Fetal culture Ultrasound imaging and the formation of the human
Mahmut Mutman and Ersan Ocak

If the medicalization of pregnancy is a defining aspect of modernity, it has reached a new stage with the invention of ultrasound imaging of the human fetus in the womb. The use of ultrasound imaging has become a routine aspect of the experience of pregnancy in  modern urban settings. Viewing the image of the fetus and of its organs, its postures and movements has now become a family rite governed by the medical apparatus and its responsible agent, the doctor or other medical practitioner. Alongside the rapid development of this technological and institutional practice in the hospital cubicle, there is a proliferation of fetal images in the public sphere. As Barbara Duden puts it, ‘we are overwhelmed with fetuses.’ The abundance of fetal images and their photographic renderings in advertising, health campaign literature and so on, in all media forms, can blind us to the fact that the ultrasound fetal image is a very specific form of image produced under particular institutional circumstances by highly sophisticated technology. In what, then, does the specificity of this image consist, and what are the specific technological and institutional processes through which it is produced? What are its political and ethical implications? In this article, our perspective on the ethics and politics of ultrasound imaging is inspired by two major theoretical sources. Employing Michel Foucault’s concept of the medical gaze, we approach obstetrics as a biopolitical regime or discipline of the visible and the articulable, which depends on certain institutional and technological processes and which produces and distributes individual and social bodies. A speculative reconstruction of an alternative obstetrical regime is informed by Luce Irigaray’s understanding of sexual difference.

The medical gaze
The ultrasound is a relatively recent innovation in the medical field structured by what Foucault called the ‘medical gaze’. This is not a merely neutral and scientific gaze, but a complex perceptual–linguistic formation that makes the invisible pathological body visible and readable through the employment of a plurality of senses. The medical gaze required a new concept of pathology as well as a shift in the place of death in the medical field. Following a series of transformations, there emerged in Europe a new concept of disease conceived in terms of the complicated idea of pathological life (rather than disease as an attack on life from the outside), and a new kind of sign – the anatomo-clinical sign, which is not just a symptom but a marginal, restricted, imperceptible sign, diagonally traversing the visible body of the disease.

The concomitant new methods of seeing, hearing and touching attempted to read the lesional signs of disease projectively, to locate disease within the body of the patient. Signs projected an anatomico-pathological series upon the living body; the medical task was now to analyse the series and map the volume of the body. The invention of the stethoscope was strategic in this process. The concept of the ‘gaze’ began to refer to a multiple and complex sensorial field, which Foucault describes as a new perceptual configuration defined by the trinity sight/touch/hearing. This new complex organization made it possible to locate the invisible spatially. Consequently, the medical gaze is now endowed with a plurisensorial structure; a gaze that touches, hears and, moreover, not by essence or necessity, sees.

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