Technoscientific entanglements of reproduction

Abstracts

Menstrual Materialities as Research Companions: An Ethnographic Study of Danish Menstrual Experiences and Bodily Understandings

Signe Banke, University of Southern Denmark

New materialist ethnographic research on reproductive entanglements faces a dual problem of inaccessibility; unable to observe the practices unfolding in these intimate spheres, as well as an obvious inability to interview the agentic technologies and bodily materials. They depend on humans to speak up for them, a painful acknowledgement for researchers as I, intending not to privilege discourse over matter. The aim of this paper is thus to develop an ethnographic posthuman method overcoming this seemingly inherent distance between discourse and matter in new materialist research. The paper builds on ethnographic fieldwork and in-depth interviews with 15 women in Denmark that asks what the menstrual materialities facing women are like and how these shape menstrual experiences and bodily understandings. Non-humans, exemplified by a creative exercise of making theatre menstrual blood or gifted period panties along with a diary, are differently than researchers capable of asking material questions, and travelling into otherwise closed intimate spaces and back into the interview situation. On this backdrop this paper contributes to posthuman methodology, finding that by making menstrual materialities research companions, new opportunities of access arise. Building on new materialism the human body is found to also always be a non-human body in becoming and without solid boundaries. The same is true for the menstruating body whose fluidity depends on menstrual technologies as pads, tampons, menstrual cups and period panties to control the menstrual blood in accordance with social norms. Menstruation is thus conceptualized as ‘body-blood-product’ entanglements, or what I theorize as menstrual materialities.

The Ambivalent Future of Gestation

Ji Young Lee, University of Copenhagen

What is known as assisted reproductive technologies (ART) was once synonymous with the innovative In Vitro Fertilization (IVF) method since the late 70s. Thanks to advances in the technique, IVF is now par for the course as an infertility treatment, and most EU states in principle offer some state-funded coverage. (ESHRE) In more recent years, however, gestation has emerged as the next frontier for the innovation of ART. In 2014, the successful birth of a child via uterus graft in Sweden was hailed as a ground-breaking moment for uterus transplantation (UTx), a procedure which had been attempted unsuccessfully by various research teams around the world for years prior, to enable people without a functioning uterus to experience pregnancy. At the same time, bioethicists anticipate ectogestation, a process in which artificial amnion and placenta technology (AAPT) might one day be used to carry out a partial or even full period of gestation outside of the human body. Such methods in theory carry many hopeful promises for enabling aspiring parents in various ways: to have a pregnancy that is not otherwise naturally possible, to outsource pregnancy altogether, or even to help us move beyond the need for surrogates.

Despite the hype around these innovative methods for gestation, it is not ethically clear why uterus transplantation should be considered desirable, and the prospect of artificial amnion and placenta technology for various stages of prenatal development present their own challenges. In this presentation, I talk about the ambivalent future implications of these gestative technologies. Firstly, the ethical stakes are heightened relative to IVF – both UTx and ectogestation imply risky and complex processes that radically change how people can experience (or don’t experience) pregnancy and birth. We must therefore try and articulate a robust justificatory scheme that might support their continued development (and perhaps their eventual routinization), but this pr

Norwegian specialist doctors’ views of AI for prostate cancer imaging

Emilie Lysø, NTNU; with Maria Bårdsen Hesjedal, John-Arne Skolbekken, Marit Solbjør

MRI (magnetic resonance imaging) is considered the most sensitive non-invasive method for prostate cancer (PCa) detection. However, cancerous and non-cancerous tissue are often visually similar, making them difficult to differentiate. With new Norwegian guidelines suggesting all suspected PCa are examined with MRI before doing biopsies, radiologists are left with an excessive number of images to analyze manually. Using artificial intelligence (AI) as decision support in PCa imaging could lessen radiologists' workload and improve speed and accuracy in separating clinically significant and insignificant lesions. It is therefore interesting to explore how specialist doctors working with PCa diagnostics see the use of AI in PCa diagnostics and its impact on diagnostic processes and practices.

