Artikelen Barbara Katz Rothman

Katz Rothman is Professor of Sociology at Baruch College

American lessons
for the Netherlands Recreating
motherhood
Something has, I do believe, gone seriously awry in our cultural under-
standing of motherhood in America. I find myself surrounded by contradic-
Katz Rothman analyseert tions. I live in a world that makes no sense.
de sociale constructie van We in the United States have seen the return of de midwife. And the rise of
moederschap in de Ameri- the cesarean section. For fifty years there were almost no midwives to be
kaanse maatschappij aan found in most of America. Then, in the same period that saw the nurse-mid-
de hand van drie ideolo- wife introduced into American hospitals, that saw the introduction of 'birth
gieën; het kapitalisme, het rooms', to replace some of our operating-room-like delivery-rooms, that saw
patriarchaat en de techno- an enormous 'natural childbirth' movement, we also saw the cesarean section
logie. rate rise to an astonishing 24 procent. Almost one out of every four births in
De ideologie van het patri- the U.S. is now by Cesarean. While there has been much talk of birth as a
archaat maakt het fysieke 'healthy, natural event,' each individual birthing woman has been acquainted
moederschap, de zwanger- with her personal 'risk factors,' factors that she is told make her birth less
schap en de opvoeding than healthy and far less than natural.
betekenisloos terwijl vader- Cigarette ads, clearly aimed at young wömen, the fastest growing market for
schap, de genetische band cigarettes, carry a warning about smoking harming fetuses. Alcohol compa-
juist allesoverheersend nies too have discovered the modern women as a new market. And bars, beer
wordt, aldus de schrijfster. cans and wine and liquor bottles now carry warnings about the dangers of
De technologie is gebaseerd alcohol use in pregnancy. The advertising is a governmentally acknowledged
op drie principes; voor- legitimate business expense; the warnings a government requirement.
spelbaarheid, rationaliteit The infant formula companies distribute sample packages of formula for new
en controle. Moederschap mothers labelled 'In support of your decision to breastfeed.' Hospitals, where
wordt gereduceerd tot virtually all of our births take place, hire lactation consultants, show breast-
werk, het lichaam een feeding videotapes, and send all mothers including breastfeeding mothers,
machine en kinderen het home with packages of formula ready-packed in disposable bottles.
produkt. Kapitalisme. Over While white babies are worth their weight in silver if not gold, some darker
moederschap wordt ge- skinned children linger for their entire childhood in foster care. And however
dacht in termen van eigen- much children may be valued, the nurturance and fostering of them is not. I
dom, welke een vertaling heard an angry black social worker on television say of a grieving white
vindt in het recht hebben op woman whose foster child was taken away after three years - its first and
een kind en op een vrouwen- only three years - because the woman was white and the child black, 'She
lichaam. In Amerika wordt had no right to love that child. It was just ajob.' And pretty much the same
een kwart van de kinderen thing is said of a pregnant woman who is not, I am supposed to believe, the
door middel van een keizer- mother of a baby in her belly because in a 'surrogacy agreement,' the baby
snede geboren. was contracted to be there.
Schrijfster onderstreept het Childbearing at forty is now considered chic, childbearing at fifty and up is
grote belang van het be- the new frontier of procreative technology, but childbearing at eighteen is
staan van vroedvrouwen en pathetic, chances lost. And we have one of the highest teenage pregnancy
vrouwengezondheidscent rates in the developed world.
ra in Nederland omdat zij
ervoor zorgdragen dat de In the name of 'family values' family needs have gone unmet: we may just
verdere medicalisering van now be starting the recovery from a twelve year administration that vetoed
de voortplanting wordt te- every attempt to provide family services, from day care to maternity leave
gengegaan. to universal prenatal care to increases in child welfare payments for despa-
rately poor people, all the while calling for a return to 'family values'.

* Aletta Jacobslezing, gehouden There are the contradictions I live with daily. This is the world in which I
8 maart 1993, te Groningen study motherhood, mother my children, live my life.

