Rayna Rapp, Testing Women, Testing the Fetus: The Social Impact of Amniocentesis inAmerica, London: Routledge, 2000.
Rayna Rapp’s Testing Women, Testing the Fetus is led by her own failed motherhood after a prenatal diagnosis of Down’s. To investigate the social construction and cultural meaning of amniocentesis as reproductive medical technology, she conducts a quite broad ethnographic research on “pregnant women” who have faced with prenatal diagnosis technologies and also who have come from diverse cultural and social background.
Since this study has been propelled by her own experience, I expected at the beginning that her voice will dominated in narrating the process of her research. Opposed to my false expectation, Rapp’s personal voice was not even protruded throughout the book, and it seems to me that she’s tried to keep herself being as objective as possible. However, she seems to think that the objectivity is contaminated by the problem concerning the subject of language: “I was also contaminating my own data collection process, for my translation choices were …”(19); “the palpable presence of the Heisenberg uncertainty principle – that observation contaminates the very process it seeks to observe…”(20).
Because of the nature of the object this book deals with, she seems to need of inventing a methodology, working with diverse group of people related, directly or indirectly, with the new reproductive technologies. Through observations and interviews with pregnant women and parents supports group with Down syndrome as well as scientific professionals of prenatal technologies and social service, she construct this book “neither chronologically nor ecologically” (2). Her goal is not just to narrate the sequence of the technologies pregnant women confront and experience, but “to create a Venn diagram, overlapping the social spaces in which amniocentesis and related technologies have developed” (3). In order to do this complex project, she traces the steps of technological applications and, along the steps, shows how social, cultural, and political perspectives intersect, as if weaving a complicated textile with the weft and the warp.
After the introductory chapters about her methodology and the history of prenatal diagnosis and its related technologies, Rapp focuses on analysis of language, a tool for communication between genetic counselors and pregnant clients (Chap.3-4). She parses how scientific and technological discourses around amniocentesis have been interpreted, translated and applied in different cultural situations, how “code switch” by genetic counselors has been conducted depend upon clients’ cultural (racial, ethnic, class status, etc.) background, and how pregnant women and their family understand and misconceive the scientific concepts. And then she delves into pregnant women’s anxiety while waiting the result of amniocentesis (Chap.5). Women’s “anxiety invokes dread because it confronts the issue of ‘choice.’” (128). Since amniocentesis is situated in the complex social and cultural relations where each pregnant woman’s life is embedded, there are imaginary differences on disabled fetus according to gender, religious affiliation, and other social agencies (Chap.6).
While there are those who accept the medical intervention, there are those who choose not to accept its complicated benefits and burdens of the new technologies (Chap.7). Their “choice” seems “the interplay of social history and individual volition, of collective position and personal choice, in short, the imbrication of structure and agency” (167). From her laboratory internship experience (chap.8), she argues “laboratories, like clinics, schools, and home interviews are sites of simultaneous and imbricated material and discursive construction” and thus laboratory is “factory for fact construction” (192).
Then Rapp investigates how delivery of a positive diagnosis entails different reactions and how women lost their babies with genetic problems experience the philosophical conundrum of life (chap.9). And she asks how the disability such as Down syndrome is normalized and stigmatized in different cultural communities (chap.10). Finally, she concludes that her object of study is located in “unstable amalgam of scientific literacy, cultural resources, and fetal health aspirations” (317).
As an anthropological work about paradoxical situation of agency and structure, this book sheds light on the practices of biomedicine and technology and on complex cultural ground the technology is related with: “development and routinization of prenatal diagnosis depended on complex intersections in biomedical scientific research, social policy affecting abortion, and social movements influencing cultural climates” (39). The tension between two social movements, Feminist movement and disability rights movement, might be the point which should be more explored in detail.
It would be worth comparing with other ethnographic texts focusing on communication and text interpretation: Ong’s Buddha is Hiding is about how social workers interpret Cambodian refugees (especially women old or young); Harding’s The Book of Jerry Falwell is a discursive analysis on fundamental evangelist belief and vision; Lutz and Collins’s Reading National Geographic concentrates on interpretation of anthropological images used in the journal which is popular and scientific as well.