By Tara Penman
On Tuesday, October 21st, I attended the Health Humanities Grand Rounds lecture given by Dr. Virlana Shchuka. I was intrigued by the subject matter, as well as the statement that one of the first feelings mothers have after a premature birth is guilt—guilt that their baby was born too early or too small. But where does this sense of guilt come from?
Dr. Shchuka approaches this issue from an interdisciplinary lens: She first learned about premature birth through her PhD work in Cellular and Molecular Biology. At a conference, a nurse compared a premature newborn to “3/4s the weight of a can of Coke.” That imagery stuck with Dr. Shchuka; it made her wonder where the specific ideas about premature birth in medicine developed. Dr. Shchuka studies the period from 1688 to 1832 for clues on how the narrative of guilt and medicine evolved during the “Long Eighteenth Century” and how it may influence today’s understanding of premature birth.
As a Psychology and English student, I am fascinated by the origins of current mental health disparities. Premature birth guilt, shame, and depression operate differently from postpartum depression and haven’t been studied significantly. Two themes emerged throughout her research: the idea of premature birth as deception, and doctors as unheard advocates.
Premature Birth as Deception
During this time period, 1688 to 1832, the idea of premature birth as deception was established. In this story type, it was believed that women who gave birth before their due date were covering up the fact that the baby was born from a different father, and that the wedding/marriage was designed to distract from the fact that the baby had been conceived earlier than thought. There is a sense of trickery and deception to these narratives: the idea that the father had been “tricked” into believing the baby was his, and the shame the mother feels having to defend her child’s early birth. Evidence of this deception was a healthy child being born. A lack of medical evidence made it seem that a child born healthy, yet early, could have only been made through suspicious means. For example, a minister was stripped of his titles for several years because his child was born prematurely, falsely suggesting that he had engaged in malicious activities.
Doctors as Unheard Advocates
Dr. Shchuka also touched upon what medical professionals at the time understood about premature birth. It was fascinating that both the trimester and the monthly (as we know it) way of viewing premature birth were not thought of in this way. Interestingly, some doctors during this era believed that babies born in the seventh month were healthier and stronger than babies born in the eighth month—an understanding supported by the belief that babies are able to pass through the cervix easier at that time. Also, many doctors of the era were placed at the defense of the idea that these premature births were “deceptive,” using their early medical understandings to underscore that premature babies could live long and successful lives, and that their births had not been a scheme on the part of the mother. Whereas many early medical narratives paint doctors as (accidentally or not) inflicting more pain on their patients, doctors stood in defense of these mothers, explaining that the development of the child matched that of a premature birth.
As Dr. Shchuka’s talk demonstrated to me, looking to the past is always the best way to bring change into the future. Even though the cause of shame for mothers may have changed throughout centuries, this research clues us into the unseen influences. Dr. Shchuka even suggested that epigenetics of stress and guilt—the idea that stress can be passed down from generation to generation—may increase the feelings of shame and guilt in mothers of premature babies today. Writing therapies to deal with guilt and grief may be a solution in the future.
Walking away from Dr. Shchuka’s talk, I feel more inspired about how interdisciplinary research is solving questions thought to have been lost to history. This talk gave me a greater appreciation for qualitative research, and how sometimes the answers to our questions are buried in time.