Casper, Monica J. : University of California-Santa Cruz

MONICA J. CASPER is an assistant professor of sociology at the University of California, Santa Cruz. She is also affiliated with the Stanford University Center for Biomedical Ethics. The work upon which this book is based won the 1996 dissertation award from the American Sociological Association's Medical Sociology section.

"Fascinating! Casper's work on fetal surgery is cutting-edge scholarship. The author uses the methods of qualitative, grounded sociology in the service of science studies and women's studies to produce a compelling, well-researched analysis of the history and social practices through which fetal surgery is currently emerging. In doing so, she provides substantial food for political thought."

--Rayna Rapp, professor of anthropology, New School for Social Research and co-editor of Conceiving The New World Order.

Rutgers University Press Web Site, November, 2000

A fascinating and provocative look at fetal surgery, one of the most promising yet disturbing practices of our time.

It is now possible for physicians to recognize that a pregnant woman's fetus is facing life-threatening problems, perform surgery on the fetus, and if it survives, return it to the woman's uterus to finish gestation. Although fetal surgery has existed in various forms for three decades, it is only just beginning to capture the public's imagination. These still largely experimental procedures raise all types of medical, political, and ethical questions. Who is the patient? What are the technical difficulties involved in fetal surgery? How do reproductive politics seep into the operating room, and how do medical definitions and meanings flow out of medicine and into other social spheres? How are ethical issues defined in this practice and who defines them? Is fetal surgery the kind of medicine we want? What is involved in reframing fetal surgery as a women's health issue, rather than simply a pediatric concern? In this first ethnographic study of the social, cultural, and historical aspects of fetal surgery, Monica Casper addresses these questions.

The Making of the Unborn Patient is the first book to examine two important and connected events of the second half of the twentieth century: the emergence of fetal surgery as a new medical specialty and the debut of the unborn patient. Drawing on a wide range of sources, Casper shows how biomedical work has intersected with reproductive politics for three decades to generate new cultural meanings of fetuses, women, and medicine itself. Since its inception, fetal surgery has been controversial both inside and outside of medicine precisely because it transgresses a number of boundaries, challenging our most cherished assumptions about pregnancy, maternal sacrifice, fetal life and death, and the limits of technology. Like many other medical innovations, especially those at the beginnings and ends of human life, fetal surgery is proceeding rapidly but without careful reflection about what it means and without public debate about its consequences. Fetal surgery is risky, expensive, and fraught with peril for both women and their fetuses. This book offers a critical social and cultural analysis of this nascent yet significant innovation in biomedicine.

Analyzing original data, Casper explores early fetal surgery efforts and the emergence of the unborn patient in the 1960s. She examines several related practices, including fetal physiology, diagnostic technologies, animal experimentation, and fetal wound healing research, and the ways in which they have shaped fetal surgery. She presents ethnographic data collected at one of the premier U.S. fetal treatment facilities, offering a behind-the-scenes look at the various kinds of work involved in operating on human fetuses. She also examines the many ethical dilemmas involved in research on human subjects in experimental fetal surgery. Perhaps most significantly, the book draws attention to the many ways in which fetal surgery affects women's health.