Five Decades of “Semiotic” Fetal Imagery in the US: Part 1

Emilie Egger // In July 2019, Dr. Leana Wen resigned from her post as president of Planned Parenthood, citing philosophical differences with her former employer. In an op-ed published in The New York Times published days after her resignation, she summarized their differences as medicine versus politics.

“I have long believed that the most effective way to advance reproductive health is to be clear that it is not a political issue but a health care one,” Wen wrote. “I wanted to tell the story of all of [Planned Parenthood’s] services — and in so doing, to normalize abortion care as the health care it is.”

Wen has a point. Abortion certainly counts as medical care. It is also intensely political, a fact no one living in the United States would dispute. Indeed, Wen’s argument—calling abortion apolitical—sounds like the radical position in a country in which abortion laws are constantly contested.


While abortion has a complicated history of controversy (and normalcy) in the United States, the most ardent coordination of anti-abortion activists has occurred in the years after the Supreme Court decision Roe v. Wade (1973). This era has also coincided with the widespread use of fetal imagery in medicine and politics. This trend toward the multivalent “visualized fetus” began in the 1970s, a shift which historian Johanna Schoen has written “reshaped the social meaning of pregnancy” (Schoen 15).

This piece will outline five decades of fetal imaging since the 1970s and contour the disconnect between how some medical professionals view fetal images as primarily informational and the general public’s long-mediated relationship with the same pictures.


No matter how advanced, detailed, or annotated, fetal imagery never provides straightforward meaning; rather, as historian Julie Roberts writes of ultrasounds, it is “semiotic,” and takes on the priorities of the society in which it exists. In the United States, anti-abortion activism has led to the widespread semiotic conflation of fetuses with babies and an associated set of political consequences. 

The 1975 case against Boston obstetrician Kenneth Edelin illustrates the beginning of this phenomenon. Edelin was charged with manslaughter after performing an abortion procedure called hysterotomy on a patient in her sixth month of pregnancy. When jurors saw photographs of the fetus, they convicted Edelin of “killing a baby boy.” When Edelin was questioned by the prosecutor about his actions, he calmly described the process in medical terms: “I placed the fetus in [a] stainless steel container [and] I turned my attention back to the patient.” The prosecutor seized on Edelin’s focus on the pregnant woman as his sole patient (Dubow 95). The case led to a temporary ban on all research on fetal specimens in 1974. While Edelin’s conviction was later overturned by the Massachusetts Supreme Judicial Court, Dubow argues it shifted women’s responsibilities vis-a-vis their pregnancies and put the movement toward fetal personhood into full force (Dubow 78).*

Anti-abortion activists, especially members of the surging Religious Right, drew on this conflation of the fetus with a fully developed baby, the moral-political victory of Edelin, and the ability to mass produce images to push for fetuses to be recognized as full people. Moreover, obstetric research care also began to absorb these dynamics. By the 1980s, scientists and doctors had developed dubious theories of ultrasound bonding, first published in the New England Journal of Medicine (1983) and the British Medical Journal (1980). These theories were embedded in centuries-old understandings of women’s relationship with their pregnancies, such as the sixteenth-century theory of maternal impressions and more recent twentieth-century theories of attachment. Yet medical scholarship did not extricate what became known as “bonding scans” from their historical context, and the language of bonding “seeped into the vernacular” (Roberts Chapter 5). 

In 1984, obstetrician and anti-abortion activist Bernard Nathanson released The Silent Scream, a 28 -minute film in which he narrated an abortion procedure of a fetus of 12 weeks gestational age (Dubow 159).  Medical professionals discredited the film as deceptive, namely in its depiction of the fetus as larger than its actual size and the speeding up of film to (falsely) indicate the fetus was reacting in pain. Yet, as historian Rosalind Petchesky has written, “The Silent Scream brought instant stardom to the foetus,” and both the public and medical communities continued focusing on questions of fetal personhood at the expense of pregnant people. 

Screen Shot 2019-10-18 at 6.01.07 PM
Still from A Silent Scream (1984)

Pregnant people were cast against this fetus-in-pain, and their behavior was policed accordingly. Public service announcements used doctored ultrasound images to warn against the effects of drug and alcohol use by pregnant women; illustrators created images of fetuses smoking and drinking in utero and equated a pregnant woman drinking to someone giving their baby alcohol. While these dynamics hurt all pregnant people, they especially mapped onto longstanding racialized sexism and classism in the United States. Black mothers were characterized as “welfare queens” who did not adequately care for the babies in their wombs. Women who used drugs (and many who did not—again, especially Black women) were accused of irrevocably harming the “crack babies” in their wombs. Legal scholar Dorothy Roberts writes, “portraying Black mothers as irredeemable drug addicts who are their children’s worst enemy supports the view that population control is the only answer to Black people’s plight” (D. Roberts 154, 179).

Screen Shot 2019-10-18 at 7.05.39 PM
Still from American Cancer Society public service announcement advising pregnant women not to smoke (1984)

Fetal images, whether they were doctored ultrasound photos or exaggerated illustrations, exacerbated these dynamics. Anthropologist Janell Taylor has argued that the widespread production of fetal images in the United States changed the image of pregnant women, who were “…positioned  in new ways relative to work, family, and political life, as well as relative to their sexual and reproductive bodies” (Taylor 51). For white women, the increase in rights for fetuses undermined liberalism’s promises for women in the conservative 1980s (Dubow 7). For women of color, artificial concern for fetal wellbeing played into a case against their right to have children. 

Part II will include an analysis of fetal imagery from the 1990s-2010s. 

*See Sexing History’s podcast episode “Abortion on Trial” for an excellent breakdown of the many racial, gender, class, and religious dynamics of this case.


Bibliography

Dubow, Sara. Ourselves Unborn: A History of the Fetus in Modern America (Oxford: Oxford University Press, 2010).

Roberts, Dorothy. Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (New York: Pantheon Books, 1997).

Roberts, Julie. The Visualized Foetus: A Cultural and Political Analysis of Ultrasound Imagery (Routledge 2012).

Schoen, Johanna Abortion After Roe: Abortion after Legalization (University of North Carolina Press, 2015).

Taylor, Janelle. The Public Life of the Fetal Sonogram: Technology, Consumption, and the Politics of Reproduction (Rutgers University Press, 2008).

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s