We interviewed 17+ specialist doctors working with PCa in different stages of the diagnostic trajectory about the possible implications of AI in PCa diagnostics, collaborative work in the hospital, ethical issues and challenges, and communication and information about AI. Preliminary results suggest that doctors are positive about using AI in PCa imaging, as it could alleviate radiologists so they can do the tasks that they themselves find most important and exciting to do, and the tasks where humans are considered irreplaceable, such as interpersonal communication. Another preliminary result suggests that doctors are hesitant about sharing information with patients about AI’s involvement in diagnostic processes, as information about AI’s involvement could impact patients’ feelings of certainty and safety in the situation of receiving a diagnosis.

Technologies of care in female urinary incontinence – intimate entanglements with Tension free Vaginal Tape

Josefin Persdotter, Chalmers University of Technology

Urinary incontinence affects about 30 percent of all who give birth and is widely reported as negatively impacting quality of life while simultaneously belittled as a minor nuisance. The so called TVT– (Tension-free Vaginal Tape) procedure is the most common treatment for so called Stress Urinary Incontinence (SUI). About 1400 patients had the procedure done in Sweden in 2021. Since the mid 1990’s, when it was developed by a team at Uppsala university, it has become widely adopted globally, praised for its simplicity and efficacy; “the gold standard” of SUI treatment. However, in recent years, TVT has been fraught with controversy, strictly regulated and even banned in some countries. Patient activists have voiced experiences of devastating health complications, and TVT has been called a global “gynecological scandal”. At the same time, medical follow up studies report on the effectiveness of the procedure and show a high success rate and significant improvements in terms of elimination of SUI symptoms and improved quality of life. This project explores how this technology is enacted within the Swedish medical community on the one hand and within those who seek and receive the treatment on the other, exploring tensions within/between TVT as “good care” or ”bad care”, as “emancipatory” or “repressive”; as “safe” or “risky”. This presentation analyzes how the Swedish medical community defend/maintain the technology in public texts and compare that to autoethnographical data on seeking and receiving TVT care.

Bzzt! - A parent is born

Jesper Petersson, University of Gothenburg - Department of Sociology and Work Science

Caregiver-infant bonding, including prenatal bonding, has attracted much attention. Whereas expecting mothers are understood to bond to their forthcoming child already through the sensation of caring it within them, expecting partners are expected to have less access to such embodied feelings. In this context fetal ultrasound is often recognized for how its fetal visualization afford the non-pregnant partner to experience the sensation of the forthcoming baby, reinforcing involvement in both the pregnancy and the unborn child – but is simultaneously criticized for enacting medical surveillance and downplaying the pregnant woman’s fetal experience (e.g., Draper 2002).

However, in the wake of the explosion of apps, wearables, and commercial sensors, new ways of attempting to establish and shape the relationship between caregivers and their yet-to-be born child have emerged beyond medicine. In 2016, Libero, a world leading diaper company, introduced The BabyBuzz, consisting of an app and two bracelets. The advertised idea was that when the mother felt the baby move, she pressed a button on her bracelet, which created a vibrating buzz on her bracelet-wearing partner’s wrist. According to Libero The BabyBuzz should create a more shared and intimate experience of the pregnancy. 

In this presentation I would like input of what an initiative like The Babybuzz may tell us about “corporate-activism” and design in the context of norms and emotions around pregnancy and parenthood.

Draper, J. (2002) ‘It was a real good show’: The ultrasound scan, fathers and the power of visual knowledge. Sociology of Health & Illness, 24(6): 771-795.

