Anthropology of Life and Death: Exploring concepts of life and death through the lens of pregnancy loss

As part of our third year Anthropology of Life and Death module, students explore cross-cultural understandings of life and death. This week, our featured essay is by Jack Robson.
Jack Robson
Jack’s bio: I am a final year anthropology undergraduate student, having studied the majority of my degree part-time alongside work. When I discovered anthropology a number of years back, all my interests and passions, both in work and in my hobbies, slotted into place in an academic field and I knew this was the subject for me. My time at Roehampton has been formative, allowing me to study a variety of topics within the discipline and to stretch my thinking and approach within these, such as in the vast subject of Life and Death.

Within anthropology, the topic of life and death covers a large spectrum of subjects with much ethnographic and anthropological literature spanning a variety of cultures, societies, and specialised topics that fit into this theme. Studies within the area of pregnancy loss seem to challenge concepts of how life and death are formed within Western societies (Kaufmann & Morgan, 2005; Leith, 2009 & Mitchell, 2016). In particular, they challenge the generally held societal belief and viewpoint around how life is attributed to the formation of life in the womb and, by contrast, how death or non-life is approached regarding an embryo or foetus (Littlewood, 1999; Martel, 2014; Mitchell, 2016; Navne & Svendsen, 2019).

In the context of pregnancy, the medical profession has been a leading discipline in creating concepts that surround the formation of life within the womb (Kilshaw, 2017; Littlewood, 1999; Martel, 2014). The biological sciences have arguably been crucial in shaping how society and culture view the nature of the unborn (Mitchell, 2016), perceive the notion of life (Andaya & Mishtal, 2017), how people conceive a child and engage with reproductive technologies (Bennet & de Kok, 2018), and behave, feel, and think regarding these (Layne, 2006; Martel, 2014). These biomedical fields arguably correlate to what occurs with the legal and political sphere surrounding concepts of life and death (Andaya & Mishtal, 2017; CAR, 2016; Ruppanner et al., 2019). Layne similarly suggests the blurring of lines between disciplines, with reference to science and religion, since people “may not experience their lives in this fragmented way, and in fact often actively weave together these domains” (2006: 537). As a result, disciplines and ideas can’t be so easily separated and concepts often become woven together by the very fact that people engage in these various topics.

What language is used is also a good indicator of the underlying worldview, for it both demonstrates the belief and helps construct it (Kilshaw, 2017; Martel, 2014). Layne (2006) highlights that there can be differences in how people, even of the same culture, understand certain terms, particularly where other factors may contribute to their individual beliefs and worldviews, such as religion. Surrounding the topic of pregnancy loss, the example Layne uses is that of the term ‘miracle baby’, which some anthropological texts have used to refer to a medically improbable event brought about with the aid of in vitro fertilization. Layne’s point is that it doesn’t account for the way in which someone from a religious background, for example Christianity, may read and interpret the meaning of the term. How they infer meaning surrounding the concept of life and how it is formed could be affected by their interpretation of the term.

In regard to pregnancy loss, many anthropological texts recognise, however, how views and opinions regarding the beginning of life change over time and culture, and can also differ drastically between contemporary cultures (Car, 2016; Kilshaw, 2017, Leith, 2009; Littlewood, 1999; Martel, 2014; Mitchell, 2016; Navne & Svendsen, 2019; Ruppanner et al., 2019). They recognise that context is key in understanding a concept and how it might change (Miller et al., 2019).

Kilshaw (2017) demonstrates how language can affect how something is perceived and regarded, where positive and negative attributions can be assigned to a topic, an idea, an individual even, and therefore shape its reception and cultural understanding. Debates around abortion are rife with such examples of positive and negative language that both demonstrate a viewpoint as well as help construct it (CAR, 2016; Kilshaw, 2017; Martel, 2014; Mitchell, 2016; Rupanner, et al., 2019). This leads to shifting cultural narratives and concepts surrounding the formation of life, where, for some, life definitively begins at fertilisation, for others, life begins at birth, and for others, still, the womb is the site of a liminal state of life where the unborn are neither fully alive with their own personhood nor fully dead having lost their personhood (Bennet & de Kok, 2018; CAR, 2016; Layne, 2006; Mitchell, 2016; Navne & Svendsen, 2019; Ruppanner et al., 2019).

