Dr Elselijn Kingma is a Lecturer in Philosophy. Here, she shares her research interests, in collaboration with Dr Fiona Woollard (Associate Professor in Philosophy), on the metaphysics and ethics of pregnancy and birth
I’m a philosopher of science with an interest in questions surrounding pregnancy. My main research is a project that I call ‘the metaphysics of pregnancy’. Metaphysics is the branch of philosophy that asks fundamental questions about the physical world, and about abstract concepts such as time and identity. What I’m interested in is the nature of the relationship between the foetus and the mother: are they one single organism, or separate?
When you think about it, pregnancy is a very weird and interesting state, yet it’s something that philosophers haven’t thought about much.
They have focused a lot on foetuses – when a foetus becomes a person, the ethics of abortion and so on – but they have tended to view the foetus as a tiny baby floating around inside a vessel, like a fish in a fishbowl. This ‘foetal container’ model of pregnancy is widespread: images of foetuses often depict them on their own, floating in space – or if they depict the mother, she is faded out in the background.
The theory I’m developing and defending is that you can only sensibly think of the foetus as part of the mother, or ‘maternal organism’. When you think of an organism, you think of a single metabolic system, functionally integrated and appearing as a single object. In all these ways, a foetus seems to be part of the maternal organism because, while it’s developing, it’s ‘hooked up’ like one of the mother’s organs. The implication of this is that, if you think that foetuses are human beings, you have to accept that human beings are quite radically different to how we traditionally view them: they can be part of each other. I was recently awarded a prestigious European research grant worth nearly 1.3m Euros, which will enable me to develop and investigate this hypothesis further, with the help of two PhD students and two postdoctoral researchers.
Morality and pregnancy
Thinking carefully about the nature of pregnancy has ethical implications. When people discuss the behaviour of pregnant women, for example, they are quick to think that mothers are ‘doing harm’. For example: “A women who doesn’t take folic acid harms her foetus.” But foetuses aren’t physically distinct from the pregnant woman, which means that our usual analysis of ‘doing harm’ cannot be applied to the mother-fetus relationship.
Let me explain: in morality and law, we distinguish between ‘doing harm’ and ‘allowing harm’. If I push you into a lake, I am actively doing harm to you, but if you’re in the lake already and I don’t pull you out, I’m merely allowing harm. Allowing harm isn’t seen as anywhere near as bad as doing harm. Doing harm involves crossing a space and actively interfering with another person; allowing harm means letting them be. But this distinction cannot apply to the relationship in pregnancy. There is no ‘letting the foetus be’.
Everything a woman does – every breath she takes and every time her heart beats – interferes with her foetus. So we cannot apply our ordinary ethical frameworks to the unique situation in pregnancy.
Ethics of birth
The difficulty in applying our normal moral frameworks to pregnancy is particularly pressing in birth. During birth, women and care-givers frequently choose between options that present different trade-offs in terms of risks and benefits to the mother and the future offspring. How should we make these trade-offs ethically?
We are very tempted by wrong answers here. Many suppose that a woman should do whatever it takes to expose her offspring to the least amount of risk – and that when she doesn’t, she is harming a child and should be subjected to legal force. But this, once again, misconstrues the relationship between mother and fetus.
If we do ask the difficult question how much risk is reasonable and when we can interfere, the nature of pregnancy may help. Consider again the view that the mother and the foetus are a single organism. One could argue, that the pregnant woman is someone who has two future selves: a mother and her baby. And the obligations we have to our future selves are generally weighty and important – to eat well, not incur debts, to take care of our bodies, and so on – but they are also private obligations that the state does not intrude into. I think it is interesting to consider whether this gets it about right for the pregnant woman’s obligations to her unborn child.
I was recently awarded a £10,000 grant from Public Policy@Southampton to work with policymakers on the rights of pregnant women in the context of birth choices.
Breastfeeding and ‘moral duty’
My colleague Fiona and I are also interested in other mistakes we make in our moral judgements in pregnancy and early motherhood. Fiona is currently focussing on the example of breastfeeding. Women report experiencing huge pressure to breastfeed. Those who don’t – for whatever reason – often end up with feelings of guilt, and need to constantly justify their decisions. Fiona argues that breastfeeding is mistakenly viewed as a ‘moral duty’: something you must do, and that you need to justify not doing. This is opposed to a ‘moral reason’, which is something that is good to do, but needs to be balanced with all the other demands on your time. Breastfeeding obviously falls in the latter category: even if breastfeeding has benefits, these need to be weighed against all the other beneficial things women could do with their time and energy. Fiona has recently been awarded a £3,000 grant from the Public Engagement with Research Unit (PERU) for public engagement activities, which includes working with the main provider of birth-education in the UK: the National Childbirth Trust (NCT).
So the nature of the relationship between the foetus and the mother raises many interesting questions. Although Fiona and I have started to put forward arguments, some questions we raise won’t be completely answered any time soon because there are a lot of ways in which you could argue both sides. However, I think opening up the debate and showing that it matters is important, and I am very pleased that the European Research Council grant and other funding sources will allow me to do so.
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