The Medicalisation of the Female Body and Motherhood: Some Biological and Existential Reflections

Abstract

Maternity is a biological process that has increasingly changed into an authoritative medicalized phenomenon and requires techno-medical intervention today. Modern medicine perceives women’s procreative functions as pathological that need medical involvement and control. Medical biologists claim that the female body is destined to procreate in which medical sciences can assist them with techniques. But is a woman’s body biologically evolved merely for procreation? Or is it a sexist interpretation of her socially situated self? How can we justify the idea of universality and neutrality of medical sciences in a social context? Arguing against deterministic biology, existential feminists advocate that female body is not merely a biological fact but rather a social situation under which the maternal act has become the essence of being a woman. Social situations influence medicine in a way that they are used as a rhetorical tool to achieve social desires authoritatively. The present paper explores and examines the increasing medicalization of female body and maternity through the lenses of biological determinism and phenomenological existentialism. I argue that medically supported theories of female body are socially interpreted that perpetuate the traditional role of women as mothers instead of emancipating them from their immanence. The paper discusses how the scientific model of medicine is implicitly influenced by socio-cultural forces and, consequently, tries to reduce social phenomena into biological factors to justify women’s inevitable destiny as motherhood. Thus, we need a de-medicalized model of medicine in order to comprehend the true meaning of maternal body and self.

Introduction: Medicine and Medicalisation

Generally, supporters of modernization assume that science and technology are crucial for any conscious attempt to change and transform the traditional structure of society, but it seems ambiguous in the context of women. It is not wrong to say that medicine has played a significant role in shaping women’s bodies and their maternal selves by providing them new reproductive possibilities. However, due to this, the majority of women are no longer acquainted with their maternal body and lack birthing knowledge. Throughout the maternity process, women are subjected to medical and technological interventions. They take directions and suggestions from medical experts and prefer giving safe birth in hospitals. But to what extent these facilities are helping and providing gender-neutral tools for women needs a careful look. It is observed that these choices and opportunities are influenced by the patriarchal ideology of an ideal woman as a mother. The scientific model of modern medicine perceives women’s reproductive biology as their ultimate destiny, and irregularities in it are treated as a disease or abnormalities in the natural act of reproduction. In this way, medicine has become another patriarchal tool to fulfil traditional gender-oriented societal assumptions and expectations authoritatively. It tends to essentialize, naturalize, and idealize women’s bodily destiny and reduce them to motherhood. This scenario brings with it vexed questions such as how do medical science and biology define and give meaning to an individual’s bodily situation? Does medical science neutrally help women to attain their bodily emancipation and provide unbiased choices? Or is it just a social construct to control their bodies? And so on. Finding answers to such questions requires an existentialist-phenomenological understanding of the relation between deterministic biology and socially constructed body and medicine. Social situations influence our perceptions and understanding of biology; therefore, it is inappropriate to permanently knot an individual with her/ his inherent bodily destiny. A woman is located as a sexually differentiated body whose biology defines her social situatedness. There are two contrasting views to reflect on women’s bodily biology and their social status: firstly, patriarchal perspective in medical sciences that defend and believe in biological determinism to advocate that the work division in society is based on the fixed biological facts. According to this approach, motherhood is natural to women. Secondly, questioning the above view, supporters of existential-phenomenology argue that the use of socially created or interpreted biological facts is inappropriate and an illogical justification for women’s oppression, subordination without taking into account their lived experience, and women’s inherent ambiguous situatedness. They stress the point that medical sciences and biology are indirectly and unconsciously influenced by pre-existing structures of society and cultural norms that require serious exploration.

The present paper attempts to critically analyse the meaning of maternal body in relation to the use of scientific medicine and technology within existentialist phenomenological framework. Medical sciences seem to provide new reproductive opportunities for women to enhance their procreative choices but often disable them and contribute to perpetuating patriarchy in new ways by treating women’s bodies as procreative machines and for making profits for the pharmaceutical companies and medical practitioners. This has deleterious implications on women’s lives and their bodies as they are becoming fragmented, depersonalized, and alienated from their procreative selves. With that in my mind, I have analysed the deep-rooted phallocentric prejudices persistent in medical sciences and technologies and their internal link with women’s biology. I have traced out the historical shift of gender and power relationship from women midwives to medically trained men in the context of motherhood. Women were gradually viewed as incapable of mothering knowledge and experience than men and directed to follow instructions of medically and scientifically skilled authorities which led to the medicalisation of their body. It is not an exaggeration to say that the modern idea of medicine and patriarchal understanding of procreation strengthens each other through the maternal experience of women. I will explore the global phenomenon of medicalisation of maternal body from western perspective and its implication in the form of control over women as mothers. Further, the paper explores the way biology is socially interpreted and associated with situated bodies in order to give sexually differentiated meanings and values that maintain traditional social roles and position of an individual within such practices. The focus of the paper is on the ways women are perceived and located as sexually differentiated bodies whose biology defines and plays a foundational role in their social situatedness. For this, I have discussed the arguments for and against the notion of biological determinism and feminist existentialism in the context of medicalisation of female body and their reproductive selves with a view to explore to truth behind their use and abuse. In so doing, the works of various biologists, feminists, and existentialist thinkers have been taken into account. They have analysed the way women are situated within the patriarchal structures where medicine has become a rhetorical controlling tool, yet it seems they are liberating one. I propose to argue in this paper that the men made modern medical science and technologies “rhetorical artefacts” that marginalize and control women’s feminine embodiment by medicalizing and objectifying their maternal body and subjectivity instead of providing them emancipatory choices. In this situation, there is an urgent need to introduce a de-medicalized model of health care and medicine to establish an unbiased and egalitarian environment for the welfare of women as well as society.

