Hello and welcome to FAB Gab. This is the podcast for the International Journal of feminist approaches to bioethics brought to you by fab Network. My name is Kathryn MacKay. And today I'm joined by Jeanne Proust from Fordham University to discuss her paper which is entitled women and their uteruses, symbolic vessels for prejudiced expectations, which is co authored with Paola Nicholas and Margaret Fabiszak. Hello, Jeanne. Hi, there. Thanks for joining me today.
So glad to be here. Thank you for having me.
Not a problem. So I wonder if you could get us started by giving the listeners a kind of elevator pitch of your paper.
Right. So this paper was very interesting to write to me, because it's kind of finds itself at the crossroads between gender ethics on the one hand, and bioethics on the other. And basically, we were asking ourselves with the two other authors. Why that started there? Really? Why do we have so many hysterectomy is in the United States? And why we were thinking about hysterectomy is we're like, well, maybe we should ask ourselves also, what relationship do women have with their uterus with the uterus? So that's really where it started. And then we kind of broaden the question to more of a general reflection regarding reproductive rights, but really about mostly, I would say, a reevaluation of the perception we have and the expectations we might have of women Uteri. So it's about really, I would say, an exploration of cultural representations that we have of the uterus. And also, I would say something that challenge is a very common view regarding the uterus as a container, as a male, your cavity, a recipient. And so we want to see what that also, of course entails in terms of ethical problems. But more broadly, it's really about elucidating different narratives that we might find in the medical world, but from women themselves as well, that might have to do with perhaps an essentialist approach where basically, if women associate with the uterus, they actually might also consider that the uterus is the part of the woman who then that it's a very important thing. Also, you find other feminist discourse would say, actually, the opposite that uterus might be or should be separated from womanhood. And so we found it interesting to just explore what is said about the uterus today, how it informs our policies, how it informs medical practices, but also how it might have to do with a lot of culturally, you know, cultural biases that are extremely deeply ingrained within our society, and how maybe the narratives even within a feminist discourse might actually contradict itself. So that's, that's basically what we aim that at exploring.
Yeah, and some of the data that you presented in the article was interesting to me, I didn't realize that the United States had such a high rate of hysterectomy. And you said that that's one of the things that kind of prompted this paper.
Right. So there is of course, you know, the ongoing abortion debates, though, at the time, it was not as heated as it is today in the US, right. But there is also you know, accounts of false Tyrion sections. And I would say here, I would say perhaps the personal experience of Paola Nicola also came into the picture because she just gave birth to two boys and she went really within that medical system in a certain hospital that would, you know, behave, the medical team would behave a certain way with her and that also made her question, you know, what, what, you know why? Why is it C sections would be so encouraged, for instance, and then yes, indeed, the United States has one of the highest rates of hysterectomy is in the world. And so we were just asking yourself why. So, what are exactly the factors that play within that high rate of austerity tummies?
Yeah, yeah. So what were some of the main points of exploration in the paper then?
Right. So really, we want to encourage with this paper, the phones for female health research that are still very scarce. If you look, for instance, at NIH funding for endometriosis, or for uterine fibroids, you actually don't have a lot of funds that are allocated to such research in comparison to other you know, chronic conditions. There is really a lack of research also about hysterectomies, side effects are more generally about, you know, study of the nature of the functions and the representation of the uterus. So we really want to kind of contribute to, you know, to re revitalize I would say that that debate, so this need for really a holistic review. ration of perception of the uterus basically tackled, I would say several parts. First of all, we were really exploring what KingMa has to say in a very great article that I highly recommend called, were you a part of your mother, we wanted to explore what Kimber has to say about what she calls the containment view versus the path with view. So she defends actually the path of view, which is the idea that as a as a fetus, or when you're, as she calls it, the first step, you're actually part of the Gavi, that which is the pregnant person, you are not the gravedad of the pregnant person is not merely a container, it's not a male