How we view the fetus

Recent release of video footage showing Planned Parenthood official Deborah Nucatola describing collection and costs of fetal tissue has attracted attention and controversy.  With this controversy playing out in background, the Wall Street Journal published a new report on the overuse of ultrasounds.

The Journal article argues that low-risk pregnancies do not need the average 5.2 scans American women now receive in the months before delivery.  Ultrasounds can help doctors assess fetal development and discover abnormalities, and some physicians may order more than necessary to avoid overlooking something.  Still, there are significant nonmedical reasons why many patients seek out those extra ultrasounds, even go to buy additional boutique “4-D” ultrasounds.  Expectant parents want to “see” their babies, and ultrasounds may help with parent-child bonding.  The images give waiting mothers and fathers a chance to “Get to Know Your Baby Before It’s Born,” in the words of a GE promotional slogan.  Seeing and sharing ultrasound pictures have acquired cultural importance as milestones in the American experience of pregnancy.

Of a wanted pregnancy, that is.

Beyond arguments over whether Planned Parenthood’s provision of fetal tissue for research constitutes sale or donation, what startles in Nucatola’s comments is her detailed description of picking out organs: “We’ve been very good at getting heart, lung, liver, because we know that, ‘I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”  For the liver, she noted, “most providers will do this case under ultrasound guidance, so they’ll know where they’re putting their forceps”—a very different use, we should note, of that technology that gives moms a peek into the womb.  On one hand, this provision of fetal tissue from abortion could be described as Planned Parenthood’s president, Cecile Richards, described it, “programs that help women donate fetal tissue for medical research.”  That is, given the legality of abortion, if a woman chooses to end a pregnancy, she might have help in donating the extracted tissues for research purposes, which might have potential to benefit others.  But Nucatola’s painstaking inventory of fetal organs comes closer to expressing the same thing a very different way: pregnant women who abort make available the parts of the eliminated fetus, parts that can be seen and separated out, sufficiently identifiable and valuable to require precision in extracting intact human organs, while the rest of the body above or below is crushed.

Here’s why the contrast of these news events is instructive.  In both reports, a medical procedure is employed for the monitoring, progress, or termination of a pregnancy.  In both cases too, validity of the procedure is not assessed mostly in medical terms, of the health of woman or baby, but carries moral, cultural, and emotional freight beyond the procedure itself.

In my own pregnancies, ultrasounds were underwhelming; I confess obtuseness in deciphering those black-and-white prints. I did not need a picture to know I was carrying a baby, and I “met” my babies through the rolls, kicks, and jabs they directed at my surrounding innards.  Historically, men and women did not rely on an image to bear news about a coming baby, as Nick Hopwood and Tatjana Buklijaz demonstrate in their Making Visible Embryos project.  A woman’s feeling of fetal movement, called quickening, was evidence of pregnancy.  Still, for many, seeing is believing: nothing matches those pictures for prompting recognition of the reality of the developing baby.  Parents stare at them to look for parts, check sex, guess family resemblance.  When we want to recognize this as a baby, we do, with great care; when we do not want to recognize this as a baby, we do not, though great care still might be taken in looking for parts.  The difference is not with the creature in utero but in how we see and name it.  Cecile Richards followed conventions of polite speech when responding to the Nucatola video, describing the extracted materials as tissues, but the Journal article shows no embarrassment at referring to the creature alternately as fetus,  “the unborn,” even “baby,” worrying about the effects of sound waves on its health.

The point is not that the fetus being imaged and admired by doting parents-to-be is the same as the fetus being carefully dismantled in order to preserve some of its organs for medical research.  Of course it is the same, a point too obvious to dwell upon.  The point, rather, is how fluent our forked-tongue speech has become in describing the same thing in different contexts.  One might have predicted that these parallel views and vocabulary could not persist together, that one would have to give way, either the neutralized terminology of fetal tissue, or the other, through pressure exerted by the fact that, as Hopwood and Buklijaz note, “Images of human embryos are everywhere,” in magazines and movies and friends’ Facebook posts.

Maybe there’s something to be said for even more ultrasound images.

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  • Maine_Skeptic

    “…The point, rather, is how fluent our forked-tongue speech has become in describing the same thing in different contexts…”

    Having faced end-of-life decisions with my parents, I’m aware of how medical procedures can sound very different in different contexts. Surgical procedures that we would have fought to have for them when they were in their sixties became acts of cruelty in later years. I resent that anyone would use this contrast of contexts to manipulate the public’s emotions at the expense of the factual truth.

    The people who released this heavily-edited video are skilled at manipulating people emotionally. They sat on this “horrifying” video for a year until they could coordinate with the GOP on a public release that would have the maximum emotional impact. Clearly, the intended outcome is that religious extremists use this as an excuse to further insert themselves into other people’s medical decisions.

    Lying in the name of Christianity won’t be the cake walk it’s been in the past. The day is coming when you’re going to have to provide actual evidence before you make these accusations. Propaganda isn’t going to cut it.