Medicine as a Social Construct and Control

Medicine is considered as a universal, objective, and neutral social institution, essential to the well-being of an individual and society at large. Medical sciences have invented various life-saving treatments, technologies, and drugs to save humanity from natural and unnatural conditions and irregularities which they termed as diseases. Scientific medicine works through the medical model that provides a medico-biological interpretation and understanding of a body. It also includes construction and management of the systems, pathologies, indicators of the health of the body as independent of culture, ideology, economy, and the state. Despite its neutral and objective approach, medicine as a practice and disciple of knowledge is culturally and socially influenced and regulated (Kang et al. 2017, 82). Feminists around the world have noticed and objected to the medical understanding of body, and show how medical practitioners and their approach towards medicine play a substantial role in medicalizing bodies based on gender-power intersectionality of society that shapes the status of sexes (Kang et al. 2017, 82). The question can be asked that whether medicine is a problem or medicalization of the human body is a matter of serious discussion? In order to examine this, it may be helpful to take a brief look at the ideological understanding of medicine and the process of medicalization as a social instrument of control.

Medicine is a branch of science dealing with the maintenance of health and prevention, alleviation and cure of disease. Whereas the term medicalization is understood as subordinating certain practices, experiences, and behaviours to the authority of medicine (Cindoglu and Feyda 2010, 226). The process of medicalization depicts how normal life process is changing into an object of authoritative medical intervention depriving humans of their autonomy. Thinkers such as Freidson, Conrad, Zola, Reissman, and Foucault have talked about the process of medicalization and the way human body comes under medical control and authority. Irving Zola introduces the notion of medicalization and how it influences scientific and technological medicine as a social institution of control that has medicalized daily life of people. Zola (1972, 487) points out that medicine has the power to affect and exclude even “more traditional institution of religion and law”. Describing the nature of medicine, he says, “It is turning into the new repository of truth, the place where absolute and often final judgments are made by supposedly morally neutral and objective experts. And these judgments are made, not in the name of virtue or legitimacy, but in the name of health”. Zola sees the labels “healthy” and “ill” integral part of human existence. In addition, advances in technologies and increase of bureaucratic system led to “medicalising of social process” which is later known as medicalization (Zola 1972, 487–496). According to Zola, with the expansion of medicine, it has entered every spare of human life in such a way that we cannot even imagine our lives without medical insights. We are gradually forgetting our connection to nature and turning into mechanized and medicalized beings.

Likewise, sociologist Peter Conrad has provided a detailed account of the term. He asserts that medicalization is a process “when a nonmedical condition or problem is described and understood in medical terms and responded to with medical interventions”. It is the process whereby human problems “become defined and treated as medical problem, usually in terms of illness and disorders” (Conrad 2008) which are further managed and cured by medical professionals. Conrad’s (1979) definition of medicalization shows that the larger aspect of human life is medicalized and controlled by medical authority. In this context, he further mentions four kinds of medical social control: (1) medical ideology, (2) collaboration, (3) technology, and (4) medical surveillance. Medical ideology enforces medical authority for social and ideological gain. The medical collaboration represents various roles of medical experts such as informants, gatekeepers, institutional agents, and technicians. Medical technology advocates the use of medical technology in a controlling way such as drugs, surgery, and genetic or other types of screening. Medical surveillance which he has taken from Foucault suggests “medical gaze”, i.e. the medical lenses to interpret the world. The process of medicalization proceeds through the assistance of medical technology that serves solution of individual’s problems and makes them dependent on it (Prosen 2013, 255). Analyzing further, Catherine Kohler Riessman (2003, 47–48) illustrates two interrelated processes of the term medicalization—“First, certain behaviours or conditions are given medical meaning—that is, defined in terms of health and illness. Second, medical practice becomes a vehicle for elimination or controlling problematic experiences that are defined as deviant for the purpose of securing adherence to social norms”. This occurs at two levels of medicalization: the conceptual level, where medical vocabulary is consulted to define any problem; and the institutional level when medical practitioners interact with the patient and real diagnosis and treatment starts (quoted in 2003, 48). These explanations of medicalization reflect the controlling nature of medicine underlies within the process of medicalization itself. Gradually, all worldly objects were explained through the lenses of authoritative medicine. Foucault has discussed the role of medicine over disciplining and controlling bodies and the way medical model is used to interpret worldly reality and life problems.