vessel, not a man incubator of a passive recipients a receptacle. And that's also that's an interesting conception, of course, because in comparison, again, again, regarding our representations, you look at the way human sperm is being described, when we speak about procreation. It's often described as an as very active, you know, a part of agent almost in military terms, for instance, versus the uterus is always seen as this kind of hollow cavity waiting basically to be filled. And so but basically, she says, well, actually do uteruses. Yeah. That the it's interesting when she actually, you know, switch is the world of you. Well, well, actually, no, it's the if there is Foundation, the fetus is actually part of the mother part of the Kavita or the pregnant person. And so she actually argues for that with very, I would say, technical arguments about functional integration, metabolic unity, interdependence, basically, between, you know, the fetters, and the mother, the topological contiguity, also, between basically the, the fetus and the mother. And so that's, that's that, for us was very interesting to examine. But then we wanted to kind of go a bit further than that. And so well, when we are part of our mother, that's one question, but also is a uterus, a part of us as woman is really well, we shifted the focus, which is not that, you know, KingMa doesn't seem to consider this question as interesting. But we just wanted to kind of expand what she's been saying about the portrait view, and shift the focus from basically, the relationship between the fetus and the mother, to the relationship between the woman and their utility. So that's where then we looked at, I would say, more the density of the muscle potentially also other functions that the uterus might have other than procreative function. So that's, that's also something interesting. And just to finish about, like the last main point, I would say, artist, the point that I deemed to be the most interesting is really the conundrums in which we fall when we start asking about the uterus as as an important organ for womanhood, right? So, for instance, what one of the ambivalent narratives that I was exploring is that either we want to promote, we hear discourses that promote an essentialist approach, where the uterus is really emblematic of womanhood. Or we imply that the uterus is a dispensable organ, useless outside of for production. And so it's interesting for me to kind of try to not be afraid of seeing that there is a contradiction here, or maybe try to see a way of making this discourse compatible in a way. So that's where basically, we ended the article also focusing on views about transgender woman, for instance.
It's an interesting question, I guess I wondered. It's not exactly that. Or maybe it is. So let me rephrase. Is it the case that anybody would think that a uterus isn't a part of the woman or a part of the person's body the way that we might have this debate about, say, a fetus in the part hood container model? Or is it rather that, you know, people would maybe acknowledge that the uterus is a part of the person's body, but that it's useless if it's not, like actively just eating or something like that?
Right? So that would motivate a lot of hysterectomies, is for instance, you know, post menopause is, you would find a lot of women where we say, well, you know, you don't need it anymore. So let's just remove it. That's something that we just wanted to question and there has been a lot of interesting research quite quite, you know, recent research about for instance, functions such as a maybe the uterus has a function in female sexual response, it might contribute to lubrication for instance, but also to ascertain, you know, equilibrium in blood flow and muscle contractions that participate to arousal and orgasm. So that's one thing. Another thing that some study have tried to shown even though you know, it's still very much ongoing in fresh as a research domain. It is about cognitive functions that might actually have something to do with the uterus. So because of the interrelationship between the nervous system that has that is within the uterus, and other parts of the body, it might be that actually hysterectomy is might actually affect cognitive functions. There has been, for instance, tests run on I think female rats, on which we actually observed that they lose spatial memories when they underwent an a hysterectomy. And lastly, another function that is also interesting to consider is the fact that the non pregnant uterus might be an endocrine organ. So very often we know that varies on the Queen organs, of course, they produce hormones, but it seems to be that the uterus also has that function. So that's something we also want to keep exploring or kind of encourage a researcher to explore. And that might kind of challenge of us that the uterus is merely basically a reproductive organ.
Interesting. So I think you kind of touched on this maybe a little bit with some of Paola's motivations behind writing the paper, but I wanted to ask anyway, if there was anything in particular, that motivated the writing of it.