1993 nr 4 123
 Recreating motherhood Barbara Katz Rothman

To understand it, to explain it, to find some reason in dren are reckoned as being born to men, out of wo-
the unreasonable, I have to step back from it and try men. Women, in this system, bear the children of men.
to disentangle the contradictions. When I do so, I find In some societies, in contrast, the line of descent is
myself unweaving the strands of a fabric, under- not from father to son, but along lines of the women.
standing the pattern as I work it backwards to the These are called 'matrilineal' societies: it is a shared
underlying threads. mother that makes for shared lineage or family group.
I believe that American motherhood rests now on Men still rule in these groups, but they do not rule as
three deeply rooted ideologies that shape what we see fathers. They rule the women and children who are
and what we experience, that these are the three related to them through their mother's line. Women
threads which compose the fabric of motherhood in in such a system are not a vulnerability, but a source
America today: an ideology of patriarchy, an ideology of connection: people are not men's children coming
of technology and an ideology of capitalism. As these through the bodies of women, but the children of
three come together, with all of their multiplicity of women.
meaning, they give us the shape, and the discordance, In a patriarchal system the essential concept is the
of the American experience. 'seed,' the part of men that grows into their likeness
An ideology is the way a group looks at the world, a within the bodies of women. Such a system is inevi-
way of organizing our thinking about the world. An tably male dominated, but it is a particular kind of
ideology can let us see things, but it can also blind us, male domination. Men control women as daughters,
close our eyes to our own lived reality, our own much as they control their sons, but they also control
experiences, our own bodies. These three ideologies, women as the mothers of men's children. It is wome-
of patriarchy, technology, and capitalism, give us our n's motherhood that men must control to maintain
vision while they block our view, give us a language patriarchy. In a patriarchy, because what is valued is
for some things while they silence us for others. In the relationship of a man to his sons, women are a
what follows, I will speak first of each of these as vulnerability that men have: to beget these sons, men
separate ways of thinking, but what I understand most must pass their seed through the body of a woman.
clearly is the way they weave together to create a In a patriarchal system, when people talk about blood
pattern, a fabric, both a curtain and a cage. ties, they are talking about a genetic tie, a connection
by seed. In a mother-based system, the blood tie is the
The ideology of patriarchy mingled blood of mothers and their children: children
grow out of the blood of their mothers, out of their
The ideology of patriarchy is perhaps the easiest to bodies and being. The shared bond of kinship comes
understand of the three ideologies that shape Ameri- through mothers. The maternal tie is based on the
can motherhood, the ideology that brings us together growing of children. The patriarchal tie is based on
in celebration of International Women's Day. genetics, the act of impregnating.
Women's reality, in the United States as in the Nether- Each of these ways of thinking leads to different ideas
lands, as in most of the world, is not the dominant about what a person is. In a mother-based system, a
reality, and women's view of the world is overruled person is what mothers grow: people are made of the
by men's view. Motherhood in patriarchal societies is care and nurturance that brings a baby forth into the
what mothers and babies signify to men. For women world, and turns the baby into a member of society.
throughout the world this has meant too many preg- In a patriarchal system, a person is what grows out of
nancies or too few; 'trying again' for a son; covering men's seed. The essence of the person, what the
up male infertility; having some of our children called person really is, is there in the seed when it is planted
'illegitimate;' not having access to abortions we do in to mother. Early scientists in Western society were
want and being pressured into abortions we may not so deeply committed to the patriarchal concept that it
want. inffuenced what they saw. One of the first uses of the
The term 'patriarchy' is often used loosely as a microscope was to look at semen and see the little
synonym for 'sexism,' or to refer to any system where person, the homonculus, curled up inside the sperm.
men rule. The term technically means 'rule of Out of the patriarchal focus on the seed as the source
fathers', and it is in that sense that I use it. Male of being, on the male production of children from
dominance and patriarchal rule are not quite the same men's seed, has grown our current thinking about
thing, and when the subject is motherhood, the diffe- procreation.
rence is important. One direction this has taken us is the focus on genetic
Patriarchal kinship is the core of what is meant by determinism, whether in its most horrifying eugenics
patriarchy: the idea that paternity is the central social form under the third Reich, or in its contemporary
relationship. A very clear statement of patriarchal forms. In the United States, in the face of enormous
kinship is found in the book of Genesis, in the and obvious social problems causing disease and
'begats'. Each man, from Adam onward, is described illness, the search for genetic causes of disease and
as having 'begot a son in his likeness, af ter his image'. illness has captured the support. The United States
After the birth of this firstborn son, the men are has launched the Human Genome Project, a pheno-
described as having lived so many years and begot menal effort to track the genetic bases of human life
sons and daughters. The text then turns to that first- and human illness. A belief in genetic determinism,
born son, and in turn his firstborn son after him. the seed as the cause of our being, continues to
Women appear as the 'daughters of men who bore flourish.
them off spring.' In a patriarchal kinship system, chil- Modern technology of procreation and modern gene-

