On the Threshold of the Living Subject: Pregnancy, Risk and Vital Politics (Transformations: Thinking Through Feminism)

251 Pages·2006·1.54 MB·English

by  Lorna Weir

Pregnancy, Risk and Biopolitics
Historically, western cultures have considered that human status was conferred at
the end of childbirth. However, in the contemporary medicine, law and politics of
the global north, the living subject is often claimed to pre-exist birth. In
Pregnancy, Risk and Biopolitics Weir argues that the displacement of birth as the
threshold of the living subject occurred in the 1950s with the novel concept of
“perinatal mortality” referring to death of either the fetus or the newborn just
prior to, during and after birth.
Pregnancy, Risk and Biopolitics calls attention to the significance of
population politics, especially the reduction of infant mortality, for the unsettling
of birth as the entry to human status. Weir traces the introduction of a new
perinatal threshold into child welfare and tort law through expert testimony on
fetal risk, sketching the clash at law between the birth and perinatal thresholds of
the living subject.
This novel book makes original empirical and theoretical contributions to the
history of the present (Foucauldian research), feminism, and social studies of risk.
Weir conceptualizes a new focus for the history of the present: the threshold of
the living subject – the historically and culturally variable processes through
which the boundary of human status is established at the points of entry and exit
into collective existence. She argues that the risk techniques are heterogeneous,
subjects of contention, and plural in their political effects rather than singular,
neoliberal, and uniformly supported by expertise.
This book is a well researched and accessible study of biopolitics which is of
interest to students and researchers in anthropology, health studies, history, legal
studies, science studies, sociology, and women’s studies.
Lorna Weir is an associate professor in the Department of Sociology at the York
Centre for Health Studies at York University, Ontario, Canada, and is a member
of Health Care, Technology and Place, Canadian Institutes for Health Research
(University of Toronto).
Transformations: Thinking Through Feminism
Edited by
Maureen McNeil, Institute of Women’s Studies, Lancaster University
Lynne Pearce, Department of English, Lancaster University
Books in the series include:
Transformations Class, Self, Culture
Thinking through feminism Beverley Skeggs
Edited by Sara Ahmed, Jane Kilby,
Celia Lury, Maureen McNeil and Haunted Nations
Beverley Skeggs The colonial dimensions of
multiculturalisms
Thinking Through the Skin Sneja Gunew
Edited by Sara Ahmed and Jackie Stacey
The Rhetorics of Feminism
Strange Encounters Readings in contemporary cultural theory
Embodied others in post-coloniality and the popular press
Sara Ahmed Lynne Pearce
Feminism and Autobiography Women and the Irish Diaspora
Texts, theories, methods Breda Gray
Edited by Tess Cosslett, Celia Lury and
Penny Summerfield Jacques Lacan and Feminist
Epistemology
Advertising and Consumer Citizenship Kirsten Campbell
Gender, images and rights
Anne M. Cronin Judging the Image
Art, value, law
Mothering the Self Alison Young
Mothers, daughters, subjects
Stephanie Lawler Pregnancy, Risk and Biopolitics
On the threshold of the living subject
When Women Kill Lorna Weir
Questions of agency and subjectivity
Belinda Morrissey
Pregnancy, Risk and
Biopolitics
On the threshold of the living subject
Lorna Weir
First published 2006
by Routledge
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Simultaneously published in the USA and Canada
by Routledge
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Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2006 Lorna Weir
This edition published in the Taylor & Francis e-Library, 2006.
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Every effort has been made to contact copyright holders for their permission
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any errors or omissions in future editions of this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from British Library
Library of Congress Cataloging in Publication Data
Weir, Lorna, 1952-
Pregnancy, risk, and biopolitics : on the threshold of the living subject / Lorna
Weir.
p. cm.
Includes bibliographical references and index.
ISBN10: 0–415–39257–8 (paper back) – ISBN10: 0–415–39258–6 (hard back)
1. Prenatal care–Social aspects. 2. Fetus. 3. Fetal–Legal status, laws, etc.
4. Biopolitics. I. Title.
RG526.W45 2006
362.198'2–dc22
2006004013
ISBN10: 0–415–39258–6 (hbk)
ISBN10: 0–415–39257–8 (pbk)
ISBN13: 978–0–415–39258–7 (hbk)
ISBN13: 978–0–415–39257–0 (pbk)
Contents
List of figures vi
Acknowledgements vii
1 On the threshold of the living subject 1
2 A genealogy of perinatal mortality 31
3 Health beyond risk: a midwifery ethos in prenatal care 76
4 Legal fiction and reality effects: evidence of perinatal risk 115
5 Child welfare at the perinatal threshold: making
orders protecting fetuses 143
6 Biopolitics at the threshold of the living subject 181
Notes 190
Bibliography 207
Index 233
Figures
1.1 Calculating epidemiological risk 18
2.1 Potter on the causes of fetal and neonatal mortality 46
2.2 Pfaundler’s perinatal period 50
2.3 The perinatal threshold: a representation 72
3.1 Philosophy of midwifery care in Ontario 83
Appendix to Chapter 3: The Ontario Antenatal Record 1992–2002 111
(a) Antenatal Record 1 112
(b) Antenatal Record 2 113
(c) A Guide to Pregnancy Risk Assessment 114
Acknowledgements
A number of friends and colleagues provided steadfast encouragement while I
was at work on this book. Carolyn Strange lent a willing ear on many occasions,
patiently instructing me in the importance of reconciling scholarship and
publicity, titles and electronic database searches. Bruce Curtis radiated calm
confidence at crucial junctures. I am hoping to repay Eric Mykhalovskiy for his
long patience and comments on the manuscript over the course of our current
joint research on global public health surveillance. Pat Elliot read and commented