In his book, The Birth of a Clinic, Foucault (1973, 89) explains the way utmost human problems and issues gradually have come under the medical gaze, which has not only changed our experience towards body but has become a mode of power for social control and reinforcement of self-regulation. Foucault defines medical gaze as “it was no longer the gaze of any observer, but that of a doctor supported and justifies by an institution, that of a doctor endowed with a power of decision and intervention”. Foucault explains the irony of modern medicine as the modern medicine emerged out of the rejection of medieval superstitions. But modern conceptualization of medicine does not exist without presuppositions. Medicine has its own way of seeing the world, known as medical gaze that can penetrate illusions and see hidden reality and bodily truth which could be comprehended by the medical specialists (Foucault 1973, 54–57). This medical gaze or authority is not a new phenomenon, but the theoretical underpinnings and justifications for the authoritative power in modernity were, as shift from abstract to concreate practical knowledge and examination is based on the expert’s intelligence (Hancock 2018, 443). Similarly, in another book Discipline and Punish: The Birth of the Prison, Foucault (1979, 136) discusses the relationship between man and machine in terms of “docile bodies”. The body is something that “may be subjected, used, transformed and improved”. He declares that “the body had become the object of such imperious and pressing investments in every society, the body was in the grip of very strict powers, which imposed on its constraints, prohibitions or obligations”. According to him, it is the beginning of a new era when “The human body was entering a machinery of power that explores it, breaks it down and rearranges it … it defines how one may have a hold over others’ bodies, not only so that they may do what one wishes, but so that they may operate as one wishes with the techniques, the speed and the efficiency that one determines. Thus, discipline produces subjected and practised bodies” (Foucault 1979, 138). Thus, Foucault and others have given a comprehensive understanding of the control mechanism of medical institution and the way body is medicalized to satisfy the demands of society. However, society is classified in various sections based on class, caste, and gender which is ignored and remained unnoticed in these definitions. In a society, every individual works according to the assigned role that defines their identity and status which has a deleterious effect on women. Women’s maternal body is a centre of medical investigation and experiment. Feminists point out the gap in these definitions of medicalization remains unnoticed by medical experts and thinkers. They claim that there is a deep-rooted gender aspect of medicine; the patterns of patriarchal influence and domination on scientific medical model are crucial to discuss.

Feminists such as Gena Corea, Janice Raymond, Renate Klein, Robyn Rowland, Patricia Spallone, Barbara Rothman, and Sara Franklin are sceptical and concern with these techno-medical transformations and their impact on women in terms of emancipation. They believe that such changes should be critically analysed in order to trace the patriarchal domination of modern medicine over women’s reproductive body and their maternal experiences. By using phrases such as “living laboratory”, “baby machine”, mother machine”, “test-tube women”, and “medical metaphor”, they started posing questions about the future of maternity, women’s autonomy, and subjectivity. They raise voices against the persistent power relation, gender biases, and unfair medical treatments of women in society. It is evident that during the eighteenth century, the female body started becoming the subject of medical study and investigation to establish control over them. Women’s reproductive functions are seen as medical problems and subject to medical intervention and control. Sybil Shainwald (2016), in her speech on “The Medicalization of Women”, discusses the medical understanding of women’s reproductive body in these words, “According to western medical model, pre-menstrual syndrome is a disease, menstruation is a disease, pregnancy is a disease, childbirth is a disease, and menopause is a disease. From this model I have reached a conclusion that being a woman is a disease”. Due to this, natural birth was replaced by medical birth or hospital birth which is further linked with the patriarchal ideology of motherhood. Medical sciences discovered maternity as inherently pathological and women as a victim of their own procreative biology (Cindoglu and Feyda 2010, 227). However, it is observed and argued that women themselves embrace medicine and allow medicalization of their body in order to free themselves from the social control and biological destiny that gives their control to the medical’s hand. To find a reason behind these actions, we need to go back to trace the historical emergence of medicine in relation with female body.