124 NEMESIS
 Recreating motherhood Barbara Katz Rothman

tics have been forced to go beyond the sperm as seed. And upper class women can, as they so often have,
Modern science has had to confront the egg as seed be bought off with these privileges, and accept men's
also. But that does not mean that we no longer conti- world view as their own. And so in the United States
nue to think of the seed as the essence of being. It is we have women, right along with men, saying that
not the end of the belief that the seeds, the genes are what makes a child one's own is the seed, the genetic
everything, that they are what really matters in the tie.
making of a baby, the unfolding of a person, that they The ideology of patriarchy thus shapes women's as
are what real kinship is based on. well as men's view of motherhood. Physical mother-
The old patriarchal kinship system had a clear place hood, the nurturance and intimacy of pregnancy, is
for women: they were the nurturers of men's seeds, made meaningless, while paternity, the genetic con-
the soil in which seeds grew, the daughters who bore nection, becomes all-meaning.
men offspring. When forced to acknowledge that a
woman's genetic contribution is equal to a man's, The ideology of technology
Western patriarchy was in trouble. But the central
concept of patriarchy, the importance of the seed, was In a technological society, we apply ideas about ma-
retained by extending the concept to women. Valuing chines to the physical and social world. In the Nether-
the seed of women, the genetic material that women lands, the outsider is struck by your passion for con-
too have, extends to women some of the privileges of trol and order of the land: never in my life have I seen
patriarchy. Specifically, this has given women some a countryside, a landscape, with so many straight
rights to their children, rights based not on their lines, so many right angles. No creek meanders, no
nurturance and care of these children from conception path twists. You put seas where you want them, in
onwards, but rights based on their genetic connection. awe-inspiring displays of rational control.
This does not end patriarchy, and it does not end the Technological ideology asks people, like the land, to
domination of the children of women by men. Inste- be more efficiënt, productive, rational and controlled.
ad, by maintaining the centrality of the seed, the A technological society treats our bodies as machines,
ideology maintains the rights of men in their children, hooking them up to other machines, monitoring and
even as it recognizes something approaching equal managing bodily functions. When a doctor manages
rights of women in their children. In the United States, a women's labor, controlling her body with drugs and
since men's control over women and the children of surgery, it is to make her labor more efficiënt, predict-
women is no longer based simply on men's (no lon- able, rational.
ger) unique seed, men's economie superiority and the And so it is when mothers and fathers push their
other privileges of a male-dominated social system babies onto a schedule, so that feeding the baby
have become increasingly important. Children are, meshes with the workday. Books like 'Toilet Training
based on the seed, in American law 'half his, half in One Day' have become best sellers in the United
hers,' - and might as well have grown in the backyard. States, showing us how to 'train' our children effi-
American men win custody battles for children be- ciently. When we think of parenting, or raising our
cause they are equally entitled to the children based children, of our relationships with our children as a
on the genetic connection, but better equipped, based job to be done well, then we have invoked the ideo-
on the economie advantages. logy of technology.
This is the context in which the elaborate new tech-
The most obvious application of technological ideo-
nologies of procreation are understood. We have, for
logy to American motherhood has occured in the
example, a technology that takes Susan's egg and puts
medicalization of pregnancy and childbirth. From the
it in Mary's body. And so we ask, who is the mother?
medical management of pregnancy with the new
Who is the surrogate? Is Mary substituting for Susa-
quality control technology of prenatal diagnosis,
n's body, growing Susan's baby for Susan? Or is
through the rigidly monitored and controlled labor
Susan's egg substituting for Mary's, growing into
typical of an American hospital birth, the focus is on
Mary's baby in Mary's body?
the 'mechanics' of production, and not the social
In the United States we have used the technology both
transformation of motherhood.
ways. When Mary's husband wants a child, he and
In the American management of childbirth we see the
Mary can purchase Susan's egg, use Mary's hus-
ideology of technology played out in all its humane
band's sperm and Mary's body, and grow their 'own'
absurdity. Pregnant women become seen as workers
baby. But when Susan's husband wants a child, he and
in an unskilled assembly line, conceptualized as ma-
Susan can rent space in Mary's body, use Mary as a
chines, containers holding precious genetic material.
vessel for their baby. In the United States people with
One of more ultrasound sessions have become fairly
money can contract for pregnancy. The brokers have
Standard practice in American obstetric care. It is no
books of pictures of women for potential parents to
longer quickening that marks the first realization of
choose from, to take this women or that woman to
the baby as a separate being within: it is now the
carry the pregnancy to nurture the seed.
moment it is first seen on the screen.
Just as upper class men and women historically have
Women report that in that moment of seeing the fetus
been able to use the milk of poor women to raise their
on the ultrasound screen, it suddenly becomes real to
children, upper class men and women are now using
them: real is probably the most often used word to
the bodies of these poor women. Upper class women
describe the fetus on the screen. It is not so surprising
can have some of the privileges of patriarchy, using
that the first generation of women to grow up wat-
the bodies of poorer women to 'bear them offspring.'
ching television now feel their first real connection

