La posición dominante y la ejecución de la competencia

These constructions, of the personified, rights-bearing foetal subject, produce an antagonistic conception of the relationship between the maternal body and the foetal body (Lupton, 2012). Women are reduced to incubators, carrying ‘precious cargo’ (Lupton, 2012); and foetuses are presented as vulnerable and in need of protection (Leppo, 2012). The reproductive health needs of the pregnant women are, by these processes, diminished. The use of biomedical technologies has in this way produced a personified foetal subject, whilst further propagating the objectification of the pregnant women.

This dichotomous construction, between the foetal and maternal subject, is demonstrated in Rutman’s (2000) review of how substance-use by pregnant women was discussed in Canadian print media’s coverage of the supreme court case of Ms D.F.G., an Aboriginal women. The newspaper headlines used to report on this case employed the foetal rights discourse, recruiting public perceptions into the dichotomous construction of the pregnant and foetal subject, as well as advocating for the supremacy of so-called ‘foetal rights’, over women’s rights.

The discourse of foetal rights, based upon the conception of a maternal-foetal conflict (Armstrong, 1998), implies that the interests of pregnant women and their foetuses can be separated (Rutman et al., 2000). Because pregnant women are reduced to carriers of precious foetuses, their reproductive health needs are backgrounded and efforts around FASD prevention become about protecting the foetus.

1.3. ‘The Problem’ of FASD

Leppo (2012) traces the genealogy of this foetus-centred discourse by analysing medical journals and political documents in Finland in the 1980s and 1990s. The author reports that during this time the political discourse oscillated between protecting the substance-using women and protecting the foetus. Leppo (2012) reports that formerly the onus was placed on protecting women’s rights and providing welfare and public services to them. However, this

47 evolved into negative constructions of substance-using mothers and compulsory treatment as a measure to protect the vulnerable foetus, thus preventing FASD.

Leppo (2012) describes how pregnant women were initially constructed as ignorant, yet well- meaning. This construction affected FASD prevention efforts: prevention entailed providing health education to women of childbearing age. However, since the mid-1980s, FASD prevention discourse has predominately been foetus-centred. The production of the maternal and foetal subjects, in conflict, has affected the problem category of FASD. Pregnant women are constructed as ignorant and indifferent alcoholics (Leppo, 2012). This has resulted in the demonization of the drinking pregnant women, exemplified by the conception of heavy- drinking (pregnant) women as more deviant than men who drink at the same levels (Benoit et al., 2014; Rutman et al., 2000).

The emergence of the foetal subject as instigated by biotechnologies, as above-described, converges with liberal ideals of ‘good mothering’ to further ‘the problem’ category of FASD discourse. According to these ideals, “a ‘good’ mother is self-sacrificing, self-disciplined, morally irreproachable and capable of meeting the needs of her family without assistance from the State” (Salmon, 2011, p. 167). Contrastively then, alcohol-consuming women may be considered to be self-indulgent, deviant, immoral and burdensome to public health. Women (who drink) are thus constructed as ‘the problem’ of FASD. In studies such as Rutman et. al’s (2000), women were constructed by health service practitioners as: self- serving, pleasure seeking, substance misusing figures; as transmitting harm directly to the foetus; and incapable of self-care. This is antithetical to the ideals of prospective motherhood (Radcliffe, 2011).

Hunting and Browne (2012) importantly note that, “the way health issues or ‘problems’ are framed in health policy discourse directly relates to how the issue is understood, thus the type of solutions that are considered to address it” (p. 40). Critical scholars have shown how the construction of women as ‘the problem’ of FASD has made it permissible for healthcare workers to monitor women’s behaviour, in the interest of foetal rights (Benoit et al., 2014; Radcliffe, 2011; Rutman et al., 2000). Salmon (2011) argues that, under Canadian neo-liberal governance, antenatal drinking becomes a political issue, justifying increased regulation by the state of women’s behaviour in the interest of the foetus, and the tax-payers (Hunting & Browne, 2012). Similar regulations, such as the Basic Antenatal Care (BANC) guidelines (Pattison, 2007), are observed in South Africa. These guidelines instruct healthcare workers

48 to engage with women regarding alcohol use during pregnancy during all antenatal clinic visits.

Hunting and Browne (2012) further note that this ‘problem category’ and ‘the solutions’ conception fails to contextualise women’s health, leaving the structural, social and health inequities, that give rise women’s alcohol use, obscured. Additionally critical scholars highlight that the discourses employed around the issue of alcohol use during pregnancy, those that construct women as the perpetrators of FASD, are characteristic of a ‘moral panic’: a situation wherein an identifiable and typically marginalised entity becomes the scapegoat for a social crisis. This entity is constructed by hegemonic institutions as threatening or antagonistic to the morals, values and interests of a society (Bell et al., 2009). The actions of the pregnant women are “constructed as dangerous to the interests of children, families, communities and nations” (Bell et al., 2009, p. 157). These constructions, which function to monitor and regulate women’s lives and are intended to address the issue of FASD, may have inadvertent effects. These constructions, and the interpellation of (alcohol-consuming pregnant) women into ‘the problem’ category may act to deter pregnant women from accessing healthcare services. Salmon (2011) argues that FASD intervention efforts should thus target state policies that perpetuate colonial conditions and health disparities, rather than scapegoating pregnant women of particular racialized bodies. Because of Australia’s colonial histories, these marginalised entities, which become scapegoats for FASD, are typically Women of Colour. Similarly in South Africa, due to our socio-political history discussed in the introductory chapter, it can be argued that Black14 women become the scapegoats for FASD.