  • DaleyR

    I wish I could be as optimistic as you. What with the recent losses extremist christians have had to endure, I gather they’re looking hard for a new place to claim moral superiority. Abortion rights might just be their next black sheep.

  • Maine_Skeptic

    “…Abortion rights might just be their next black sheep…”

    It’s been a boogieman of the religious right for decades already, though.

    As much as conservative Christians claim they’re being persecuted, they still get a pass on behavior the public would never accept from those who didn’t cloak themselves in religion. Churches are, by and large, unaccountable for anything they do, which is why there are so many corrupt ones out there. They can’t be audited. They get tax exemptions other groups don’t get. And all they have to do is claim their religious freedoms are being attacked and most politicians compete to be the worst demonizer of a church’s critics.

    The most flagrant example has nothing to do with Christianity, but when you see what the Church of Scientology has gotten away with, you realize those who say religions are getting an unfair shake are either delusional or lying through their teeth.

    I think it’s a tactic that’s reaching its apex, and more people are waking up to the reality that there’s no causal link between conservative religion and morality.

  • nursecathy123cat

    End of life decisions that allow gentle death for the elderly are one thing; decisions that force death on the unborn are quite another. I have no problem discerning the difference between making someone die and allowing someone to die.

  • Maine_Skeptic

    “…I have no problem discerning the difference between making someone die and allowing someone to die…”

    I have reason to doubt that, since we disagree that any person is being made to die.

  • TimTripod

    If you didn’t go in there and crush it, it wouldn’t have died. Someone made him or her die.

  • Maine_Skeptic

    A being that has never been conscious, is not capable of consciousness, is probably (depending on how many weeks pregnant) not capable of receiving pain signals, is not a person.

  • nursecathy123cat

    Not a person? When would you consider it a person? I have seen tiny, tiny preemies who seemed to have no awareness I was a few inches away from them. Yet they moved, reacted to my voice, to light and sound. They had every single bit of DNA within them to guide growth to a full size adult. To have harmed one of them would have been murder. Yet a few hours earlier, they were in utero. Not a person then? So okay to crunch and dismember?

  • Maine_Skeptic

    “…They had every single bit of DNA within them to guide growth to a full size adult….”

    So does a zygote, and a zygote is a potential person, but not a person. In the real world, that distinction needs to be made. You say you understand end-of-life decisions, but clearly you don’t, if you don’t see that.

    “When would you consider it a person?”

    Probably sometime after birth, but it’s the physical capability of consciousness that is the best determinant of when and whether abortion should be illegal.

  • nursecathy123cat

    If you honestly believe what you just said, that someone is a person “probably sometime after birth” and is physically capable of consciousness, then you are so far from help only God can save you. And I certainly hope you do not work in healthcare at all, in any way.

  • Maine_Skeptic

    You didn’t understand what I said, but that’s kind of beside the point after your melodrama.

  • Andrew Dowling

    The WIDE majority of abortions are conducted earlier than 20 weeks (after 24 weeks you’re talking about less than 2%). These are not preemies. These are fetuses with no pain receptors, no consciousness, no sentience.

    Once you get into second or third trimester you are dealing overwhelmingly with women who intended to have the baby but have discovered serious health concerns regarding the mother, the baby, or both.

  • TimTripod

    You appear to be arbitrarily defining “person” in a way that best suits your own agenda.

    Tell me, would you deny any of the following?
    1) The fetus is a being (you’ve actually already affirmed this in your comment).
    2) The fetus is human (if not human, than what?).
    3) The fetus is an individual (i.e., distinct DNA from the mother – and please don’t make the common mistake of confusing “individual” with “independent”).

  • Guest30

    I want to see an article “How we view the woman”.

  • Veritas

    “They have closed their eyes,
    Lest they see with their eyes,
    And hear with their ears
    And understand with their hearts and be converted…”

    This is not a new problem, but an ancient one

  • David Hennessey

    Isn’t it common for us to view things differently, to me a moth is a furry butterfly, to my ex-wife they were banshees from hell. Fetal tissue can be a baby to you and an unwanted pregnancy to another, you can state your position without insults or laws that interfere with women’s natural right to birth-related decisions since cavemen hunted mammoths. I am certain that had my mother decided to abort my fetus, I wouldn’t have noticed or cared. I wasn’t conscious of anything I can remember until long after birth, I would have nothing to regret, I hope my potential mother would be thrilled with the result of my abortion and I would hope she would worry least about my unformed flesh. I hope she would follow her own best interest and ignore zealots.
    Word trickery is the least convincing argument I have heard, what something is called by you or others changes nobody’s mind about the reality. You came up just short of old epithet “babykiller”, please leave the women alone, they didn’t ask for your help or insults, they would like your respect instead. They know a thousand times more about their bodies and birth than you do and are well capable of making moral decisions.