1993 nr 4 125
 Recreating motherhood Barbara Katz Rothman

with their pregnancies and their coming babies when nological ideology in the social order. When the
they see them on a television monitor. Like starvation authors of the American constitution declared 'All
in Somalia or the earthrise from the moon, television men are created equal,' they were drawing on this
makes the unimaginable real for people. The screen philosophical insight. The equality they spoke of was
visually disconnects the woman from the fetus: the of the mind, the rational being. Certainly some were
woman herself and her doctor look away from the weak and some strong, some rich and some poor -
belly to the screen to see the baby. The feeling of but all share the human essence, the rational mind.
direct contact with the fetus that ultrasound gives the The extension of such equality to people of color and
physician changes the relationship between the wo- to women is based on the claim that these groups too
man and her physician, between the fetus and the share the essence of humanity, the rational mind -
physician. American obstetricians now routinely housed in the 'accident of birth' in the body of the
speak of the fetus as their patiënt, and of the mother black, the body of a woman.
as the 'maternal environment,' of even 'maternal If we belie ve, then, as this philosophic tradition holds,
barder.' that what is especially valuable about human beings
The conceptual separation of mother and fetus conti- is the capacity for rationality, then the ordering, ratio-
nues in the management of birth. Virtually all Ameri- nalizing and purposeful efficiency of technology will
can woman go into the hospital, where the medical, be seen as a good. But hand in hand with the valuing
obstetrical, mechanical reality overrides the human of rationality is a theoretical disdain for the signifi-
drama of birth. In almost a parody of itself, the cance of the body, and a disdain for physical work in
management of a birth in America means hooking the preference for mental work. The latter, dividing the
laboring woman up to a machine, a 'fetal monitor'. physical from the menial work, and then using ma-
Fetal heart tones can be read from a central location, chines and people interchangeably to do the menial
with less and less need for direct contact with the physical work, is the essence of technological orga-
laboring woman. nization.
American obstetricians are entranced with the idea of This division of labor is a particular problem for
'managing' labor. The earlier focus was on the control women as mothers: mothers do the physical work of
of pain in labor; more interest is now aroused by the body, we do the mental work of body maintenan-
controlling the length of labor. Studies report the ce. Thus women become identifies with the physical,
wondrous advantages of agressive management, the the body, and men with the higher, the rational. This
use of drugs to keep contractions coming every two distinction between menial physical labor and the
minutes, to have the woman birth the baby within highly valued rationality goes a long way toward
twelve hours or do a Cesarean section. explaining the utter disdain with which an American
None of the studies even ask the women how they feel laboring woman is strapped down, ignored or even
about any of this. insulted, while the doctor who 'manages' her labor -
Fort the majority of American women, the physical reading her chart and ordering others to carry out his
experience of pregnancy and birth thus becomes decisions - is held in such high esteen. Or similarly,
transmuted from an expression of power, to one of why the women who produces perfect nourishment
dependency, as the woman experiences her body as a from her body for her baby is seen as 'cow-like' and
recalcitrant machine. the pediatrician who 'prescribes' a formula receives
In a technological ideology, it is not only the body that such respect - and high pay.
is treated as a machine, as mechanical, but everything If it is the mind that is so clearly valued, and the bodily
from the physical world around us to the social order. work equally disdained, then using one's body as a
Carolyn Merchant, in The death of nature, traces the resource make sense. The liberal tradition can thus
development of a mechanical order in Western socie- support prostitution, so long as it is done on the basis
ty to replace the organicism of earlier times. Whereas of ostensibly free choice. The notion of 'surrogate
in the time of the Renaissance the earth was perceived motherhood' is an even better example: the American
as alive and considered to be a beneficient, nurturing liberal focus turns to the issue of informed consent,
female, by the end of the seventeenth century the legal representation and rational and deliberative
world view had changed and the machine became the choice. If the woman freely chooses to use her body
metaphor. Merchant writes: 'Nature, society and the as a rentable commodity, the Liberal tradition in
human body are composed of interchangeable atomi- American law would uphold any surrogacy contract
zed parts that can be repaired or replaced from the into which she may enter. The baby, the product of
outside.' This she says, is the ideology that has per- seed, is merely planted within her body, and she is
meated our consciousness. You can move a sea, trans- making rational use of her body.
plant a liver, contract a pregnancy. In sum, the ideology of technology has as its basic
With this shift in the vision of the body and the land, themes order, predictability, rationality, control. It
came a shift in te image of human relationships: 'A brings with it the rationalization of life, the systema-
new concept of the self as a rational master of the tizing and control of things and of people as things,
passions housed in a machine-like body began to the reduction of all to component parts, and ulimately
replace the concept of the self as an integral part of a the vision of everything, including our very selves, as
close-knit harmony of organic parts united to the resources.
cosmos and society.' Liberal philosophy, the intellec-
tual underpinning of the American revolution and of
American government, is the articulation of this tech-

