Prenatal diagnostic technologies in Germany: Ideologies and histories of reproductive health surveillance

Prenatal diagnostic technologies (PDTs)—primarily obstetrical ultrasound and amniocentesis—provide pregnant women and their physicians throughout the world with more information by which to monitor maternal and fetal health prior to birth than has ever before been possible. In Germany, as elsewhere, reproductive health surveillance has structural origins and ideological roots that undergird contemporary practice. Using both quantitative and qualitative data collection and analysis methods, this dissertation is a case study of how German women came to be among the most prolific users of PDTs in the world by: (1) detailing actual use through descriptive statistics; and (2) analyzing historical and ideological trajectories of prenatal health surveillance. Based on 449 prenatal exam observations and 111 patient interviews divided evenly between two hospital fieldwork sites—one in former East Germany, the other in former West Germany—this dissertation demonstrates how one postindustrial nation has successfully nationalized universal PDT use. But, a decade after German reunification, significant differences in attitudes related to PDT use—about post-diagnostic abortion and disability, women's work and reproductive health—can be correlated to the historical division of the former socialist and capitalist Germanys, thereby supporting the hypothesis that some aspects of reproductive health surveillance are ideologically and historically contingent. Linking the effects of reproductive health surveillance to broader issues of gender, political, and regional identities, as well as to historical developments of reproductive welfare policies and visualizing ideologies is a feature of the dissertation that brings the gendered domain of reproduction center stage as a theoretical focal point through which contemporary German society a decade after reunification can be better understood.