Sårbar, suveren og ansvarlig. Kvinners fortellinger om fosterdiagnostikk og selektiv abort.
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- Department of Government 
Vulnerable, sovereign and responsible.Women’s stories about prenatal diagnostics and selective abortion.“In Norway we make sure that some children with Downs’s syndrome are born, and thattheir mothers are younger than 38 years”. This statement illustrates an importantconsequence of the Norwegian politics on prenatal diagnosis and selective abortion. Womenolder than 37 have to decide whether they want to “know” or not (undergo prenataldiagnosis). Other women may experience the discovery of anomalies at ultrasoundexaminations. And after discovery, or test result, the women have to decide whether or not tohave selective abortion.Women’s stories about their dilemmas, paradoxes and choices that arise from these“discoveries” are the empirical backdrop for this dissertation. The investigation follows twolines: First I ask what understandings of fetal diagnosis, deviance, selection of abortion andnon-selection of abortion, the abortion committees, rituals, post-procedure social encountersand the grief, are expressed through women’s stories? Secondly I ask how the woman mustbe or perform in order to make her words sound legitimate (what kind of subjectivities areproduced in the understandings?) These different understandings of “ultrasound and prenataldiagnostics” are tracked through seven chapters of empirical analysis. Each chapter has itsown findings and focus.“The examinations” describes the non-directive genetic counselling as both a “utopia” and anecessity. The “non-directive” presumption creates a woman with a fragile autonomy – ifyou give her advice she will abandon her own will and follow yours. By the silentcommunication of these dilemmas through the withholding of opinions and advice, thewomen are educated into an understanding the decisions potentially to come as soproblematic that the potential decisions is on the outside of the society’s moral.When the abnormalities are discovered a “state of exception” occurs. The woman may seeherself as invaded, in a situation on the border between sanity and insanity. The impossiblehas happened, and when this could happen, anything may happen. A characteristical featureof this “state of exception” is its exclusivity- you have to experience the situation in order tounderstand the situation. The understanding is dependent on emotions, on having lived andfelt the depth of the situation, of “hitting rock bottom”, only then the required authenticity isin place. Following the discovery of abnormalities there are decisions to be made, decisionsthat may change the future of the woman, the fetus and the family. The dissertation showshow this decision is a “sovereign” decision.When the abnormalities are deadly, there is no need for the woman to meet with the abortioncommittee. In this situation a meeting with the committee may be experienced as a formality.To some this is unproblematic, to others the formality of the proceeding is an assault on theirown perception of how serious the situation is. The committee ensures the presence of amorally responsible subject capable of making autonomous and “sovereign” decisions. Thecommittee does moral groundwork on behalf of society. Through work the systemdisciplines the women, and through this disciplining the committee takes part in creating themorally responsible woman. In Norway medical abortion is the routine procedure for selective abortion, the women haveto give birth to the aborted fetus. This “abortionbirth” is inscribed into themidwifery/naturalist discourse, where the pain of birth plays a central, positive, part. Incontrast to women’s sovereign position before the choice is made, the medicine and themidwives know what is best for these women. Women are more or less gently persuaded tosee, hold, clean and dress the fetus. Through abortion birth, the “seeing and holding” andother rituals, the fetus is humanized and a production of dignity commences. In this emergingunderstanding meaning is drawn from birth and stillbirth. The other rituals after selectiveabortion also reinterpret the event. Rituals functions as a magical spell or formula. In thereligious rituals like the “blessing” and the “funeral”, the dignifying and suppression of thefact that this was an abortion, are most evident. Through these rituals the fetus are given anew status as a child that was dead at birth. But this translation of what has happens needs toremain implicit in the ritual in order to enable the ritual to be a production of morallegitimacy.After the abortion the mourning process starts. It is important to a person in mourning to beseen as a legitimate mourner. To obtain this position the women finds it difficult to tell“everything” to “everyone”. The story of what happened are tentatively made in relation toother people. By telling “a little lie” (the fetus would have died anyway) it is possible for thewoman to ensure understanding and legitimacy. For a woman that opted for selectiveabortion because of lethal abnormalities, it is likewise important to tell this – in order toavoid suspicion for “only” mild abnormalities.Analytical summaryThe dissertation focuses on the governing logics of biopower and their relation to socialvalues in the field of “prenatal diagnosis” and “selective abortion” in Norway – and themeaning constructed within these logics and values. Subsequently, the main objective of thestudy is to describe how the field of “fetal diagnosis and selective abortion” is governed,what logics of governing that are in play.Before deviances are discovered, when the women are first introduced to ultrasoundexaminations and prenatal diagnostics, the field (and the individual’s thoughts and actions)are regulated through social values. Extensive genetic counselling tells stories about selectiveabortion as ethical and morally controversial, and the withholding of advice forebodesdisaster. The existence and shape of genetic counselling mediates an understanding of adanger in progress, as a preparation for a logic of exception.During the decision, an existential, social, moral, normative and political situation unfolds.But these dimensions of the situation dissolve into a black box – a box where the decisionsare made, under the woman’s own jurisdiction. The responsibility and the definition of thetruth lies upon the woman. The women are in a situation in witch she is vulnerable andexposed at the same time as she is sovereign and responsible.But after the decision has been made the social deliberations are back in order. From asituation where everything was in the hands of the woman, a new situation starts wherehospital routines (i.e. method of abortion), rituals, and the reactions from others, provide amoral positioning of the events, defines what happened, and gives roles to each individual.The fetus is created as a child; the aborting woman is created as a mother, and so on. Themoral scale of abortions, and the normality assessments, is back in function.
PublisherThe University of Bergen
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