Book contents
- Frontmatter
- Contents
- New Introduction
- Acknowledgement
- Note on Numbers
- Introduction to the Original Edition
- 1 Social Origins
- 2 ‘A Friend a Day Keeps the Doctor Away’: Social Support and Health
- 3 Sickness in Salonica and Other Stories
- 4 Eve in the Garden of Health Research
- 5 A Bite of the Apple
- 6 Who’s Afraid of the Randomized Controlled Trial?
- 7 ‘One of Mummy’s Ladies’
- 8 Four Women
- 9 ‘Real’ Results
- 10 Women at Risk
- 11 The Poverty of Research
- 12 Models of Knowing and Understanding
- Appendix I Study Guidelines
- Appendix II Publications from the Social Support and Pregnancy Outcome Study
- Notes
- References
- Index
10 - Women at Risk
Published online by Cambridge University Press: 14 April 2022
- Frontmatter
- Contents
- New Introduction
- Acknowledgement
- Note on Numbers
- Introduction to the Original Edition
- 1 Social Origins
- 2 ‘A Friend a Day Keeps the Doctor Away’: Social Support and Health
- 3 Sickness in Salonica and Other Stories
- 4 Eve in the Garden of Health Research
- 5 A Bite of the Apple
- 6 Who’s Afraid of the Randomized Controlled Trial?
- 7 ‘One of Mummy’s Ladies’
- 8 Four Women
- 9 ‘Real’ Results
- 10 Women at Risk
- 11 The Poverty of Research
- 12 Models of Knowing and Understanding
- Appendix I Study Guidelines
- Appendix II Publications from the Social Support and Pregnancy Outcome Study
- Notes
- References
- Index
Summary
Many of the diagnostic judgements made by both experienced and inexperienced individuals will continue to be based on incomplete and imprecise characterization of individual women and babies. (Mohide and Grant 1989: 67)
The term ‘risk’ is … vague and undefined. (Alexander and Keirse 1989: 346)
This chapter moves on from the case-study material for the four women presented in chapter 8 and the quantitative findings relating to pregnancy ‘outcome’ discussed in chapter 9 to attempt a synthesis of how all the women in the study regarded their participation in it.
A critical focus of this part of the analysis is the notion of risk. The women who took part in the SSPO study were not only exposed to the ‘risk’ of taking part in research, they had been identified as ‘at risk’ in the narrowly biological sense of having already given birth to at least one baby weighing less than 2500 g. In using a quantifiable measure of risk derived from the medical domain, the study thus participated in a particular conceptualization of women and motherhood – one which prioritizes a set of meanings attached to motherhood by people other than mothers themselves. The challenge – the ethical requirement – here is to invert the analysis, and allow the women themselves to speak about their own conceptualizations of risk and mothering within a broader framework that includes the ‘social’ risks of material disadvantage and inadequate social support, the hazards of being identified as ‘at risk’ by health professionals, and any personal costs consequent on participation in the research process itself.
Although the potential benefits of using the medical risk approach have been widely publicized, its potential harm is scarcely ever mentioned; such harm must include that resulting from ‘unwarranted intrusion in women's private lives, from superfluous interventions and treatments, from creating unnecessary stress and anxiety, and from allocating scarce resources to areas where they are least needed’ (Alexander and Keirse 1989: 361). Clinical trials are planned, conducted and used largely by medical and academic scientists, with the subjectivity of participants taken seriously only at the point of trial entry, where there is a (limited) obligation to consider the provision of conditions for ‘informed’ consent. After that, it is implicit in the clinical trial methodology that evaluation of benefit lies firmly in the domain of medical science.
- Type
- Chapter
- Information
- Social Support and Motherhood (Reissue)The Natural History of a Research Project, pp. 337 - 376Publisher: Bristol University PressPrint publication year: 2018