on the first chapter, assuring me it made sense. Fiona Miller and Tom Loebel
generously read part of the manuscript. Gottfried Paasche improved translations,
and Barbara Godard supplied emergency advice in literary theory.
Paul Datta’s critical comments tried to save me from empiricism. The
manuscript benefited from his critique, and I continue to contemplate the status
of theory in theoretico-empirical work. The preliminary theoretical observations
on sovereignty found here are indebted to recent writing with my colleague Brian
Singer. Barbara Duden gave the penultimate draft a welcoming reception. Her
remarks on the manuscript strengthened the final version, making the process of
revising more intellectually interesting.
Many thanks to the feminist legal scholars Shelley Gavigan, Joan Gilmour,
Mary Lou McPhedran, Pam Shime and particularly Karen Schucher for their help
at various points, though they remain entirely blameless for the resulting
treatment of law. The reference librarians at the York University Law Library
were extremely helpful with requests for locating sources.
Research on this book began when I was affiliated with the Centre of
Criminology, University of Toronto, while on sabbatical. I thank Clifford
Shearing and Mariana Valverde for facilitating my initial research while at the
Centre, and especially Mariana for her observation that I needed to consider the
question of legal evidence more closely.
The contributions of graduate students to the life of the university are many.
They are sometimes the people who have the most ongoing engagement in
faculty research projects. Lachlan Story provided research assistance for the
midwifery and perinatal chapters, and was the only one in my life for an awfully
long while who had any interest in the recondite concept of perinatal mortality. It
viii Acknowledgements
is a pleasure to thank him for his convivial research support. Patti Phillips helped
track down citations on short notice. I am grateful for her astute editorial
observations, which especially helped the chapter on midwifery. Bill Leeming
provided highly skilled research on case law. I am fortunate to hold an
appointment in a department (Sociology, York University) that has a strong
graduate programme with singular, gifted students.
I thank the midwives and physicians who consented to be interviewed for the
gift of their time. My writing here on midwifery was much improved by the
remarks of Holliday Tyson to whom I am in many ways grateful for rendering my
understanding of midwifery more careful and complex. While I write as a social
scientist, I hope my work here will be of interest to health professionals,
particularly midwives. Heidi McDonell listened and listened as I talked and
talked. Gustava Zhuravskaya kindly tracked down sources in Vienna. Marg
Phillips did fine work on the pilot interviews for what became the chapter on
midwifery, health and risk.
I have been gifted with a fine editorial process at Routledge. Many thanks to
Maureen McNeil, Lynn Pearce and other members of the editorial board for the
Transformations: Thinking Through Feminism series for their enthusiasm in
accepting the manuscript. I much appreciate the intellectual generosity of the
anonymous reviewers who lent their minds and time to the peer review process.
And lastly I am glad to thank my sister Lorraine Weir for her comments,
intellectual and personal. Many times in our conversations she burst into gales of
laughter at my mention of antenatal records and fetal apprehensions. It sometimes
takes a Finnegans Wake scholar and literary theorist to appreciate fully the
paradoxes found in the biopolitical discourse of our present.
Lorna Weir
Toronto
1 On the threshold of the living
subject
The threshold of the living subject constitutes the zone of transition into and out
of human bodily substance. Unlike the threshold of exit, the threshold of entry
occurs in and through another body. Women in pregnancy bear the between, the
entrance across which the unborn must pass in order to be distinguished from
those who carry them. Neither a pure moment in time nor a single point in space,
the threshold of the living subject has duration and extent. When and where that
between begins and ends, what status the bodily substance at that threshold might
have, is an entirely social and cultural matter.
Thresholds mark the transition from inside to outside, the imperceptible to the
perceptible, the non-reactive to the reactive. “The threshold (die Schwelle) bears
the between” wrote Heidegger (1971: 201) in his essay, “Language”.1 Being the
“settlement of the between,” the threshold “sustains the middle in which the two,
the outside and the inside, penetrate each other” (Heidegger 1971: 201).2 The
between, however, may be difficult to conceptualize for cultural reasons. As
Irigaray (1985) argued in her commentary on Plato’s myth of the cave, Western
philosophy – and other truth regimes – have been incurious about zones and
techniques of transition due to their persistent habit of thinking in dualistic
categories such as inside and outside, light and dark, truth and illusion. At the
birth of Western philosophy, Plato ignored the entrance to the cave.
Without a threshold, a building could not be entered or left; there would be no
passage between inside and outside. The most ancient meaning of “threshold” in
English pertains to dwellings: “the piece of timber or stone which lies below the
bottom of a door, and has to be crossed in entering a house” (Oxford English
Dictionary, second edition 1989). The first entries for “sueil” and “Schwelle” in
the French and German historical dictionaries, Littré and Duden, also refer to the
wood or stone at the base of a doorway passed over on arrival. Over the past
thousand years the meaning of threshold extended to figure the border separating
regions or fields, the beginning of an action, and the lower limit of perceptivity
or reactivity. A threshold makes possible a relation between heterogenous places,
practices and perceptions.
Until the mid-twentieth century in Western Europe and the territories of the
European diaspora, the threshold of the living subject had been stabilized in