southampton

Published:: 30 May 2019

Pregnancy has been largely ignored by philosophers up until now. Southampton research is shedding new light on the fascinating philosophical questions the state of pregnancy presents, for a real-world improvement in care for women and their babies.

“Pregnancy presents us with some interesting philosophical problems, such as what, during the pregnancy, is the nature of the relationship between the fetus and the mother; what is the relationship between the pregnant organism and the later baby; and when does one person or organism become two?” says Dr Elselijn Kingma , Lecturer in Philosophy at the University.

Elselijn and colleague Professor Fiona Woollard , whose specialism is ethics and epistemology , are leading the Philosophy of Pregnancy, Birth and Early Motherhood project, which was highly commended for the Arts, Humanities and Social Sciences Research Project of the Year at the Times Higher Education Awards in 2018.

“Philosophers have tended to view the fetus as a tiny baby floating around inside a vessel, like a fish in a fishbowl. Images of fetuses often depict them on their own, floating in space – and if they do depict the mother, she is faded out in the background,” says Elselijn. The research team is developing the theory that the fetus can only be sensibly considered as part of the mother, or ‘maternal organism’.

When you think of an organism, you think of something that is a single metabolic system, functionally integrated and appearing as a single object. In all these ways, a fetus is clearly part of the maternal organism because while it’s developing, it’s ‘hooked up’ like one of the mother’s organs.

So what are the implications? “We think of ourselves as distinct individuals with our own bodies, but this view of ourselves can only start after birth, because before birth the fetus is linked to the mother through the umbilical cord and placenta. If you think that fetuses are distinct human beings, you have to accept that human beings are quite different to how we traditionally view them – for instance that they are not always physically distinct, but can be part of each other,” says Elselijn.

This theory also has ethical implications. “The unique nature of pregnancy also means that many traditional ways of thinking about morality do not apply easily in pregnancy,” says Fiona. “Women who make less than optimal choices when it comes to their fetus’s wellbeing are often treated as if they are doing harm, rather than merely allowing harm or failing to benefit. This matters because we treat ‘doing harm’ much more seriously in ethics and law.

“However, the difference between doing and allowing harm relies on the idea that there is a normal state of non-interference; you can just leave someone alone. But there’s no state of ‘non-interference’ in pregnancy; a pregnant woman can’t just ‘leave her fetus alone’.”

The project is funded by a €1.2m European Research Council grant, a Templeton-funded Research Fellowship, PERU grants and ESRC Impact Acceleration Awards. The University is becoming a hub for the topic, having hosted an international conference on the Philosophy of Pregnancy and Early Motherhood in 2018.

Through public engagement initiatives, workshops, conferences and outreach events, Elselijn and Fiona are shedding light on previously ignored questions about pregnancy. They are also engaging with healthcare practitioners and policymakers to translate the outcomes into real-world improvements for women and their babies.

By fully appreciating the unique processes of pregnancy and birth, we are shedding light on how the medical profession could analyse medical and ethical questions differently, to benefit women during their antenatal care.