You know, it was funny for me, it's, so I actually. So personal note, I never wanted children. And pregnancy is not something that I'm really interested in, in, in a personal way. But I've had, you know, I'm at an age where a lot of my, my close friends, a lot of people in my family are having children. And I've been hearing a lot of different. Different, I would say, indignation in regards to either obstetric violence, in regards also to perhaps some reflection of certain friends of mine, realizing that they didn't know much about their own uterus, unless, you know, they actually got pregnant, and then they got to know more about it. And that actually brought me back in time into my classes in biology when I was, you know, a teenager. And I remembered that the uterus very often was presented to us in a coronal plane, meaning in the frontal view. And this frontal view, if you look at it tends to emphasize the representation of uterus as a whole cavity. Whereas if you look at way more way, Ray, her views of the uterus have, you know, pictorial representations of it, you have also the possibility of representing it as in the past digital plane, which means a side view, where we can visualize way more all the muscular structure, the density of the organ. And so that made me think about even pictorial representation. For example, another example would be during an ultrasound, also, a friend of mine told me it was funny, because, yes, I have the impression, my uterus is a vacuum, it's a void, because the fetus appears during ultrasound in white on a black background of amniotic liquid, right. So that also conveys an idea of a fetus growing inside a uterine cavity, instead of within the uterine wall, which is where, you know, KingMa is coming from when she speaks about the path with view, right? And this uterine wall constitutes the essential structure of the uterus, not its wholeness. So that's kind of where I was coming from in regards to winter. That's interesting that even the images that I have the first image that even pops in my head, or pops in my, in the heads of certain friends of mine, when they were asked to draw a uterus, I don't know if you remember, within the article, there is this drawing from a friend of mine, actually Nino who I was asked during, during her home, you know, when she was going to the hospital before to draw her uterus, she drew an empty circle, basically. And so I found that interesting, and I wanted to just develop on that. Whereas I had other discussions with my sister was a biologist, and she was telling me what the uterus is not an empty place at all, actually, the lumen. There is a very small part of the uterus. And what is the lumen? The lumen is the low light, basically, one could say it, it's that's the etymology of the word. It's where indeed, we could speak about a cavity. But really what makes the uterus is definitely this density. And so really, the goal of the article for me was, you know, through this kind of literal sense of density of fullness of the uterus, again, speak also about the density of the symbolic weight, basically, that we tend to attribute to the uterus. And so that's kind of what I wanted to debunk and explore with this article.
Yeah, that's fascinating. So did you find that there were any sort of particular challenges that you faced when you were writing the paper?
Um, several challenges for sure. So first of all, it was it was Currington. So that has its own challenges. And I do think you need to be able to very well communicate with the people you are getting ready to write an article with. It hasn't been too challenging for me in terms of, I would say, a respect and mutual understanding, but you find yourself confronted to different writing styles. And so that's something that, of course, comes into the picture, in terms of okay, do you know, I don't find that this passage is very clear, etc. So how can we make that clear, so that was something that a lot, a lot of, I would say, back and forth, that's, you know, actually corresponds to a lot of time spent, that probably you can avoid, if you write the paper by yourself, right. But I would say this is, you know, while that might be a downside, I think the feedback from the people you're writing the article with is actually extremely stimulating intellectually. So I would say for, you know, for people who are starting research, starting with a co authored article might actually be a good strategy in the sense that you experience the research project with different voices that have also their own, you know, challenges with the academia have also their own, you know, ways of writing conception of what clarity means or structure means within an article, etc. aren't afraid, in different ways of the feedback that the commentators might give, you know, when they will have read the article. So it's interesting. Yeah, I mean, another challenge, of course, that's not related to the co authoring, of course has to do with you know, the the comments that that you might receive from from the journal, and I have to say that each fab has been extremely, I would say, benevolent, are extremely patient with us, and really willing to publish. And so we really had the time to revise the time to reorganize the article in a way that made more sense to them. And, and that also was extremely, I would say, Yeah, intellectually stimulating, because I didn't think for instance, the order in which the ideas in the article are now presented is very different from the initial order that we had in mind. And nonetheless, now that I reread it, I definitely think that it makes more sense. So it's, it's, it's, it's an interesting thing. And, of course, it is also extremely hard to keep your hopes up, I would say when you are trying to find somebody to publish with and I think one thing that might be, you know, important to tell to people who are about to do research is also like, here's the academia is one of the worlds in which you want to do research in order to have, you know, scholarly care here. But it's not the only one. And I would say, as a proponent of public philosophy, for instance, I would say reach out also to magazines that might be very well interested in your ideas in the, you know, potentially a less formal way, and potentially Freer way of publishing that's also very interesting to explore. So I would say, don't give up if you think that your article has good ideas in it. There might be also other platforms on which you might be willing to just publish, even if it might not have the prestige, of scholarly publication for sure.
That's good advice. So we're kind of coming towards the end of our discussion here. And just to get back to the paper, I wondered if there was any sort of key takeaway message that you hope that readers will glean from the paper?