126 NEMESIS
 Recreating motherhood Barbara Katz Rothman

The ideology of capitalism accorded the same rights of bodily autonomy and
integrety that men have. For women, that has meant
I will be speaking of capitalism in two ways here: fïrst sexual and procreative autonomy. Because it is her
as an ideology, like technology and patriarchy, which body, she cannot be raped. Because it is her body, she
explains the practices and the contradictions surroun- cannot be forced to bear pregnancies she does not
ding American motherhood. But later I will also want. Because it is her body, she cannot be forced to
discuss capitalism as a practice, as a mechanism, as abort pregnancies she does want.
the way that American motherhood and American This does not mean that American women are not
ideas about motherhood are marketed throughout the forced by circumstances into these very situations en
world. eventualities. It only means that the society will not
Capitalism, like the other ideologies, is complex; and use the official power of the state to force her. Women
I am forced to be brief, and inevitably must simplify. are in fact prevented from having abortions they
Here I will focus on only one essential aspect of the might want by family pressure, by economie circum-
capitalist ideology's contribution to the meaning of stances, by religious and by social pressures. And
motherhood: the idea of ownership of the body. women in America are forced into having abortions
Capitalism as an ideology as well as a system encou- they might not want to have because of poverty,
rages the extension of ownership or property relations because of lack of services for children and mothers,
in ways that are at best inappropriate, and too often because of lack of services for disabled children and
morally wrong. There is a great deal of contemporary adults. By offering amniocentesis to identify fetuses
social criticism that makes exactly that claim, inclu- who would have disabilities, and by cutting back on
ding for example, the ecologists. They argue that it is services for disabled children and their families, for
inappropriate to think we can own the land, the wa- example, we do effectively force women to have
ters: the earth, they claim - significantly - is our selective abortions.
mother, not our property. But we have held the line on adding to that pressure
But what happens when we start thinking of mother- of official power of the state. In American society,
hood itself in terms of property? As wrong as it is to when we bring it back to the simple legal questions -
think of the human relation to the earth this way, it is who can force an abortion o5r forcibly prevent one,
worse when we start thinking about our relations with force a woman to have sex or stop her from doing so,
each other in the language of property. People do not to use contraception or not - we wisely retreat to
often use the actual word 'property' in discussions of safety, calling forth our most sacred value. It's her
human relations. More often the key term is rights, body, We invoke a higher power, the power of ow-
with the concept of property kept as implicit. There nership.
are two directions in which property rights have ex- This then is the way that American women have been
tended that are directly relevant to motherhood: rights able to combine the dominant American liberal phi-
of ownership over one's children, and rights of ow- losophy with capitalist ideology to our benefit. We
nership over one's own body. It is the latter on which have made use of the mind-body dualism, to allow a
I will now focus. view of the body as owned, like a shelter which
In American society, as a capitalist system, one cannot houses the more important mind. The high value of
legally force or forcibly prevent people from doing ownership, of property rights to their own bodies. In
something with their own property without very com- the name of ownership, American women have de-
pelling reasons. The right to won, and therefore to manded access to contraception, sterilization, and
control, property is among the most valued of rights. abortion. And given the prevailing liberal philosophy,
In technological society, I have argued, the body is we've gotten rights to control our fertility - although
treated as a thing and as a resource. In capitalist given the capitalist class system, we have fared less
society, where the emphasis is on private ownership, well with access to the necessary means.
the body is viewed not as a resource for the commu- While the 'owned body' principle has worked for
nity or the society, but as a private property, a personal women in avoiding motherhood, it is less clear how
resource. Rights of privacy are in a sense just a it can be made to work to empower women as mo-
variation on other rights of ownership, of private thers. Our bodies may be ours, but given the ideology
control. of patriarchy, the bodies of mothers are not highly
Given the view of the body as owned property, the valued: the bodies are just the space in which genetic
extension of ownership to all of our body parts allows material matures into babies. In a patriarchal system,
women some measure of control over the use of our even if women own their bodies, it may not give them
bodies in procreation. If women are full persons, then any real control in pregnancy. Women may simply be
we are moved out of the category of owned property, seen to own the space in which the fetuses are housed.
and into the category of owners of our own bodies. This is the argument on which attempts to control
Men can no longer entirely legally barter in women's women's behaviour have been successfully based:
bodies. owning her own body is not enough to assure a
American feminists have made good use of this con- woman her civil liberties if her body is believed to
cept of bodily ownership. Within the American legal contain the property of someone else, someone else's
system, intelligent feminist use of the individualist baby. Thus American women have been literally jai-
ethos has been invaluable in assuring women's rights led for using drugs in pregnancy, literally been drag-
in procreation. Once women themselves are recogni- ged against their will into operating rooms for cesa-
zed as full citizins, then individual women must be rean sections. A woman's claim of ownership and thus