Choice of language can also be used to silence and to conceal opposing concepts or voices (Martel, 2014). It can be implemented as a tactic to silence what one viewpoint may see as a voice that could unsettle the cultural narrative and norm. Language can, therefore, be used as a catalyst for change as well as a hinderance to it (Kilshaw, 2017). Miller et al. (2019) demonstrate how this is actioned, whether consciously or not, through social media posts to proliferate certain opinions and attitudes.

Despite the presence of cultural differences in this area, much of the ethnographic work surrounding pregnancy loss demonstrates how varying ideas and concepts can interact, merge, and support one another, even, at times, being embraced by, and melded with, existing constructs (Bennet & de Kok, 2018; CAR, 2016; Kilshaw, 2017; Navne & Svendsen., 2019), sometimes not even knowingly or deliberately (Leith, 2009). There are instances where, despite an individual’s upbringing, they merge different cultural understandings surrounding the formation of life with their previously held concepts (Kilshaw, 2017; Leith, 2009; Littlewood, 1999; Mitchell, 2016), such as embracing concepts of the afterlife with their Western scientific and medicalised understanding of life (Bennet & de Kok, 2018; Kaufman & Morgan, 2005; Leith, 2009). These differing concepts aren’t only from sources outside of Western culture, either. They can also come from within (Miller, et al., 2019), for instance, through practices that once weren’t possible or not considered the norm, but are now more widely embraced and which reshape concepts around life and death. An example of this is how the formation of family life isn’t simply framed through natural conception anymore; other methods such as adoption or new reproductive technologies must now be considered when exploring kinship and identity (Bennet & de Kok, 2018; Layne, 2006).

The ever growing and varied opinions surrounding where life begins, where personhood is attributed, and what makes someone human, has contributed to an expansion of anthropological literature surrounding reproduction examined with concepts of life and death, kinship, religion, and pregnancy loss (Kaufman, & Morgan., 2005, Kilshaw., 2017, Littlewood., 1999, Mitchell., 2016, & Navne, & Svendsen., 2019). The way personhood is understood has affected societal response to pregnancy loss, for example, what is considered an appropriate mourning response to such a short ‘life’ (Martel., 2014). Medicinal and technological developments have altered societal perceptions of a foetus and constructed a new entity that some would regard as a not-yet-human (Kilshaw., 2017, Mitchell., 2016, & Navne, & Svendsen., 2019). It is an ever-shifting landscape of concepts, theories, and understandings, often marked by an individual’s experience, such as the way in which some women attribute the category ‘baby’ to a foetus when they can feel movement (Kilshaw., 2017). The medical, legal, and political spheres have needed to define life and its beginnings, but these definitions arguably are affected, and can be altered, due to societal, cultural, and scientific pressures because of a narrative change, or at least a challenge to the narrative (Andaya, & Mishtal., 2017, CAR., 2016, Kaufman, & Morgan., 2005, Littlewood., 1999, & Ruppanner, et al., 2019). It could be argued that this creates a constantly shifting pendulum of influence, where the cultural view is influenced by politics and then vice versa. What is understood as personhood can be legalised and formalised, but then adapted and altered as a result of “cultural understandings, values and needs and the historical setting” (Littlewood., 1999: 224). Personhood, identity, and humanness can therefore been seen as a social and cultural production (Kaufman, & Morgan., 2005, & Navne, & Svendsen., 2019), something that has been the key focus for many anthropological studies.

“Research into terminations, miscarriage and the fetus is scant, not just because of sensibilities of it as taboo, but precisely because of their ambiguity. Uncertainty surrounding the embryo and fetus abounds: living but not yet alive; it falls between category of ‘human or non-human’” (Kilshaw., 2017: 201).

Yet, within all the discussions of varying cultural, political, religious and historical views, there is a persistant theme of liminality emerging across the ethnographies. As Kilshaw (2017) describes, there are fluid borders and boundaries between life and death, and these are understood differently depending on cultural backgrounds. Understandings around how personhood is formed lead discussions into the realm of the ‘in-between’, to situations of life and not yet life, being human and not quite human; “somewhere between person and human tissue” (Kilshaw., 2017: 201). As these concepts and value systems are grappled with, in turn, the categories they create need to be identified in order to assert what does or doesn’t fit the conceptual definitions (Kaufman, & Morgan., 2005). Doing so informs the liminal by helping us recognise what culturally would be understood to fit in the in-between.

