Negotiating normalization: the perils of producing pregnancy symptoms in prenatal care

In this paper, I argue that pregnant women confront a "double-bind" in complying with medical directives to report pregnancy symptoms: the combination of the routinization of prenatal care, understandings of fetal subjectivity, and the cultural discourse of maternal sacrifice create a situation in which women are at risk of failing as either as good patients, good mothers, or both. Longitudinal, in-depth interviews were conducted with 64 pregnant women in the New York metropolitan area. I found that health care providers make women's embodied experiences a priority of surveillance, connecting symptoms to fetal well-being and emphasizing timely reporting of these symptoms to medical authorities. I found that women generally accepted this connection between symptoms and fetus, but were often perplexed as to which symptoms they needed to communicate to their providers when time constraints on routine prenatal appointments limited women's ability to comply fully. Women also reported cultural pressures to "suffer nobly" the symptoms of pregnancy, no matter how uncomfortable. As a result, women found themselves with considerable responsibility for identifying problems in their pregnancies, with no clear way to adhere to the multiple and sometimes opposing mandates for managing symptoms they encountered.