Medicine, Women, and Biological Determinism

Over time, the incessant expansion of medicine and medical knowledge of human body has generated a greater health awareness and understanding of the common people’s minds. People are becoming more conscious about their bodily functions and health care which resulted in elimination of some dangerous diseases, a decrease in infant mortality rate, maternal morbidity, health-related movements, and the increased medicalization of human body. In the context of women, medicine, and medical technology have facilitated their reproductive possibilities and biology to a greater extend. Women’s biological processes have been considered as separate from men. Their procreative bodies are seen as deviant, inferior, and mutilated and cause of all diseases that require proper medical care, treatment, and control that led to the medicalization of their body and self. Sybil Shainwald (2016) remarks on women’s medicalized situation as “their normal bodily stages and functions not only are medicalised but pathologized. In every era of history and in every phase of women’s lives doctors have sought to control or intervene in women’s reproductive function. Functions have become symptoms, and symptoms have become disease”. Medicine is a male-dominated mechanism that provides societal structure to establish control over women’s procreative body resulting in a denial of their bodily choices and autonomy. The contemporary medical imagery of women’s biology is based on and affected by socially and culturally constructed assumptions. But the question needs to be addressed that if biology is a gender-neutral discipline, then how is women’s biology a cause of their subordination whereas men’s biology places them in a higher position? Getting an answer to this question, it is crucial to analyse biological meaning of body and its impact on women’s reproductive self.

It is known that biology studies life and its meaning in terms of bodily processes, functions, and anatomy of living organisms. Studying these functions of living bodies, biologists demarcate the factors that are responsible for the procreation of species. Some biologists claim that these predetermined and inevitable biological facts are the foundation of social structures and diverse human social life. It was further taken by medical tradition to study human body. Classical medical literature and philosophy mention the dominant structural analogy of two sexes—men’s external and women’s internal organs seen as one and known as the theory of “one-sex-body” which is later imagined as “two-sex-body” have seeds of deterministic biology. Thomas Laqueur (1992), in Making Sex, discusses the deterministic scientific evolution of sexual differences from one-sex to two-sex theory in terms of two models, i.e. “one-sex model” and “two-sex-model”. Followers of “one-sex model”, such as Aristotle, Galen, Vesalius, and Dorothy Sayer, maintain that women’s and men’s bodies are different configurations of the same body parts; that is to say, a woman’s body is isomorphic of man’s body. Laqueur (1992, 25) claims “The corporeal theatrics of a world where at least two genders correspond but one sex, where the boundaries between male and female are of degree and not of a kind, where the reproductive organs are but one sign among the many of the body’s place in a cosmic and cultural order that transcends biology”. Agreeing with Laqueur, Emily Martin (2001), in her book, The Women in The Body: A Cultural Analysis of Reproduction, reflects on the deep-rooted patriarchal mind set in these anatomical theories for women. She states that these interpretations implicitly present inferior and subjugated status of women’s biological body as their sex organs are inside and invisible or sometimes lacks body part in comparison to men. Referring to Nemesius’ statement that “women have the same genitals as men, except that theirs are inside the body and not outside it”, Martin (2001, 27) shows the inherent gender biases in biology and medicine.

In this regard, statements given by Aristotle are worth mentioning. He presents a more austere interpretation of one-sex model. For him, sexes existed for the purpose of procreation, but they are not biologically separate. According to him, a male is the efficient cause, whereas a female is the material cause of procreation. Nevertheless, all male organs are similar to female except the womb which he later adjusts with male scrotum: “the path along which the semen passes in women is of the following nature: they [women] possess a tube (kaulos)—like the penis of the male, but inside the body—and they breathe through this by a small duct which is placed above the place through which women urinate” (Aristotle 1883, 10–11). These assumptions are gradually changing the relationship of both bodies and their position in society. In the same way, in his book, On the Usefulness of the Parts of the Body, Galen maintains that both sexes have similar body part and suggests, “Think first, please, of the man’s [external genitalia] turned in and extending inward between the rectum and the bladder. If this should happen, the scrotum would necessarily take the place of the uterus with the testes lying outside, next to it on either side” (quoted in Laqueur 1992, 25). The purpose behind these statements is to present the close link between the two sexes regardless of their physical or biological differences. We find the same perspective in Dorothy Sayers’s The Human-Not– Quite- Human: “The first thing that strikes the careless observer is that women are unlike men. They are “the opposite sex” (though why “opposite” I do not know; what is the “neighboring” sex ?). But the fundamental thing is that women are more like men than anything else in the world”(quoted in Laqueur 1992, 1). In this way, these biologists justify female reproductive organs as a reverse form of men’s genitals. It can be said that the “one-sex model was not fundamentally grounded on the gender ideology. However, it seems implicitly it was accepted in terms of men and women two distinct sex phenomena. Nevertheless, such representations of human reproduction tended to perpetuate a kind of previously established hierarchy between male and female sexes in which women are always seen as subordinate and inferior to men’s bodies regardless of their complementary bodily sexual functions. Such representations result in legitimisation of prevailing sexual oppression and subjugated location of women.

