The Rhetoric of Pregnancy by Marika Seigel (review)

Marika Seigel’s The Rhetoric of Pregnancy begins and ends with a description of the author’s own childbirth experiences, using personal reflection as a jumping-off point for a rhetorical analysis of American pregnancy manuals and advice. Seigel recounts how the handbooks she read when pregnant told her that her body was risky, that she needed medical supervision, and that she must be compliant to the medical system in order to birth a healthy baby. She knew that something was wrong with how this advice positioned her, but it was not until she was in the midst of labor that she realized the problem: she had not been instructed on how to question the medical system, “only how to comply,” and was therefore unable to understand her rights, know when she could ask for more information, or understand which procedures she could refuse (p. 3). This experience made her realize that “learning how to question the experts, how and when to disengage from the system, and what one’s rights are, should be routine prenatal care instruction for both pregnant women and their partners” (ibid.). One of the main goals of The Rhetoric of Pregnancy is uncovering why this is not routine advice, therefore, in the hopes of reframing prenatal care to help facilitate pregnant women’s critical access to the medical system.

In order to understand how pregnancy manuals position readers as needing functional rather than critical advice, Seigel uses rhetorical theory and criticism. She analyzes how pregnancy manuals developed “alongside of, out of, and sometimes in opposition to the technological system of prenatal care” (p. 6) by studying early written manuals from the 1900s to current online forms of instruction and advice. This temporal structure provides an opportunity for Seigel to historicize pregnancy advice, and to trace the development of pregnancy manuals in relation to the medicalization of prenatal care. Her methodology focuses on uncovering the rhetorical and material effects of these manuals, and on analyzing how the manuals articulate pregnancy, or, following Kenneth Burke’s concept of piety, how they are organized by assumptions about the identities of their audience. What she uncovers is that many commonsense ideas about what constitutes good prenatal care today have their roots in early 1900s medical advice, which was itself attached to eugenics movements concerned with the betterment of the nation through better “breeding” practices. For instance, early pregnancy manuals made assumptions that a pregnant woman should adequately discipline herself in order to ensure the health of her future child, and that when she did not do so it was the role of husbands, doctors, and other patriarchal figures to do this work in her stead. This was because the end-goal of every pregnancy, as articulated in these manuals, was not only a healthy baby or mother, but also a “normal” baby. In other words, from the first instance, pregnancy manuals have positioned pregnancy as a social event connected to national interests, and the pregnant body as in need of institutionalized support and supervision.

If the end-goal of prenatal care has consistently been to produce normal babies, this helps to explain why pregnant women have been figured as “at risk” in mainstream pregnancy manuals, both from the advice of those outside the medical establishment and from within. From J. W. Ballantyne’s Expectant Motherhood: Its Supervision and Hygiene (1914), discussed in chapter 3, to the current popular website <www.babycenter.com> (run by BabyCenter LLC, a subsidiary of Johnson & Johnson), discussed in chapter 8, Seigel reveals that the pious pregnant woman has consistently been figured as a nonexpert. Even as mainstream manuals have shifted away from seeing the ideal pregnant woman as totally submissive and compliant, several pieties have remained constant. For instance, the fetus (and not the mother) has remained the primary patient of prenatal care, and the pregnant body has remained unreliable, dangerous, and in need of medical surveillance. In fact, whereas early manuals suggested one’s doctor as the source of specialized knowledge...