Right, so just to go back maybe on the technical point, in the paper, when I spoke about the distinction between the containment view and the pathway view, I think it's interesting to see that there is a slippery slope that you can find also on many different levels. So the view that uterus itself, only as fetal containers, can transform the discourse into a discourse in which women themselves become seen as mere containers. Right. So that's also I think, a very important aspect of the paper that is might be not enough emphasized, where we really want to question paternalistic attitudes that we can still find today in maternal care, but also in just, you know, postnatal care of prenatal care that women have to face where really, the importance is being even more to the fetus than to the pregnant woman, and the suffering but also the strength of the pregnant woman are very often underestimated. So I think it's very interesting to bring all this reflection in the medical field as well and to not keep it simply, I would say a theoretical discussion Can we really aim to have some, of course, it's it sounds very, uh, you know, very optimistic and perhaps a bit pretentious to say that. But I think with more articles like this, we intend at least, to also challenge political views and perhaps policies in order to really build a safe place and a frame framework within a woman can find that their respective personal views on the relationship they have, with perhaps their desire or absence they have of, you know, pregnancy or their relationship. They have resilience theories, maybe they say, Well, you know, what, no, we actually don't associate with the uterus, right. But then we need to listen also, to transgender woman who might say, well, actually, and that is taken from studies as well, a lot of transgender woman do say that the uterus transplants, you know, promises, because we're really at the verge of her an immense, you know, change in bioethics. He also, uterus transplants may be a huge thing in regards to procreative rights and a huge step forward for transgender rights. Nonetheless, one can question, you know, if, for instance, how can I pray that I would say, for instance, that perhaps transgender women's aspiration to have a uterus might very well not only emerge from but also reinforce the idea that desire for gestation is a woman needs to be called behavior, right? And that's something that feminist views or a lot of feminist views want to challenge precisely. So that's, that's the kind of conundrums that I think, instead of being just, you know, kind of finger pointing the contradictions, here are the paradoxes here, maybe we should just say, let's find a place in which all these different voices that might indeed not be compatible, can't find a place in the hospital, or wherever also in society in general, where they can be heard, even if they don't function as just a one unit directional voice. So that's something that I think is very, very important as well.
And I think something that I would add, that I think is important in your papers, just taking away how complex the uterus is, and how little we really know about that organ. And there's a lot that we don't know about the female reproductive system in general, things we don't understand very well. But that seems to be one really interesting feature of your paper too, that would hopefully complicate certain conversations that people might have around. Yeah, the uterus, keeping it getting rid of it, donating it, you know, what, it's what it's doing in the body in general.
Right, absolutely. So here, again, I go back to what I said about the density of not only the organ, physically, but also the density of the concept, right. And the many layers also literally, literally and metaphorically, that need to be taken into consideration when we speak about the uterus. So it's interesting, actually, to see that this density can be used, of course, in a progressive discourse, as we are trying to do in the paper where we are trying to say, Well, precisely, let's look at this at this. It's not an insignificant organ, it's something that actually we're lacking research on, etc. But it can also be hijacked in a conservative discourse, replicating the patriarchal view that the uterus is an essential, very important characteristic of womanhood, right. So we find ourselves also in this kind of working on eggs, if I no pun intended, you know, where we actually find that, well, even when the powerful density or significance of the uterus is acknowledged, the function of it is mostly conceived still as ancillary, the uterus is still meant, very often, as you know, a receptacle for another entity, potential features, then, you know, then then really something important for the person themselves, therefore minimizing also the potential conflict of interest that there might be between the fetus and their mother. If I might say maybe one less thing that I think we should actually emphasize in the article is also the huge discrepancies regarding you know, racial bias, where, you know, that is something that we point out to us in the paper, but it's not, I think, emphasized enough, and maybe, you know, this article calls for further, you know, research in that regard, where, of course, it's now well known that African American woman are almost four times more likely to undergo an aesthetic Tomi, actually than white woman. And it's not only about the fact that Uterine Fibroids in African American woman is indeed you know, there is a higher incidence of it, but it's not it's not actually it does not fully account for this discrepancy in three admits between African American women and white men. So that's something also very, very interesting that I think we should be talking about. So it's not only about women in general again, but it's about the different voices of women. So the intersectionality here is also extremely important to take into consideration when we speak about woman's relationship to their uterus.
Yeah, yeah, definitely. Well, thank you so much for speaking with me. This was really great.
And thank you so much for having me. It's been a pleasure. It was a pleasure.
Yes. Thank you for listening to this episode of FAB gab. You can find Jeanne's paper linked in is episodes notes along with a transcript of our conversation. Fab Gab is hosted and produced by Kathryn MacKay. You can find our other episodes on Spotify, radio, public anchor or wherever you get your podcasts as quality. Thanks again for listening. Bye