Later, the acceptance of the “two-sex model” account in a science world explicitly exposes the hidden gendered ideology of “one-sex model” in the form of indisputable biological separation between both sexes. This model presents men and women as two different sex bodies which are disconnected from each other and understand the world differently. Walter Heape (1913, 23), in his book Sex Antagonism, states that “The reproductive system is not only structurally but functionally fundamentally different in the Male and the Female; and since all other organs and systems of organs are affected by this system, it is certain that the Male and Female are essentially different throughout”. He further says that “They are complementary, in no sense the same, in no sense equal to one another; the accurate adjustment of society depends on proper observation of this fact”. The “two-sex model” has not only naturalized and approved the biological difference between sexuate bodies whose purpose was to facilitate the act of procreation. This idea has further transformed biological thinking into deterministic biological ideology that was regularised by the followers of patriarchy. They warned that the deterministic ideas of biology should be followed strictly to save human species from future destruction in terms of decreasing women’s bodily function to reproduce. For this, it is crucial not to alter or make change of the meaning of biology. They dedicated themselves in exploring women’s body for motherhood. In addition, many biologists started arguing maternity as natural and essential to women in the form of “biological instinct”. The purpose of such an idea was to reject feminine subjectivity, reducing their role in so-called natural reproduction. In this regard, Moi (2005, 15) aptly states that “The more science they read, the less obvious the meaning of the body became”.

In order to justify their deterministic and gendered stance, biologists often state Darwin’s theories related to maternal instinct. Darwin (1896, 98) believes that every woman has an inherent maternal instinct for their offspring that she shows to them with greater extend. He states that “The social feelings are instinctive or innate in the lower animals; and why should they not be so in man?”. By supporting the idea of maternal instinct, Alice Rossi advocates that women are biologically assigned the role and ability to procreate and they should completely devote themselves for rearing and bearing children (Sayer 1999, 149). In a similar vein, Edward Clark, Henry Maudesley, Spencer, E.O. Wilson, W. K. Brooks, and others argue in favour of women primary role as mothers. Edward Clark and Henry Maudsley argue that energy spent by one part of the body reduced the amount of energy available to another body part. Thus, it is crucial for women to use her energy solely for procreation purpose because performing other mental act is dangerous for future human existence. They cautions that the energy utilised for academic tasks will reduce the potential of fertility capacity in women (Sayer 1999,12). Likewise, Spencer holds that doubtlessly nature must have bestowed with women ‘specialized instinct’ in the form of ‘parental instinct’ more than men to protect and nurture their vulnerable offspring. His stress on parental instinct meant that women should keep themselves away from public enterprises to comprehend the value of maternity for human life. He states: “Only that mental energy is normally feminine which can coexist with the production and nursing of the due number of healthy children (Spencer 1972, 31). According to him, the roles assigned by the society to men and women are the result of evolutionary determinism, which is bestowed by nature itself. Similarly, biologist Edward Osborne Wilson and William Keith Brooks further claim that social division of labour is based on the biological differences of sexes and interference in it is futile and ethical. In his book The Law of Heredity, Brooks (1883, 243) comments on the way biological differences between sexes affect their socially assigned role and practices. He postulates that “If there is fundamental difference in the sociological influence of the sexes, its origin must be sought in the physiological differences between them”. In this way, we can say that biological determinists made use of biological facts to justify social control over sexes as a natural. In the context of women, it is their maternal biology that is justified as their natural destiny.

During the mid-nineteenth century, there was a serious interest in women’s deterministic biology and maternal body by male practitioners in western thought and medicine. Medical literature and books are inundated with descriptions and interpretations of reproductive functions and anatomical study of sexes especially female maternal body. On the basis of biological determinism, medical experts perceived maternity as a machinal process, women as procreative body machine or uterus and that can be technically modified, changed, and used led to the medicalization of her body. Emily Martin (2001, 55) describes woman’s procreative function through machine metaphor in these words, “The women’s body is the machine and the doctor is the mechanic or technician who ‘fixes’”. This interpretation of female body in influenced by Descartes’s Cartesian model where body is seen as an instrumental: “the Cartesian model of the body a machine operates to make the physician a technician, or mechanic. The body breaks down and needs repair in the hospital as a car in the shop; once ‘fixed’ a person can be returned in the community” (Martin 2001, 56). The machine-body metaphor has dominated the scientific medical field in the early stage of medicinal development and has further affected professional female midwives and healer’s works in assisting women in procreation. Reproduction and childbirth which was handled by these skilled women gradually shifted from their hand to male medical professional hands. Riessman states this situation as “over a period of more than a century, “social childbirth” was replaced. The site of care shifted from the home to the hospital. The personnel who gave care changed from female midwives to male physicians. The techniques changed from noninterventionist approaches to approaches relying on technology and drugs” (Martin 2001, 51). The result of such medical intervention has changed the meaning of maternity and childbirth experience for women as well as for society. Now maternity is considered as a techno-medical problem that requires medical treatment.

