What the eye doesn

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What the eye doesnt see ultrasound, monitoring,
and the unborn

• HI 269
• Week 7

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Seeing is believing A quick history of medical
imaging
1895 Prof Wilhelm Roentgen discovers X-rays
they quickly become a popular phenomenon and
fad only later are they adopted for medical
purposes (eg only In 1920 are 100 of fracture
cases examined by x-ray in large US hospitals).
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Seeing is believing A quick history of medical
imaging
It is worse than useless to suppose that any new
method of forming mental pictures, no matter how
startling or radical, can equal the accuracy or
approach in value those which the science of
medical diagnosis has taught us to form with
well-nigh infallible precision. It would be
supererogation on the part of anyone to think
that the mental pictures which he might form by
use of the Roentgen rays could replace or even
add much to the pictures which modern physical
diagnosis is capable of presenting. The property
which gives this new method of diagnosis its
greatest value ... is its power to form real
images, to make tangible shadows where before
only mental pictures were possible. These
tangible shadows eliminate the personal equation
of the observer from the resulting diagnosis, and
thus remove a source of error common to all
methods that depend on the senses of the
individual for the accuracy of their results. CC
Leonard, 1897
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Seeing is believing? Interpreting the x-ray
The fondest swain would scarcely prize a picture
of his ladys framework to gaze on this with
yearning eyes would probably be voted tame
work! Whether stout or thin, the x-ray makes
the whole world kin. 1897 Sight is a much more
satisfactory agent of information than hearing or
touch. Philip Mills Jones, 1897 "I will admit
that I can see broken bones that I can see
metallic foreign bodies in the extremities, but
when it comes to X- rays of the chest and to some
extent of the abdomen, I am much less clear.
Frank Williams has just shown you some plates and
tells you that the heart is here and the lung is
here. Now I can't see a thing in these plates,
and to be truthful, I don't think he can." Dr.
F.C. Shattuck, after a presentation by Francis
Williams, 1899
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Seeing the foetus before ultrasound
Leonardo da Vinci, Sketch- Books, c. 1510
Hunter, Anatomy of the gravid uterus, 1764
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The Foetus in Pop Culture Giving the Foetus a
Public Presence
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The astonishing medical machine resting on this
pregnant woman's abdomen in a Philadelphia
hospital is looking at her unborn child in
precisely the same way a Navy surface ship homes
in on enemy submarines. Using the sonar
principle, it is bombarding her with a beam of
ultra-high-frequency sound waves that are
inaudible to the human ear. Back come the echoes,
bouncing off the baby's head, to show up as a
visual image on a viewing screen. (p. 45) Text
from Lifes A Sonar Look at an Unborn Baby,
1965 quoted in Rosalind Pollack Pechesky,
"Foetal Images the Power of Visual Culture in
the Politics of Reproduction,", Feminist Studies,
Vol. 13, No. 2 (Summer, 1987), pp. 263-292 at
p.276.
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Foetus in Pop Culture
Art for Arthur C. Clarke, 2010 Space Odyssey,
novel (1982) and film (1984)
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Technologies and ideologiesThe Silent Scream

• Role of Cinematic technology
• Allows widespread electronic distribution via TV,
  web..
• Edits image to increase drama (eg. speeding up
  images to create sense of fetal movement)
• Allows simultaneous interpretation of images
  (which are not immediately transparent without
  medical expertise)

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"Now let's turn to the actual film itself. We are
now looking at a sector scan of a real time
ultrasound imaging of a 12 week, unborn child.
The child is oriented in this direction. You are
looking now at the head of the child... here...
the body of the child... here.. and this image is
the child's hand approaching its mouth. Looking a
little more closely at the child, we can discern,
the eye or the orbit of the eye, here, the nose
of the child, here... and the mouth of the
child... here.. and we can even look at the
ventricle of the brain, here Now, we see the
heart beating, here in the child's chest And we
can see the child moving rather serenely, in the
uterus. One can see it shifting position from
time to time. It is still orientated in this
manner and the mouth is receiving the thumb of
the child. The child again is moving quietly in
its sanctuary. Narrative of Silent Scream 1985
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1984 report by joint National Institutes of
Health/ Food and Drug Administration panel on the
use of ultrasound in pregnancy

• Results of study
• no clear benefit from routine use
• no improvement in pregnancy outcome
• no conclusive evidence either of its safety or
  harm.
• Recommendation
• not for routine use or to view ... or obtain a
  picture of the fetus or for educational or
  commercial demonstrations without medical benefit
  to the patient
• Approved for use to estimate gestational age

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Images and the right to choose?

• This is the ONLY image of a foetus I have been
  able to find used in a pro-choice political
  context (and it is hardly intended as a tool of
  persuasion) Why?
• Could pro-choice activists use medical imagery to
  advance their message?

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Do technologies (necessarily) create a tension
between maternal and foetal interests?

• Womb as hostile environment or womb as foetal
  sanctuary do either of these images benefit
  women?
• Can we envision a way of imaging the foetus that
  would not exclude the woman carrying it?
• What do women gain from ultrasonography?
• Do men gain more (and if so, do their gains come
  at cost to women?)

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Reading Self-AssessmentDid you notice these key
terms and concepts?

• From Pollack Petchesky
• autonomous fetus/fetal autonomy
• adversarial pregnancy
• visual bonding
• Silent Scream/Dr.Nathanson
• homunculous
• fetus fetish
• fetus as patient
• prevalence of the gaze
• panoptics of the womb
• From Sandelowski
• two-patient model of obstetrics
• family-centred maternity care
• vicarious knower/parental knower/professional
  knower
• Epistemology
• Women as gatekeepers (and spectacles)/men as
  spectators
• democratization of fetal experience

• From Taylor
• unskilled reproductive workers
• reproduction/pregnancy as consumption
• fetus as commodity/person (commoditized vs
  singularized)
• doctors as managers/mothers as consumers
• pathological vs normal pregnant subjects
• ethnography
• From Oaks
• public fetus/fragile fetus/fetus-as-subject
• fetal protection messages
• pregnancy policing
• fetal abuse
• maternal/fetal conflict (but not paternal/fetal
  conflict)
• Smokey Sue/ Itty Bitty Smoker

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Seminar Topics

• When does a woman become a mother, responsible
  socially and legally for the wellbeing of her
  child?
• Do men become fathers at the same time and in the
  same way?
• Who qualifies as a person in our culture, and
  what effect have technologies of visualization
  had on our perceptions of personhood?