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This thesis has been submitted in fulfilment of the requirements for a postgraduate degree (e.g. PhD, MPhil, DClinPsychol) at the University of Edinburgh. Please note the following terms and conditions of use: This work is protected by copyright and other intellectual property rights, which are retained by the thesis author, unless otherwise stated. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the author. The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the author. When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given. Exploring tentativeness: risk, uncertainty and ambiguity in first time pregnancy Emily Jane Ross PhD, Population Health Sciences The University of Edinburgh 2015 Abstract This thesis explores fifteen women’s accounts of pregnancy over the course of gestation. It highlights the fluidity and dynamism of these women’s experiences, placing these in the context of the breadth of medical interventions they engaged with. Much existing literature concerning pregnancy focuses on specific instances of contact with medical professionals or technological interventions. This study explores the mundane and routine elements of the everyday practice of pregnancy, including during the first trimester. This is a period rarely addressed in academic literature. The thesis draws on data from in-depth interviews with women in Scotland, experiencing a continuing pregnancy for the first time. These were conducted at three points over the course of gestation. Interviews aimed to explore women’s interactions with medical interventions, their conceptualisations of the foetus, and changing experiences of embodiment. Analysis took place in several stages, incorporating three ‘readings’ of interviews and the development of a case study for each participant. This was inspired by the voice centred relational method of analysis. Themes were then identified and developed within, and between, individual women’s accounts. Participants’ narratives, particularly in early pregnancy, resonated with Rothman’s (1988) concept of the ‘tentative pregnancy’, originally developed to describe pregnancy in the wake of amniocentesis. Tentativeness emerged as a key theme characterising women’s experiences. Tentativeness was especially evident during the first trimester, largely due to women’s understanding that the risk of miscarriage was at its highest during this period. Women described managing their emotions at this time, in order to balance excitement about their wanted pregnancy with the possibility that it may end in a pregnancy loss. One aspect of this emotion work, explored in this thesis, was the effort made by women to keep their pregnancy a secret from wider family and friends for the first twelve weeks of gestation. ii Medical intervention and its associated technologies played a key role in both constructing pregnancy as tentative, but paradoxically, also provided a means to resolve this through reassurance. Women engaged with these interventions flexibly. In contrast to much existing literature, this thesis highlights that while contact with prenatal technologies cemented the reality of the pregnancy for some, they also had the power to add to the ambiguity of participants’ status as a ‘pregnant woman’. In later pregnancy, women’s shifting embodied experiences contributed to a reduction in tentativeness. The ability to feel definite foetal movements, coupled with medical and popular discourses of foetal viability, allowed women to feel less anxious about the safety of the pregnancy and the foetus. As a result, women reported changed interactions with health professionals and advice during the final trimester of pregnancy. This thesis, engaging with literature from sociology, science and technology studies (STS) and anthropology, makes theoretical contributions in three areas. First, its consideration of gestation over time nuances discussions of pregnancy in terms of risk. Second, this research further contributes to literature regarding pregnant embodiment, and conceptualisations of the foetus. Third, the thesis demonstrates that relationships between forms of knowledge mobilised by participants during pregnancy were complex, shifting over the course of gestation, and reflective of women’s experiences of pregnancy as tentative. iii Declaration I declare that (a) this thesis has been composed by myself (b) the work presented in this thesis is my own (c) this work has not been submitted for any other degree or professional qualification Emily Ross March 2015 iv Acknowledgements I am grateful to the University of Edinburgh, for providing me with a Principal’s Career Development Scholarship to undertake this PhD. I would like to thank Professor Sarah Cunningham-Burley for encouraging me to embark upon this research. I am so grateful for your support throughout, both academically and pastorally, and really would not have been able to achieve this PhD without you. I am also indebted to my co-supervisors, Dr Jeni Harden and Dr Martyn Pickersgill. Thank you for your guidance and interest in my work, for listening to me, and most of all for your belief in me. Tasha and Becci, thank you for your constant support throughout the process, and for the last ten years. Thank you to Dan for helping me to relax by teaching me how to (try to) play squash, and to Callum for making me laugh. I am grateful to Emma for helping me through the ups and downs, and to Varia for being my library buddy, in terms of employment, writing our PhDs and beyond. I am also thankful to my PhD and department colleagues Sarah, Suze and Catriona. Thank you for taking time to discuss my work, for helping me to make sense of Merleau-Ponty, and for buying me coffee. To Clare I am grateful for more than I can write here, and to James for being there for us. Special thanks are given to Christopher. Thank you for reading over my work, and for making the last year of my PhD better than the rest. Finally, I am most grateful to the fifteen women who gave up their time to take part in this research. Thank you for sharing your pregnancies with me, without you this research would not have been possible. This thesis is dedicated to Liz, Malcolm and Jessie. v Contents Chapter One Introduction: Exploring experiences of pregnancy .................................................. 1 1.1 Introduction ........................................................................................................ 1 1.2 Academic engagement with pregnancy: the turn to the ‘everyday’ .................. 2 1.3 Conceiving my research focus ........................................................................... 4 1.4 Structure of thesis .............................................................................................. 7 Chapter Two Literature Review ...................................................................................................... 11 2.1 Introduction ...................................................................................................... 11 2.2 Situating pregnancy in the medical domain ..................................................... 12 2.2.1 Medicalisation in sociology ...................................................................... 13 2.2.2 Feminist accounts of technology and pregnancy ...................................... 15 2.2.3 Risk, uncertainty and pregnancy ............................................................... 27 2.2.4 Summary ................................................................................................... 32 2.3 Pregnancy and the foetus ................................................................................. 33 2.3.1 Creating the foetus .................................................................................... 34 2.3.2 The concept of prenatal bonding .............................................................. 36 2.3.3 The patchwork foetus: beyond technology ............................................... 38 2.3.4 The elusive foetus ..................................................................................... 40 2.3.5 Summary ................................................................................................... 42 2.4 ‘Doing’ pregnancy – embodiment and experience .......................................... 43 2.4.1 Transcending dualisms ............................................................................. 43 2.4.2 Pregnant embodiment ............................................................................... 48 2.4.3 Summary ................................................................................................... 50 2.5 Conclusion and research aims .......................................................................... 51 Chapter Three Methodology ............................................................................................................... 54 3.1 Introduction ...................................................................................................... 54 3.2 Epistemological and ontological foundations .................................................. 54 3.3 Methodological influences ............................................................................... 58 3.4 Pilot Study ......................................................................................................

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