1993 nr 4 127
 Recreating motherhood Barbara Katz Rothman

control over her body cannot withstand the competing women, often in America at the expense of women of
claim of the fetus or the state's claim on behalf of the color. If I talk about nurturance, daily acts of caring,
fetus, for its ownership rights in its own body. of tending, of raising children as constituting mother-
hood, then women who hire other women to perform
Weaving the fabric those acts in their absence, as babysitters, housekee-
pers and nannies, feel their motherhood claims threa-
From the standpoint of the ideology of technology, tened.
we have seen that motherhood is perceived as work, Thus we in the United States find ourselves trapped
and children as a product by the labor of mothering. in a fabric whose weave tightens, comes to appear
Mother's work and mother's bodies are resources out seamless. We have come to think about motherhood
of which babies are made. From the standpoint of the and about our children in certain ways, and we have
ideology of patriarchy, it is men's babies that are developed technologies out of that thinking. The tech-
being made. From the standpoint of the market, not nologies in turn act back on us, further encouraging
all work is equally valuable, and not all products are the way of thinking. We think of the body as a
equally valued. There is not a direct relationship machine, and so develop machines to attach to the
between the value of the worker and the value of the body until finally the body - the laboring body of a
product. What is essential to capitalism is the accu- woman with child - appears to be an extension of the
mulation and investment of capital, of wealth, by machinery. We think of the woman's body as a barrier
people who are in a position to control others. Under to access to the child planted within, and develop
capitalism, workers do not own or control the pro- technology that makes the woman visible, opens up
ducts of their own labor. the fetus to our eye, makes it appear as the trapped
Babies, at least healthy white babies, are very preci- child we thought it was. We think of seed as precious,
ous products in the United States these days. Mothers, and develop techniques for harvesting it, for culling
rather like South African miners, are the expendable, it, for selecting the most precious seeds. We think of
cheap, not-too-trustworthy labor necessary to produ- the site of growth of those seeds as interchangeable -
ce the precious product. This is the end result of the and we interchange them. We create a world in our
evolution of these three ideological perspectives. This image.
is what ties together the new technology, the legal, the And then we sell it.
medical, the political and the psychological creation
of motherhood in American society. Selling the vision
From these three ideologies, that of patriarchy, tech-
nology and capitalism, we get the supportive fabric It begins in a way that generally makes some sense,
for the strange patterns we see emerging in the United that pulls on your heart strings, that captures your
States, patterns which may already begin to threaten imagination. We start with some woman in a very
the Netherlands. In combinations, sometimes with high risk situation: the technology offers her a chance,
one thread dominating and sometimes another, these maybe her only chance, to have a baby. But then very
three ideologies explain the contradictions with quickly the technology begins the spread to people at
which Ibegan. lower and lower risk, until virtually every woman is
These ideologies also explain the direction that the caught up in the net. In the United States the cycle
development of new technology of procreation is may take just a few years. Often, once the technology
taking us: further and further towards treating babies is in fact routinized, the problems with it - the pro-
as commodities to be produced out of precious gene- blems it causes rather than solves - are discovered,
tic material, mothers as 'cheap labor,' untrustworthy and the technology is abandoned. Often it is abando-
workers on a reproductive assembly line. ned in favor of some newer technology, and the cycle
It is the nature of a hegemony - this complex world starts anew.
view constracted of interlocking ideologies - that we Such was the story of X-ray use in pregnancy: from
cannot see through it clearly. And so we fear to piek a few women with abnormal pelvic structure to rou-
at the fabric, fear to pull at individual loose threads tine use in the population, to discovery of the link to
for fear of falling straight through into some abyss. If childhood cancers, to replacement with ultrasonogra-
we challenge any piece of the system, other pieces phy. It is the story of weight control programs for
rise to block our way. When I challenge technological pregnant women, of prenatal diagnosis, of fetal mo-
ideology, people hear the sound of the baby being nitors. Always it begins with some heart-rending
chucked out with the bathwater, fear of return of the crisis. Always it ends with the routinization of the
angel of death hovering at every birth, fear unchecked technology.
fertility, untreatable infertility, women captured and I met a physician here in the Netherlands at a confe-
held hostage to some mad biology. When I challenge rence on the. use of prenatal diagnosis. I was critical
ownership models of bodily integrity, I hear the enor- of the introduction of the technology for routine use.
mous fear of someone else claiming ownership. So Ah, she said, but don't you see: She had just come
deep the ownership model lies in American society from the bedside of a woman who was recovering
that the only askable question is whose property. And from her second selective abortion following prenatal
when I challenge the patriarchal models of genetic- diagnosis. She and her husband were carriers of a
based parenthood, I hear the fears of women of privi- dreadful condition, something no one would wish on
lege who have gained for themselves some of the their child. The decision to test for that condition in
privileges of patriarchy - often at the expense of the the fetus and to terminate the pregnancy if the condi-

