PhD project by Laura Louise Heinsen

In my PhD project, I explore the biomedical, legal and moral reasoning and ‘legitimation work’ (Coutin, Maurer and Yngvesson 2002) that shape contemporary practices of 2nd trimester selective abortion in Denmark as well as its social effects. In Denmark, as well as around the globe, prenatal screening and diagnosis have become routine as part of standard antenatal health care. Today, most pregnant women in Denmark undergo at least two prenatal tests; a first-trimester prenatal risk assessment for chromosomal anomalies, and a malformation scan in week 18-20. According to Danish statistics, 99 percent of pregnancies where a chromosomal aberration is found in uterus ends in abortion, and statistics from the abortion appeal court and the Danish regions show that 94 percent of applications for second-trimester abortion because of inborn abnormalities are granted approval. Of the 15.000 annual medically induced abortions, approx. 800 abortion are performed after the legal limit of free abortion (week 12 of pregnancy) each year, of which 80 % are performed due to the detection of a fetal anomaly. This means that on average, two pregnancies are terminated because of fetal anomaly each day. Through ethnographic fieldwork, I aim to unpack the complex social reality behind such figures by asking how very intimate decisions to terminate a pregnancy for fetal anomaly are configured, contested and effectuated in the nexus of biomedicine, law, and the private. I ask; What shapes decisions to set abortion in motion? How is it experienced to terminate the life of a fetus/child, which in many cases was wanted until the detection of an anomaly? And how are decisions to authorize abortion arrived at in the abortion committees and effectuated in the gynecological and birth wards? By exploring these questions, this PhD project aims to generate knowledge about how the operation of the Danish abortion law and its entanglement with biomedicine work, is made to work and its effects on those confronted with it. This involves both those who experience second-trimester selective abortion on their own bodies and the health and legal professionals who authorize and/or provide pre-peri- and post-abortion care in the public health care sector.

This project will explore who is granted access to late-term abortions and how legal decisions are made. Law, legal practice, and legal institutions frame the access to and the practices of the technologies of death and dying of the beginning of life in certain normative ways. Today, almost 900 Danish women a year apply for a late-term abortion that can be granted due to medical or social reasons. To explore the legal position and reproductive rights of these women, this project will analyze decisions of the abortion councils that have never been made available to researchers or the public before. The project will thus shed light on a legal practice that has been shrouded in secrecy. The lack of transparency is particularly problematic since the relevant provision in the Abortion Act is vague, leaving considerable discretionary scope for the regional councils. The project will focuse on the emergence of death by drawing on a legal doctrinal approach and legal critical analysis, but will in cooperation with Heinsen also carry out and use interviews with abortion council members. From a human rights point of view the project aims to shed light on the practices and decision from the abortion councils within the framework of disability rights and stigma contributing to an understanding of how the legal framework and practices can impact and interact with disability stigma. 

This subproject will explore how the legal regulation informs medical practices of the technologies of death and dying when late-term abortion is allowed and carried out. The legal framework regarding the status of the fetus, the responsibility to provide care for a fetus that is still alive after the abortion, the possibilities of bringing the fetus home, and burying the fetus after the abortion will be examined.

The project will be carried out in cooperation between Herrmann, Bach and Adrian. Joining legal documents with ethnographic interviews enables analysis of how technologies remake how the dead body is managed before its disposal or the funeral is carried out.

This project focuses on how dead bodies are handled and disposed of when death occurs at the beginning of life and how legal conceptualizations, social norm, technological possibilities and bodily materiality entangle in these practices. Additionally, the project examines the use of ‘memory technologies’ and the cultural  negation of being the parent of an ‘invisible’ child. Particularly, the project is interested in how relational practices of technologized memorialization (re)configures how we live with and grieve the dead, but also how an unlived life can unfold.

How do parents who have lost a child, or women and men who have terminated a pregnancy, live with the remaking of death and dying through technologies? This is the main question to be answered by this study. The study will focus on severe congenital heart defects as a diagnose-based critical case, because the potential number of advanced technologies involved are high. In addition to prenatal screening potentially followed by abortion, fetal surgery, and highly advanced and experimental heart surgeries after birth, raise questions regarding the responsibility for death, as multiple outcomes for the child can occur, depending on which decisions are made (i.e., abortion, death without interference, or surgeries with the prospect of death or severe neurological damage to the child). Inspired by Layne and Jain, Adrian will draw on a combination of autoethnography and 15 interviews with men and women who have lost a fetus or a child diagnosed with HLHS or other severe congenital heart defects. Drawing on this critical case and TechnoDeath’s other studies, this project will also secure the theoretical contribution to the field of reproductive and death studies by theorizing the remaking of death through technology. Inspired by Adrian’s theoretical and methodological work on technologies of life conceptualizations of how emergence takes place will be turned around, focusing on the technological remaking of death. This will be done combining agential realism, Haraway, and concepts of biopolitics and necropolitics.