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Invisible labours: the reproductive politics of second trimester pregnancy loss in England

隐形分娩：英国中期妊娠流产的生殖政治

基本信息

批准号：
ES/X00712X/1
负责人：
Aimee Middlemiss
金额：
$ 12.46万
依托单位：
UNIVERSITY OF EXETER
依托单位国家：
英国
项目类别：
Fellowship
财政年份：
2022
资助国家：
英国
起止时间：
2022 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FX00712X%2F1
关键词：
Invisible labours reproductive politics second

项目摘要

The loss of a wanted pregnancy, through miscarriage or termination for foetal anomaly, has historically been marginalised in the UK, and it is only recently that such events have been more widely recognised as potentially significant medical and social experiences. Events of stillbirth, after 24 weeks' gestation, and early miscarriage, before 12 weeks' gestation, are increasingly socially acknowledged, and research about their social impacts has been carried out in the UK.By contrast, pregnancy loss in the second trimester of pregnancy, after 13 weeks but before legal foetal viability at 24 weeks, has not been specifically addressed in social science. Termination for foetal anomaly has also received limited attention and is sometimes excluded from the category of pregnancy 'loss'. My research addresses spontaneous or induced forms of second trimester loss, which are managed in the English NHS by labour and birth rather than surgically, and often involve encounters with the formed and recognisably human body of a foetal being. I argue that second trimester loss is a specific experience which is different to early losses because of the degree of formation of the foetal body, the potential intensity of the labour and birth, and the way many women have begun to consider the coming baby as a specific person. At the same time, second trimester loss is different from stillbirth because the threshold of legal viability usually means that civil registration is not permitted, and the recognition of personhood and kinship which this entails is withheld, along with associated support such as maternity leave.The consequences of this betwixt-and-between status are felt in the healthcare offered to women in the second trimester, who often undergo delivery without the support offered to women later in pregnancy, such as epidural pain relief or midwife assistance. They may not be entitled to the postnatal six week check, or psychological bereavement support. Even the number of women who go through this experience is not known because pre- viability spontaneous loss statistics are not collated, and only terminations are reported nationally.My research with women about their experiences of second trimester loss in England describes the distress many feel about the experience itself, the way it is managed in the English NHS, and the subsequent social marginalisation of the event. It also describes the ways in which some women resist the dominant definitions of what has happened to them and assert the personhood of their baby as a person who lived and died. For example, women use evidence of the foetal body such as ultrasound images, photos, and cremation ashes to memorialise the life and death of their baby. They also resist their exclusion from the person-making and kin-making features of civil registration when they assert their own motherhood and the existence of their baby within their family.In this ESRC fellowship I will produce an academic book and journal articles, and develop relationships with relevant third sector and parliamentary groups. All this work will address second trimester pregnancy loss in England, including foetal death, very premature labour, and termination for foetal anomaly, through the experiences of pregnant women. In this manner, I aim to increase the visibility of marginalised reproductive experiences, to prioritise the experiences of pregnant women, and to pay attention to the understudied period of gestation in human reproduction. My work also describes how social and medical categories such as the 'second trimester' and 'foetal viability' produce particular types of exclusion, and how these can be contested by the agency of pregnant women, and it therefore addresses questions of politics and reproductive justice.During the fellowship I will also build on this work to develop future research in the social science of reproduction and prepare grant applications to UKRI and Wellcome

在英国，通过流产或胎儿异常终止妊娠而失去想要的妊娠在历史上一直被边缘化，直到最近，此类事件才被更广泛地认为是潜在的重大医学和社会经验。妊娠24周后的死产和妊娠12周前的早期流产事件越来越受到社会的认可，在英国已经开展了关于其社会影响的研究。相比之下，在妊娠13周后但在24周的法律的胎儿存活之前的妊娠中期流产在社会科学中尚未得到特别关注。因胎儿异常而终止妊娠也受到有限的关注，有时被排除在妊娠“流产”类别之外。我的研究解决了自发或诱导形式的中期妊娠损失，这是在英国国民保健服务管理的劳动和出生，而不是手术，往往涉及与形成和可识别的人体的胎儿的遭遇。我认为，孕中期损失是一个特定的经验，这是不同的早期损失，因为胎儿的身体形成的程度，劳动和生产的潜在强度，以及许多妇女已经开始考虑即将到来的婴儿作为一个特定的人。与此同时，妊娠中期流产与死产不同，因为法律的可行性的门槛通常意味着不允许进行民事登记，不承认由此产生的人格和亲属关系，沿着相关的支助，如产假。她们经常在没有为怀孕后期的妇女提供支持的情况下分娩，如硬膜外疼痛缓解或助产士的帮助。她们可能无权享受产后六周检查或丧亲心理支助。甚至有多少妇女经历过这种经历也是未知的，因为没有整理出存活前自发流产的统计数据，只有全国范围内的流产报告。我对英国妇女进行的关于中期妊娠流产经历的研究描述了许多人对这种经历本身的痛苦，英国国民保健制度的管理方式，以及随后的社会边缘化事件。它还描述了一些妇女如何抵制对发生在她们身上的事情的主流定义，并坚持认为她们的婴儿是一个活着和死去的人。例如，妇女使用胎儿尸体的证据，如超声波图像，照片和火化骨灰，以纪念他们的婴儿的生死。当他们坚持自己的母亲身份和他们的婴儿在他们的家庭中的存在时，他们也抵制被排除在民事登记的个人和亲属特征之外。在ESRC奖学金中，我将撰写一本学术书籍和期刊文章，并与相关的第三部门和议会团体发展关系。所有这些工作将通过孕妇的经验解决英国中期妊娠丢失问题，包括胎儿死亡、早产和胎儿异常终止妊娠。通过这种方式，我的目标是增加边缘化的生殖经验的可见性，优先考虑孕妇的经验，并注意在人类生殖的妊娠期研究不足。我的工作还描述了社会和医疗类别，如“孕中期”和“胎儿活力”如何产生特定类型的排斥，以及这些如何受到孕妇代理的质疑，在研究期间，我还将在这项工作的基础上发展未来在生殖社会科学方面的研究，并准备向UKRI申请资助和惠康