held at the Center for Twentieth-Century Studies of the University of Wisconsin, Milwaukee, 24-26 April 1997. A version is forthcoming in the volume Biotechnology and Culture: Bodies, Anxieties, Ethics, edited by Paul Brodwin (Bloomington: Indiana University Press, 2000). I thank Paul Brodwin, as well as Pamela Klassen, Linda Layne, Lynn Morgan, Elizabeth Roberts, Michael Rosenthal, Caroline Seymour-Join, and especially Jean Comaroff, for helpful conversations and comments on earlier drafts. Sharon Stephens encouraged this project in many ways large and small over the nine years that I was fortunate enough to know her, as a teacher and a friend, before her death from cancer in June of 1998; I offer this article in her memory.

(1.) Ultrasound is a technology that employs high-frequency sound-waves to create visual images of internal bodily structures. Although used in many different branches of medicine, it has been particularly important in the field of obstetrics, where it is used to visualize the ovaries, cervix, fetus, placenta, umbilical cord, and so forth. AFP blood screening tests for levels of a particular hormone (alpha fetoprotein) in maternal blood; abnormal levels may indicate that the fetus suffers neural tube defects (such as spina bifida or anencephaly) or Down's syndrome. Amniocentesis is a procedure in which a needle is inserted through a pregnant woman's abdomen to extract a small amount of the fluid contained in the amniotic sac surrounding the fetus; this fluid is then analyzed for the possible presence of a (steadily increasing) number of chromosomal and genetic disorders.

(2.) Emily Martin, The Woman in the Body: A Cultural Analysis of Reproduction (Boston: Beacon Press, 1987), 63.

(3.) Ann Oakley, The Captured Womb: A History of the Medical Care of Pregnant Women (New York: Basil Blackweil, 1984).

(4.) The sonographer takes certain anatomical measurements of the fetus, such as the diameter of the head (biparietal diameter), and the "crown-rump length,' and compares these to standard charts to obtain an estimate of the "gestational age" of the fetus. These always have a margin of error expressed as a function of time ("plus or minus so-and-so many weeks") which increases as pregnancy proceeds.

(5.) Barbara Katz Rothman, Re-creating Motherhood: Ideology and Technology in a Patriarchal Society (New York: W.W. Norton, 1989), 21.

(6.) Steven G. Gabbe, "Routine Versus Indicated Scans," in Diagnostic Ultrasound Applied to Obstetrics and Gynecology, ed. Rudy E. Sabbagha (Philadelphia: J.B. Lippincott Co., 1994), 72.

(7.) For discussion of dilemmas surrounding selective abortion, see especially Rayna Rapp, Testing Women, Testing the Fetus: The Social Impact of Amniocentesis (New York: Routledge, 1999).

(8.) Rothman, 19.

(9.) Ibid., 21.

(10.) Martin, The Woman in the Body, 145.

(11.) Ibid., 143.

(13.) Janelle Taylor, "The Public Fetus and the Family Car: From Abortion Politics to a Volvo Advertisement," Public Culture 4 (spring 1992): 69-87.

(12.) Carol A. Stabile, Feminism and the Technological Fix (Manchester, U.K.: Manchester University Press, 1994), 94.

(14.) I borrow this phrasing from Cynthia Cockburn and Susan Ormrod's study of the "microwave world," Gender and Technology in the Making (London, U.K.: Sage, 1993): 19.

(15.) For a more detailed discussion, please see my Image of Contradiction: Obstetrical Ultrasound in American Culture," in Reoproducing Reproduction: Kinship, Power, and Technological Innovation, ed. Sarah Franklin and Helena Ragone (Philadelphia: University of Pennsylvania Press, 1998).

(16.) I would not expect this argument to apply in any straightforward way to all contexts where obstetrical ultrasound is used in particular, the notion that knowledge of fetal sex is important primarily as an aspect of "consumption" of pregnancy is quite culturally peculiar; such information is very differently weighted where women are under pressure to bear male children, and the use of ultrasound for sex-selection is a real concern especially in India and China. Ironically, the view that things such as sex determination are harmless and generally enjoyable "extras" (which, as we shall see, is enshrined within the cultural form of the ultrasound examination in this country) opens a space for this technology to be used for sex selection here as well. Chris C. Fair, in an unpublished manuscript, discusses the case of Dr. John D. Stephens, who has patented a method for determining fetal sex via ultrasound in the first weeks of pregnancy (U.S. Patent #4,986,274) and operates clinics in several U.S. cities that advertise ultrasound for sex determination in Punjabi language newspapers, a practice protested by local Punjabi women's organizations.

(17.) Daniel Thomas Cook, "The Mother as Consumer: Insights from the Children's Wear Industry, 1917-1929," The Sociological Quarterly 36, no. 3 (1995): 519. See also his book, The Commodification of Childhood: Personhood, the Children's Wear Industry, and the Moral Dimensions of Consumption, 1917-1967 (Durham: Duke University Press, forthcoming).

