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Since the late nineteenth century, medicine has sought to foster the birth of healthy children by attending to the bodies of pregnant women, through what we have come to call prenatal care. Women, and not their unborn children, were the initial focus of that medical attention, but prenatal diagnosis in its present form, which couples scrutiny of the fetus with the option to terminate pregnancy, came into being in the early 1970s.
Tangled Diagnoses examines the multiple consequences of the widespread diffusion of this medical innovation. Prenatal testing, Ilana Löwy argues, has become mainly a risk-management technology—the goal of which is to prevent inborn impairments, ideally through the development of efficient therapies but in practice mainly through the prevention of the birth of children with such impairments. Using scholarship, interviews, and direct observation in France and Brazil of two groups of professionals who play an especially important role in the production of knowledge about fetal development—fetopathologists and clinical geneticists—to expose the real-life dilemmas prenatal testing creates, this book will be of interest to anyone concerned with the sociopolitical conditions of biomedical innovation, the politics of women’s bodies, disability, and the ethics of modern medicine.
About the Author
Ilana Löwy is an emerita senior researcher at Institut National de la Santé et Recherche Médicale, France. She is the author of many books, including Preventive Strikes: Women, Precancer and Prophylactic Surgery; A Woman's Disease: A History of Cervical Cancer and Imperfect Pregnancies: A History of Birth Defects and Prenatal Diagnosis.
"Engagingly written, provocative, and well-researched. . . . Recommended."
“Löwy gives us a masterful analysis that will be troubling to some, eye-opening to others, and thoroughly useful to all who read it. Tangled Diagnoses will interest not only historians, sociologists, and anthropologists of medicine and reproductive technology, but also advocates and policy-interested constituencies in the fields of disability, public health, and gender studies.”
— Rayna Rapp, New York University
“Discussions of the emotionally-charged topic of prenatal diagnosis tend to be highly polarized—either unreservedly pro or con, with little acknowledgment of complexities, ambivalences, mixed motivations, and diversity of outcomes. Ilana Löwy’s analysis is unusually nuanced and respectful of divergent viewpoints. A central theme is that decisions regarding prenatal diagnosis are always situated, and hence different women may make different (reasonable) choices, and that they may also make different choices at different moments in their lives. Original, well-researched, provocative, and compellingly argued, Tangled Diagnoses should influence the way ethical, social, and policy issues around prenatal diagnosis are debated.”
— Diane B. Paul, University of Massachusetts Boston
"Löwy is an accomplished sociological observer who does not blink...I admire work that is deeply theoretical and crystal clear at the same time....I would characterize it as required reading for anyone concerned with contemporary medicine in general."
— Bulletin of the History of Medicine
"Tangled Diagnoses elegantly accomplish[es] a difficult and rare feat: putting disability, medical, and feminist perspectives on prenatal diagnosis and selective abortion into conversation with one another, with productive and enlightening outcomes."
— Studies in History and Philosophy of Biology & Biomedical Science
"...of the greatest interest to historians, sociologists, and anthropologists of medicine and health, especially those working on reproduction, diagnostic and screening programs, risks, disability, genetics/genomics, gender and kinship."
— Gesnerus: Swiss Journal of the History of Medicine and Sciences