Rapp: The Sonogram as Surveillance, Normalization and Correction

RAPP article here

The technology of the sonogram allows the medical profession to extend it's gaze into a woman's womb in order to directly observe, measure and judge first an embryo and then a fetus, before its viability, and well before its birth. 

• It is suggested that about 90% of all pregnancies are subject to such surveillance.
• observations allow for the fetus to be measured and identified as "normal" or "abnormal" in their development based on the data collected from the observation of many women and fetuses within the context medical prenatal care schedules.
• using biometric data (DNA), Blood and cell growth analysis, technicians identify "disorders" which will require the woman to make decisions about whether to take corrective action and keep or terminate the pregnancy.
• Amniocentesis is one of these biometric surveillance methods in its testing for Down's Syndrome, and other genetic disorders.
• Provides independent medical knowledge of the fetus while bypassing the mother.
• the fetus becomes clearly a second patient-giving it physical, moral and subjective personhood
• FETAL SEXING: Curiosity and mystery of birth is demystified by the medical profession
• Within the technician’s lab, where chromosomal analysis occurs, fetal cells must be extracted from the amniotic fluid and placed in an incubator, where they are “planted”, “fed” and “grow.” After a few days, cells undergoing mitosis, (DNA duplication) are “harvested” and examined (Rapp 1999: 194-196). A computer program aids technicians in locating and defining an image of a cell in which all 46 chromosomes are clearly visible, and then ordering them into the karyotype chart. Every karyotype must be “diagnosed,” meaning every abnormality, even if it is not clearly associated with a known congenital disorder, must be described; Rapp sees this as a superficial attempt at control, “the continuous construction of stable interpretations in the face of material ambiguity” (208). 

• Even the most precise diagnoses is difficult to translate into a prognosis for the fetus’ future life; “the difference between a biologically described organism and a socially integrated child is, of course, enormous” (198).When relayed to the waiting mother the ambiguity of a positive diagnosis is doubtlessly distressing and complicates the decision she must make regarding the termination or continuation of her pregnancy. According to Rapp, many women would prefer “a clear-cut boundary established between pregnancy-leading-to-life and pregnancy-leading-to-death,” presumably so that the decision they must make is less a matter of choice than of obvious necessity (238).
• In the face of such traumatic information and difficult decisions, the tendency of the surrounding social network, as in the technicians’ diagnostic lab, is to medicalize and objectify the fetus. Rapp gives an example of one woman who received a positive diagnosis:
• “When we walked into the doctor’s office, both my husband and I were crying. He looked up and said, “What’s wrong? Why are you both in tears?” “It’s our baby. Our baby is going to die,” I said. “That isn’t a baby,” he said firmly. “It’s a collection of cells that made a mistake.” (1999: 220).
• Although many women do mourn for lost and aborted late-term pregnancies (Rapp 1999: 242), this kind of rationalization doubtlessly eases the transition from pregnant to not pregnant without the birth of a child. 
• In a sense, the modern array of reproductive technologies and new choices means that this sterile, medical view was available all along, just as the fetishization and mythologization of the fetus is continuously occurring within the pro-life social sphere. But as pregnancy progresses, and a mother becomes acquainted with the thing inside her, as her personal feelings for it evolve and she begins to accept and integrate a new person into her life, it is between these two opposing discourses that she must tread. And ultimately, it is she who draws the line between what is human and what is not.