Many of the ethnographies depict countless scenarios where pregnancy loss accentuates the concept of the liminal within life and death (Leith., 2009, Mitchell., 2016, & Navne, & Svendsen., 2019). Through the process of grief, and the subsequent feelings that arise following a pregnancy loss, in essence, the baby, or however this ‘being’ is defined, remains in thought in a liminal state of present and not present. The lost baby continues in active memory for the would-be parents and their family and friends, for the medical professionals tending to their case, and within societal discussions (Leith., 2009 & Martel., 2014). In this way, is this a liminal state between life and death? Is there a part of their personhood that remains alive due to their remanence in memories, or memorialisation, or feelings and thoughts? Moments of encountering the loss again, whether through support groups, anniversary dates, future offspring or other existing offspring, can continue to bring the moment of the termination of formational life into the present moment. It is brought into a liminal state of having been yet still being, and the baby/foetus/embryo becomes caught in a state of life and death (Leith., 2009).

Several previously held concepts about life and death, as seen through a Western lens, are themselves in a state of liminality, where new and different ideas are helping to question and reshape long standing opinion. Although a difficult subject, and in some cases taboo (Martel., 2014), pregnancy loss homes in on how we understand the beginnings of life. It pulls together often opposing viewpoints to draw conclusions on the uniqueness of personhood and how this is socially and culturally formed. With application to other areas within the topic of life and death, and concepts that can be applied more generally, the subject tackles difficult discussions. Further research in this area would offer insight into the various perspectives needed for a deeper understanding of this profoundly illuminating topic.

References

Andaya, E., & Mishtal, J. (2017) The erosion of rights to abortion care in the united states: A call for a renewed anthropological engagement with the politics of abortion. Medical Anthropology Quarterly. 31(1) pp.40-59.

Bennett, L.R., & de Kok, B. (2018) Reproductive desires and disappointments. Medical Anthropology. 37(2) pp.91-100.

Council on Anthropology and Reproduction [CAR]. (2016) The council on anthropology and reproduction (CAR) opposes legislation that creates barriers to safe abortion care. Medical Anthropology Quarterly. 30(1).

Kaufman, R.S., & Morgan M.L. (2005) The Anthropology of the Beginnings and Ends of Life. Annual Review of Anthropology.34 pp.317-341.

Kilshaw, S. (2017) Birds, meat, and babies: The multiple realities of fetuses in Qatar. Anthropology & Medicine. 24(2) pp.189-204.

Layne, L.L. (2006) Pregnancy loss, stigma, irony, and masculinities: Reflections on and future directions for research on religion in the global practice of IVF. Culture, Medicine and Psychiatry. 30(4) pp.537-545.

Leith, V.M.S. (2009) The search for meaning after pregnancy loss: An autoethnography. Illness, Crisis & Loss. 17(3) pp.201-221.

Littlewood, J. (1999) From the invisibility of miscarriage to an attribution of life. Anthropology & Medicine. 6(2) pp.217-230.

Martel, S.L. (2014) Biopower and reproductive loss. Cultural Studies. 28(2) pp.327-345.

Miller, D., Costa, E., Haapio-Kirk, L., Haynes, N., Sinanan, J., McDonald, T., Nicolescu, R., Spyer, J., Venkatraman, S., & Wang, X. (2019) Contemporary comparative anthropology – the why we post project. Ethnos. 84(2) pp.283-300.

Mitchell, L.M. (2016) “Time with babe”: Seeing fetal remains after pregnancy termination for impairment. Medical Anthropology Quarterly. 30(2) pp.168-185.

Navne, L.E., & Svendsen, M.N. (2019) Life-and-death decisions in a neonatal intensive care unit in denmark: The discrete authority of origin stories. Ethnos. 84(2) pp.344-361.

Ruppanner, L., Mikolajczak, G., Kretschmer, K,. & Stout, C.T. (2019) Gender linked fate explains lower legal abortion support among white married women. PloS One. 14(10) pp.e0223271..

 

 

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