(18.) Stork Site, accessed June 19, 1998, at http//www.storksite.com/index.html.

(19.) See also Linda Layne, "'I Remember the Day I Shopped for Your Layette': Consumer Goods, Fetuses, and Feminism in the Context of Pregnancy Loss," in Fetal Subjects, Feminist Positions, ed. Lynn Morgan and Meredith Michaels (Philadelphia: University of Pennsylvania Press, 1999).

(20.) Leigh Eric Schmidt, Consumer Rites: Time Buying and Selling of American Holidays (Princeton: Princeton University Press, 1995).

(21.) Jo B. Paoletti and Carol L. Kregloh, "The Children's Department," in Men and Women: Dressing the Part, ed. Claudia Brush Kidwell and Valerie Steele (Washington, D.C.: Smithsonian Institute Press, 1989), cited in Cook, "The Mother as Consumer."

(22.) Arjun Appadurai, Modernity at Large: Cultural Dimensions of Globalization (Minneapolis: University of Minnesota Press, 1996).

(23.) Faye Ginsburg, Contested Lives: The Abortion Debate in an American Community (Berkeley: University of California Press, 1988).

(24.) Arlene Eisenberg, Heidi Eisenberg Murkoff, and Sandee Eisenberg Hathaway, What to Eat When You're Expecting (New York: Workman Publishing, 1986), 16.

(25.) See also Susan Markens, C.H. Browner, and Nancy Press, "Feeding the Fetus: On Interrogating the Notion of Maternal-Fetal Conflict," Feminist Studies 23 (summer 1997): 351-72.

(26.) See discussion of ultrasound as "something surefire," in Margarete Sandelowski, With Child in Mind: Studies of the Personal Encounter with Infertility (Philadelphia: University of Pennsylvania Press, 1993), 126.

(27.) Eisenberg, Murkoff, and Hathaway, 12.

(28.) Monica Casper and Vivian Christensen make this point forcefully in their recent analysis of the medical literature on prenatal exposure to toxins, "Our Environment, Ourselves: Hormone Disruptors and the Fragile Fetus" (Paper delivered at the "Annual Meeting of the Society for Social Studies of Science," Tucson, 1997).

(29.) Faye D. Ginsburg and Rayna Rapp, Introduction, Conceiving the New World Order: The Global Politics of Reproduction, ed. Ginsburg and Rapp (Berkeley: University of California Press, 1995), 2.

(30.) Robbie Davis-Floyd, Birth as an American Rite of Passage (Berkeley: University of California Press, 1992).

(31.) See also the discussion in Taylor, "Image of Contradiction."

(32.) Arjun Appadurai, "Introduction: Commodities and the Politics of Value," in The Social Life of Things: Commodities in Cultural Perspective (Cambridge, U.K.: Cambridge University Press, 1986).

(33.) Lisa Meryn Mitchell, Making Babies: Routine Ultrasound Imaging and the Cultural Construction of the Fetus in Montreal, Canada (Ph.D. diss., Case Western Reserve University, 1993), 184.

(34.) Igor Kopytoff, "The Cultural Biography of Things: Commoditization as a Process," in The Social Life of Things, 64-91.

(35.) As I argue elsewhere, the obstetrical ultrasound examination is a site of considerable tension over the boundaries of "the medical," and sonographers' professional identity is invested in locating ultrasound squarely within the domain of the "medical"; see Taylor, "Image of Contradiction."

(36.) Merriam-Webster's Collegiate Dictionary, 10th ed., s.v. "consumer."

(37.) Sidney Mintz, Sweetness and Power: The Place of Sugar in Modern History (New York: Penguin, 1985), 180.

(38.) Marshall Sahlins, "The Sadness of Sweetness: The Native Anthropology of Western Cosmology," Current Anthropology 37, no. 3 (1996): 401.

(39.) Jean Comaroffs recent essay, "Consuming Passions: Child Abuse, Fetishism, and 'The New World Order,'" Culture 17, no. 1-2 (1997): 7-19, is exemplary and indexes much of this literature.

(40.) Daniel Miller, A Theory of Shopping (New York: Routledge, 1997).

(41.) Daniel Miller, "Consumption and Commodities," Annual Reviews of Anthropology 24 (1995): 144.

(42.) Karl Marx, The Marx-Engels Reader, ed. Robert C. Tucker (New York: W.W. Norton, 1972), 199.

(43.) Martin, The Egg and the Sperm.
COPYRIGHT 2000 Feminist Studies, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2000 Gale, Cengage Learning. All rights reserved.

 
Article Details
Printer friendly Cite/link Email Feedback
Author:TAYLOR, JANELLE S.
Publication:Feminist Studies
Geographic Code:1USA
Date:Jun 22, 2000
Words:10968
Previous Article:CIRCLE STORIES: A COLLABORATIVE PROJECT.
Next Article:THE WAY WE HOLD OUR BODIES.
Topics:

Terms of use | Privacy policy | Copyright © 2018 Farlex, Inc. | Feedback | For webmasters