128 NEMESIS
 Recreating motherhood Barbara Katz Rothman

tion was found was their only hope of having a restrictive bans on fetal and embryo research, the
healthy child. Didn't I see how fine a thing these tests scientists and researchers moved their laboratories
were, how valuable they could be? from country to country. The technologies they then
They were carriers, I asked? For a child to be affected, developed, no longer considered 'research' or 'expe-
the genes had to be present in both the sperm and the rimental' are then marketed throughout the world.
egg? Yes, yes, she assured me, that's what punt them The conferences are held internationally, the science
at such a high risk. Did you offer them donor insemi- develops its own international culture. But the mar-
nation, I asked? If they used donated sperm they keting gets targeted, like all international marketing,
would have no risk of this condition. The physician addressed to the local market. IVF Australia, which I
was silent for a long moment. I never thought of it, think of as McConception, or the McDonalds of
she said, I just never thought of it. When she had left infertility treatment, opens up branche outlets where-
them earlier that day, the man was sitting at the ver rich people with infertility problems can be found,
bedside with his head bowed over his wife's empty and now in the states calls itself 'IVF America.' IVF
belly, weeping. He might have accepted donor sperm, clinics now blanket the world.
she thought. Some technology inappropriate marketing across the
The couple was using the technology of prenatal globe costs lives: this has been the well-documented
diagnosis in this case not simply to have a healthy case with the marketing of infant formula to underde-
baby. They were using this technology, this particular veloped countries. As the mother of one child by
technology to have a healthy baby, in order to main- adoption, I deeply value the availability of good
tain the husband's paternity. And it was not even infant formula. But clearly the inappropriate marke-
necesarilly out of the husband's desire to do so: it was ting of the formula for profit has cost lives. I am not
the doctor's decision to offer this technology. Donor arguing against these technologies I am not opposed
insemination is an expensive, low technology, low to all uses of IVF, of prenatal diagnosis, any more than
risk, low profit treatment. There is no international I am opposed to all cesarean sections. But I am very
marketing program for donor insemination. The tech- aware that these technologies are not always used in
nology of prenatal diagnosis that the physician was the best interests of women, that they often grow out
offering is a technology that is being aggresively of an ideology that makes them dangerous. A needed
marketed throughout the world. It is a technology that cesarean section is a life-saver. A 24 procent section
grew out of the complex weave of ideologies I have rate is madness. To know where a technology is
been describing, but wherever these technologies headed, it helps to know where it is coming from.
come from, whatever ideology or way of life they You in the Netherlands are not in much danger of
grew out of, they are marketed throughout the world. losing lives - but perhaps it is a way of life you must
The conference at which I met this physician was think to protect. Maternity care in the Netherlands
sponsored in part by the pharmaceutical companies stands as a model for the rest of the world. Midwifery
that make the prenatal diagnostic kits. The audience has remained as a developed, respected and most