Medicalisation of women’s body includes their reproductive biological and natural functions such as, aging premenstrual symptoms (PMS), menstruation, menopause, pregnancy, parturition, and lactation that are seen as pathological and relating them with “illness” or “disease”. Medical practitioners and doctors consider reproductive function significant to understand and attempt to study women’s body and their biology within the pathological framework. They have developed new technologies and procedures to “cure” the disease. Interestingly, due to such orientation, sometimes they perform the unrequired and harmful medical treatment to their natural bodily functions that have strong effect on women’s physical and mental wellbeing. For instance, a woman’s experience of birth is fragmented and alienated because the instrumentation of the medical system and social structures ignore her control over her body. Iris Marion Young (1984, 55), in her article titled “Pregnant Embodiment: Subjectivity and Alienation” argues that “a woman’s experience in pregnancy and birthing is often alienated because her condition tends to be defined as a disorder, because medical instruments objectify internal process in such a way that they devalue a woman’s experience of those processes, and because the social relations and instrumentation of the medical setting reduce her control over her experience from her”. According to Rothman (1982), in modern birth settings, women are avoided and detached from their familiar surroundings, from their kin and social support, and are subjected to series of technological procedures—many of which are dehumanizing and others of which carry serious health risks. During pregnancy and childbirth, some unpleasant effects are natural to women, but for doctors, it is a matter of concern that needs urgent medical intervention. This pathologisation of natural bodily process further emerged in the form of pharmaceutical market, technisation, and commercialisation of body itself. Pharmaceutical companies develop products to market to women, and simultaneously a diagnostic procedure emerged to encourage prescriptions and sales of drugs (Kang et al. 2017, 82). Shainwald (2016) comments on the commercialisation of procreative in these lines, “control over women, and especially our bodies, is one of the foundations of the patriarchal system. Our fertility, menstruation, pregnancy, births, menopause, and the broader process of aging now medicalized, are all fuel for economic prosperity”. Additionally, various reproductive technologies such as in vitro fertilization-embryo transfer (IVF-ET), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), frozen embryo transfer (FET), donor insemination (DI), intra-cytoplasmic sperm injection (ICSI), and surrogacy were developed to ensure the birth of genetic and designer children, but women experience these technologies as an attempt to control and confine their reproductive choices. Many feminists and existential thinkers have attempted to deconstruct the patriarchal idea of essential maternity, that is, body is a biologically given reality. They show the truth that “natural facts” about body are influenced by sexually assigned identities as well as socially produced by scientific medical institutions. This deterministic interpretation of body lacks women’s lived experience about their maternal body which is discussed in the next section.

Existential Perspective on Maternal Body

To criticize such deterministic biological views and their social interpretations, feminists and existentialist thinkers raise their voices. They argue against the pervasive deterministic biology and its reflections on women’s bodily identity. Existential feminist Simone de Beauvoir (2009, 47), in her book, The Second Sex, argues that “In truth these [biological] facts cannot be denied: but they do not carry their meaning in themselves. As soon as we accept a human perspective, defining the body starting from existence, biology becomes as abstract science”. Human body is a composition of facts and impressions. Understanding body as a mere amalgamation of facts is an inappropriate interpretation that requires rethinking. In this regard, existential thinking emphasises on embodied subjectivity of a body. They suggest that it is crucial to describe body as an existential phenomenon from phenomenological point of view to know body as a whole. In this way, despite the medical interpretation of a body fact, they employ phenomenological method of suspension and bracketing to capture the meaning of maternal body and its non-influential experience for a woman. Young (1984, 46) shares how medical experts alienate women from their own maternal experience, “Medicine’s self-identification as the curing profession encourages others as well as the woman to think of her pregnancy as a condition which deviates from normal health. The control over knowledge about the pregnancy and birth process that the physician has through instruments, moreover, devalues the privileged relation she has to the foetus and her pregnant body”. She aptly points out that controlled medicalised experience cannot be considered as a real experience of a body. Due to the authoritative nature of medicine, the use of technology and drugs in birthing and dependent maternal process on obstetricians reduce the autonomous maternal experience of a woman.

Some existential thinkers develop a phenomenological account of the body to comprehend the specific experience of an individual. De Beauvoir claims that though human body is biologically constituted, it is a socially situated phenomenon as well. To understand the body as an existential phenomenon, we may begin with the philosophy of Edmund Husserl (2008). In Logical Investigation, he explains phenomenology as a foundational science of philosophy and method that deals with our lived experience and relation to the world. This phenomenological method is not only applicable on philosophy but also on all natural and medical sciences in order to understand the real-life experience of a body. In other words, lived experiences provide a common ground for both disciplines. Phenomenologists believe that all sciences begin by suspending everyday practices in order to understand the actual form of the world in its totality in terms of past, present, and future. Husserl states that in order to comprehend the meaning of the covered worldly bodies as it appears to us, it is necessary to suspend all previous presumptions and prejudices about the phenomena. This suspension unveils the essential structure of the phenomena in its experience and consciousness.