Artificial Wombs and Assemblages of Care

Oshin Siao Bhatt, Chalmers University of Technology - Science, Technology and Society Division

In feminist STS, Assisted Reproductive Technologies (ARTs) have been deemed technologies of disruption, hope, and maintenance. These technologies have reshaped how reproduction, childbirth, and kinship are understood, and provided alternative methods of procreation for those unable to do so through coitus. In this presentation, I will employ these perspectives to discuss the development of the artificial womb, a technology still on the horizon, yet promising pertinent discussions with regard to reproduction, childbirth, care work, and kinship at large. A technology like the artificial womb is set to push the boundaries of social imaginations around these discussions much further. The artificial wombs currently in development are expected to provide neonatal care for extremely premature babies born between 24 and 28 weeks of gestation, within the span of three or four generations. Keeping this in mind, I will first discuss the speculative experiments I conducted as part of an artistic research project, to imagine a world where the use of artificial wombs for full-term gestation is normalized. I will draw upon my Master thesis to unpack the idea of "assemblages of care," understood as collectives of human and non-human actors enacting different yet often overlapping realities of care, within specific narratives of reproduction, in the possible everyday use of artificial wombs.  Further, I will present early ideas for my PhD thesis, which will depart from the speculative and seek to study the everyday clinical experiences of using artificial wombs, by drawing upon current experiences of interfacing with Neonatal Intensive Care Units.

The multiple body and technology: entanglements of polycystic ovary syndrome

Yulia Karpova, University of Southern Denmark

My paper analyses the everyday practices surrounding polycystic ovary syndrome (PCOS), focusing on fertility.  PCOS is not specifically a fertility disorder: it affects the reproductive system, metabolism, and cardiovascular health. Even so, the possible difficulty with conceiving is one of the most common worries associated with a PCOS diagnosis. My initial pool of fieldwork interviews shows that PCOS patients often find their reproductive concerns dismissed by their GPs and gynaecologists. Without the desired amount of medical attention, people with PCOS prefer to use the technologies of daily lifestyle management to regulate ovulatory cycles. These daily technologies – such as devices for prepping healthy meals, equipment for workouts at home and in the gym, and dietary supplements such as Inositol - offer both reproductive and general health benefits. However, these daily technologies do not guarantee regular ovulation and easy conception, which requires the medically controlled use of the so-called “first line” reproductive assistance – ovulation induction with the Letrozole or Clomiphene pill. If the induction does not help achieve conception, more complex interventions, such as IUI and IVF, will follow.

I will analyse the three different types of technologies (lifestyle modification, ovulation induction through medication, and assisting conception by IUI/ IVF) together as entanglement around PCOS. I suggest that such entanglement of diverse technologies is the response to a complex character of PCOS that I call ‘multiplicity’ (Mol 2002). My talk will demonstrate how the bodily and technological multiplicities align and when they fail to align.

Concealed gender biases in Assisted Reproduction and Artificial Intelligence configurations: A symptomatic reading of influential science and medical journals

Kornilia Papanastasiou, National and Kapodistrian University of Athens

The introduction of Artificial Intelligence (AI) technology into Assisted Reproduction Technology (ART) is by now a rather generalized trend, covering, notably, even embryo evaluation and embryo viability prediction algorithms. Vast data collection, use, and appropriation are integral to the development of AI-ART algorithms and machine learning configurations. ART itself has attracted considerable attention, both technically and socially, from the late 1970s to the present. Scholars from Gender Studies and Science and Technology Studies (STS) have retrieved important biases in the technological practices involved in ART, connected as they have been to issues of relevance to gender, identity, kinship, ethics, biomedicalization and commodification of women’s bodies. As for AI, STS scholars have shown that it frequently favors particular social presuppositions, perspectives, roles, and dynamics. A range of AI design biases are actually concealed through being black-boxed. My presentation will elaborate on the integration of Artificial Intelligence into Artificial Reproduction based on a symptomatic reading of primary research on articles published in some of the most influential international science journals (Science, Nature, Scientific American), and, also special biomedical/medical publications, especially gynecological ones. I will provide a taxonomy of the social biases advanced through such integration, including ones related to gender.