was obstetricians: those who would be doing the significantly independent profession. Obstetricians
testing. The specific test under discussion was to be have worked with midwives but in marked contrast
used in low risk pregnancies, possibly eventually in to most of the rest of the world, professional bounda-
all pregnancies, to screen people for whom further ries have remained standing: your midwives work
testing would be advised. The doctor was showing me with, not under, obstetricians. Home birth remains
the path, from the tragic couple at high risk to the very much alive and well here. Maternal and infant
whole population, the path by which acceptance of mortality are among the very lowest in the world.
this technology could be routinized in this society. And into this system the new technologies of procrea-
The technology that is developed in any particular tion are being marketed. Your obstetricians are being
society is no longer simply a reflection of the cultural wooed by an international scientific community, tar-
values of that country. It is also a product, an object geted by international marketing and multinational
subject to multinational development, international industries. I see your way of birth, and by extension
marketing. Once we have an object, a marketable your ways of motherhood, being treathened.
commodity, the power of the multinational industries Some of the patterns and contradictions that plague
in the global economy begins to enter the picture. All American motherhood can be found in the Nether-
of the physical means of production of motherhood lands, and some not. We have much in common in our
in the United States - fetal monitors, screening kits ideologies, and we have our differences. But the
for the prenatal detection of fetuses with Downs greatest strength you have is resisting all that is wrong
Syndrome, ultrasound machines, infant formula, all with the Americanization of birth and of motherhood
of the products used from the lowest technology baby lies with your midwives. Underpaid and overworked,
bottle to the highest technology DNA probe - are treasured and valued, yes, but maybe taken-for-gran-
subject to international marketing. Many of these ted also, it is your midwives that distinguish you, your
objects have been developed in the United States; midwives who protect your vision of birth and of
some are imports. The culture of science, the world motherhood. As we in the United States seek to
of reproductive technology, is itself an international reweave the fabric, seek an alternative vision, one
world, and products and people move around quickly. place we turn to for inspiration is the Dutch midwives.
The case of in vitro fertilization and the other inferti- Many of us, feminists in the United States and in the
lity research is a good example. As one country after Netherlands, are seeking a new tapestry, woven from
another, including the United States, imposed various the threads of different ideologies. We want to replace

1993 nr 4 129
 Recreatingmotherhood Barbara Katz Rothman

patriarchy with a woman centered, woman grounded community. And we want to remove all images of
vision of motherhood, a vision that values nurturance, ownership, of property and of profit from the realm
the work and the care of mothering. We want to of mothers and children.
replace mechanistic, technological models with a va- This is a fitting vision to share on International Wo-
luing of the body, the organic oneness of the human men's Day, and I thank you for this opportunity.
body and mind, the interconnectedness of the human

130 NEMESIS