Merleau-Ponty (2005), in his work Phenomenology of Perception, extends Husserl’s method by extending the significance of specific and particular embodied experience in our perceptual knowledge and actions. In his view, knowing the essence of a phenomenon is not sufficient until and unless we know the origin of the essences within its particular specific experience. Consciousness, for Merleau-Ponty, encountered in its embodiment as it is associated with the worldly bodies. This embodiment is not an object among objects but rather a living subject. It is a starting point of the meanings as well as the sedimentation of various meanings and experiences that form background for the new meanings and norms. In this way, self creates new meaning along with all such pre-existed cultural and historical practices, meanings, and values (Heinamaa 1997, 26).

Similarly, seeing the human body only as a biological organism is insufficient to provide a comprehensive understanding of the living embodied subjects. With the suspension of all scientific, medical, and existential prejudices and assumptions, our bodies come in front of us as beginnings of new meanings, actions, and scientific acts rather than as mere physical objects for analysis. Merleau-Ponty (2005) claims that the scientific theories of external bodily functions are inadequate for grasping the internal dynamics of human bodies in terms of their experiences, functions, and activities. A comprehension of these dynamics discloses the intertwined and intersubjective nature of body. In other words, our body engages itself physically as well as mentally and socially when it encounters with the world and other worldly subjects and bodies. The intersubjective engagements of the body with the world indicate that it is not simply a biological organism but an ambiguous phenomenon that is neither totally associated with inside the world nor it is outside the world. Merleau-Ponty writes, “The world is wholly inside and I am wholly outside myself” ( Heinamaa 1997, 151). For Merleau-Ponty, the human body is not just a fact but a medium of experiencing and having the world.

De Beauvoir investigates the nature of women’s body as an existential phenomenon that is not purely a body but a sexed body encountering the world as a feminine embodied subject. On woman’s question, de Beauvoir (2009, 41) reiterates, “If the body is not a thing, it is a situation: it is our grasp upon the world and the outline of our projects”. For disclosing the primacy of women’s bodily phenomenon as situation, de Beauvoir insists that we have to go beyond body as a biological fact and embrace it as a living and experiencing body. She writes, “It is not the body-object described by the scientists that exist concretely, but the body lived by the subject” (de Beauvoir 2009, 52). This lived body is not an inert biological object for experiments but a concrete particular and sexually differentiated body whose lived experiences are situated within the realm of its feminine subjectivity in relation to other’s subjectivities. For de Beauvoir, the basic feature of women’s body is grounded the way it is valued and given meaning in patriarchal social structures. She argues, “But I refuse the idea that [the biological facts] form a fixed destiny for her. They do not suffice constitute the basis for a sexual hierarchy… they do not condemn her for ever after to this subjugated role”(de Beauvoir 2009, 45).

De Beauvoir traces the emergence of patriarchal definition of woman that uses the term “womb” as an alternative meaning of being women. A woman is essentialised as mother. Patriarchy projects their bodily maternal function as their essence which is actually a situation. In contrast to this, man is a transcendental subject who not only defines himself but women also. Women are circumscribed and biologically condemned to perform their bodily procreative role and considered as inferior embodied objects, whereas men are privileged and hailed as capable of transcending their bodily boundaries and consequently privileged as rational subjects. He is the man. Being defined thus, his horizon expands naturally and socially, but, for women, she is just an “ovary”. Acceptance of such a view situates her into the social realm of maternity, and her medical objectification is justified biologically in terms of maternal instinct. She loses her specific maternal experience as a woman in technologically sophisticated societies.

Since motherhood is a social situation for de Beauvoir, she states that maternal instinct cannot be a natural fact for women. De Beauvoir provides instances of various voices of mothers’ attempts to show that maternal instinct or desire is as non-natural and as complex as motherhood itself, in contrast to both biology and traditional narratives. There is a woman who desires to “retain”, the other woman “to expel the foetus” or she may have conflicting desires during her pregnancy. For a woman, pregnancy may be seen as “enrichment”, while for another woman it is “alienation from her body”. A woman may feel proud about her swelling belly (Zerilli 1992, 123) and expansion of her bodily consciousness, but for another woman, it may be a distortion of her body and self. De Beauvoir sees the desire for maternity as an ambivalent feeling. A desire, or a lack of desire, for becoming a mother is neither maternal not antimaternal but rather a mixed and contradictory feeling (quoted in Zerilli 1992, 120) that cannot be generalised as the maternal instinct for all women. De Beauvoir (2009, 570) claims that “maternity is strange compromise of narcissism, altruism, dream, sincerity, bad faith, devotion, and cynicism”. This leads de Beauvoir (2009, 554) to reflect upon the ambiguity of maternal feeling as she underlines that “the meaning of pregnancy…[is] ambiguous” in contrast to the biological meaning that claims that it is an inevitable maternal instinct.

In this fashion, maternity should be a personal choice rather than a decision made under social coercion. Like de Beauvoir, Young (1984, 47) believes that “Pregnancy can be experienced for its own sake, noticed and savored. This entails that the pregnancy be chosen by the woman, either as an explicit decision to become pregnant, or at least as choosing to be identified with and positively accepting of it”. Ironically, women often do not make their maternal choices. People think that maternity is not even a personal choice or experience that women should have. It is their destined biological or a medical situation and women take it as the chance of the approval of their existence. Adrienne Rich (1976, 6), in her book Of Woman Born, states “as soon as I was visibly and clearly pregnant, I felt, for the first time in my adolescent and adult life, not-guilty. The atmosphere of approval in which I was bathed—even by strangers in the street, it seemed—was like an aura I carried with me, in which doubts, fears, misgivings, met absolute denial”. This attitude depicts the undeniable socio-cultural influence surrounded to motherhood which automatically becomes natural to women.

In this way, existentialists reject biological determinism by arguing that lived experience is valuable than biological facts that are inert in themselves and get their meanings from various contexts such as economic, social, and psychological. Such facts play an important role in social situatedness of women as mothers, yet they do not carry a complete experience in itself. In this sense, mere biology is inadequate to define the existence and meaning of being a woman. Thus, reducing women’s life to their immanent biological function by medical science is the source of their subordinate position and oppressive experience as child bearer instead of their emancipation.

Conclusion: Searching for a De-medicalised Medical Approach

To that end, it can be said that the medicalization of a woman’s body and her maternal self is less scientific and more like a social process. The primary purpose of women’s medicine and health care is to emancipate them from their bodily boundaries by providing them real opportunities and freedom. However, medicine is used as a patriarchal rhetorical tool to established control over their reproductive bodies to fulfil social desire. Due to this, medicine has increasingly become an institution with broad and strong social, legal, and religious authority (Young 1984; Zola 1972). The pervasive social and instrumental medical control over reproduction internalizes and objectifies natural process of birth in a way that women feel medically dependent, alienated, and fragmented from their own body because medical experts define reproductive process and normal pregnancy symptoms as a disease in medical terminology. Procreation is a natural phenomenon and matter of personal choice. But patriarchy essentialises women as mothers. This patriarchal ideology of motherhood is further strengthened by medical biologists, determinists, and scientific thinkers to justify women’s biological destiny as a mother. I have discussed how existentialist phenomenologists and feminists have advocated the value of women’s maternal lived experience rather than considering them mere biological facts. As de Beauvoir points out that a woman’s body and her maternal experience are ambiguous. It is not purely a biological body but social situatedness that should not be reduced to either one of these two aspects. I argued that female body is biologically and medically defined and given meaning by a masculinist socio-cultural situation that mandates patriarchal institution of motherhood and glorifies women as mothers but rejects the possibility of maternal bodies ever becoming subjects. They devalue their personal maternal experience by medicalizing it and making part of a technologically sophisticated world where natural is a medical disease. A woman is not just biologically destined and socially situated to procreate species. Now the serious question is not what is to be a female or woman, but the question is what scientific technology and medical model have made her today! In this scenario, we need to introduce a “de-madicalized” understanding of body and maternity. It is high time to expose the truth of medical enterprises and pharmaceutical companies who are more interested in commercialization of body instead of introducing a healthy setting in a professional world. We further need to develop an egalitarian and alternative masculine environment where women’s bodily ideals and health issues get unbiased attention. We cannot deny the value of medicine in health, but we need to work for medical reforms, reforms in terms of demedicalising health care and medicine in the context of women in a real sense. Natural experiences such as maternity and birth should not be associated and defined as a disease in medical terms. Also, medical-technological treatment should not be considered as the final answer to all problems (Riessman 2003, 60). For this, we need to extend our knowledge and careful selection among available choices and search for other non-medical alternatives that are less dangerous and helpful in the holistic growth of human life. Thus, there is an urgent need to resituate and reconceptualise our pervasive medico-biological understanding towards a woman and her maternal body and the way medical experts explore the term “natural” without incorporating women’s lived experience. This understanding manifests the ambiguity of maternity and provides possibilities to change women’s medicalised situation. De Beauvoir (2009, 767) aptly concludes at the end of The Second Sex, “Once again, to explain her limits we must refer to her situation and not a mysterious essence; the future remains wide open…”.

Declarations

Conflict of Interest

I declare that no conflict of interest is involved in this manuscript.