Category Archives: pregnancy diagnosis

Frogs and annunciations

As soon as the doctor told her she was pregnant, she felt frail and nauseous, although she had not done so before.

‘But are you sure?’ she asked, foolishly, she felt, picking up her skirt and stockings. The doctor was washing his hands.

‘Oh yes,’ he said. ‘No doubt. Better book you into a maternity hospital.’

She laid a hand wonderingly on her stomach.[1]

This is how the writer Angela Carter imagined a pregnancy diagnosis at eight weeks in her unpublished short story ‘The Baby’ from about 1961. The skirt and stockings on the floor, the doctor washing his hands: Carter imagines an internal examination. ‘The Baby’ is intended to be naturalistic – a woman discovers she is pregnant and worries, particularly about her relationship with her partner. The story is mostly not magical realism of the kind that made Carter famous. However, an eight week pregnancy couldn’t, indeed still can’t be, determined by internal examination and so the story in this excerpt is inadvertently magical, more like a fairytale than anything true to life. Carter imagines the doctor here as all-knowing, even as having special powers.

One of the things that the conceiving Histories project is trying to do is to look at the history of not-knowing, a history of the time when people are wondering ‘am I? aren’t I?’. Part of what we want to look at is the search for a diagnosis in that in-between time and the desires and fantasies generated in ignorance. In ‘The Baby’ the protagonist feels foolish because she doesn’t know and the doctor does. But there is an even more profound unknowing which may be the source of the sense of foolishness described here.

Before it was possible to piss on a stick to determine pregnancy, urine was injected sub-dermally into animals. For much of the twentieth century it was frogs, mostly South African clawed xenopus laevis toads – aquatic, carnivorous and tropical. Frogs because they emitted eggs externally and did so in reaction to the injection of pregnant urine, and so didn’t have to be dissected to get the result. As Edward Elkan, a doctor  who kept a hundred frogs in a tank on the balcony of his flat overlooking Regents Park for testing his private patients in the 1930s, wrote: the xenopus test has the advantage over other tests which require ‘hecatombs of young mice’.[2] The test was as accurate as our pregnancy tests are today.

The logistics of this test, as it developed in the ‘40s and ‘50s are extraordinary. Women’s urine was sent with a fee by post from doctors’ surgeries and pharmacies to diagnostic centres where it was injected into frogs which had been sent by ship from South Africa. The Family Planning Association archive, at the Wellcome Library, is full of documents about the international transport in these frogs.[3] The FPA got their frogs from Peers Snake Farm and Zoo in Cape Town, through an animal transport agent, Thomas Cook and Sons.

London, Wellcome Library, SA/FPA/A3/11/13: Box 23
London, Wellcome Library, SA/FPA/A3/11/13: Box 23

They bought them in batches of 500; mainly these were female frogs but sometimes also male ones. They started getting them in 1949 and stopped in 1963 when immunoassay tests were available. The frog supply was dependent on the weather and the health of the population; sometimes they died in transit. One of the main questions which dogs the archive, to give a sense of the logistical challenge presented by this test, is whether it is cheaper to ship back the containers that the frogs came in or buy new ones each time.

Pregnancy really wasn’t diagnosed through internal examination, then, in the way that Carter imagines in ‘The Baby’. This lack of knowledge isn’t peculiar to Angela Carter. Most people didn’t know how pregnancy was diagnosed at the beginning of the 1960s; lots of medical practitioners themselves had no idea. Lots of people don’t know today that this was the way that pregnancy testing was done for most of the twentieth century.[4] Women got their results from doctors, rather from the test centre itself. Because tests were usually done in extremis, the result was no doubt the important thing, rather than finding out how the trick was done.

The Family Planning Archive is full of all sorts of documents about this test but what isn’t in the archive is much about women themselves, the people being tested. So, on the one hand, we have Angela Carter’s story and a lack of knowledge about how a result was achieved, that is how pregnancy was diagnosed and, on the other hand, the archive articulates an equivalent ignorance or at least a lack of curiosity about the people whose urine was being tested in the frog labs. The labs tested urine, not people.

In response to this, Anna Burel, who is making artwork as part of the Conceiving Histories project, has set about the task of creating a fictional archive which re-introduces the idea of the tested woman missing from the archive.

Frog Work, © Anna Burel 2017
Frog Work, © Anna Burel 2017

She is using the forms of the documents in the Family Planning Archive to do this, picking out the visual elements of telegrams which went backwards and forwards between the Association’s diagnostic centre in Chelsea, Thomas Cook and the snake farm in Cape Town.

Frog Work, © Anna Burel 2017
Frog Work, © Anna Burel 2017

She has also made a number of plaster frogs, each has its own type written label, marked with the name of a fictional person. Each of those tags corresponds to the label on a urine sample bottle.

Frog Work, © 2017
Frog Work, © Anna Burel, 2017

Making fictitious matches between frog and urine, by inserting names, Anna’s work is trying to close the gap between the diagnostic centre, and what went on there, and the lives of people who sent in their samples and waited for results. She is presenting, through the gesture of her figures, an impression of their responses to their results.

Anna and I have been thinking a lot about the annunciation, in relation to the whole project, as a pregnancy test before such things existed; no doubt there’ll be another blog post about it. What a wish-fulfilment fantasy: someone will come from another world and tell me the answer. We have been thinking about the annunciation, too, in relation to the lack of knowledge of the urine/xenopus test. In the traditional idea of the annunciation – when the angel Gabriel tells Mary that she’s going to have a baby in the Gospel – Mary’s pregnancy isn’t just announced it is also brought into being at exactly the same time. Often this is depicted in medieval art by a ray of sunlight, coming through a window, beaming onto or into Mary, sometimes carrying a little image of Christ or the holy spirit in the form of a dove.

Gentile da Fabriano, Annunciazione (1423-5) Pinacoteca Vatican
Gentile da Fabriano, Annunciazione (1423-5) Pinacoteca Vatican

Returning to Angela Carter’s imagined scene, she describes something rather similar. The doctor knows by putting his hands inside her, penetrating her in a mundane version of the divine conception. He magically reports and also symbolically impregnates, putting the foetus into the womb by hand.

Frog Work, © Anna Burel, 2017
Frog Work, © Anna Burel, 2017

Given the lack of knowledge about diagnostic practice, women might as well have been told their results by angels, the diagnostic centre was as remote as the other, spiritual world from which angels are thought to come.

 

 

 

 

 


[1] ‘The Baby’ (c. 1961), London, British Library MS Additional 88899/1/42

[2] Edward Elkan, Sketches from my Life, (1983), p. 56. London, Wellcome Library MS 9151.

[3] London, Wellcome Library, SA/FPA/A3/11/13: Box 23.

[4] One person who does know is Cambridge researcher Jesse Olszynko-Gryn. He is currently preparing a book on the history of pregnancy testing. You can read some of his work and find out more about the xenopus test here.

The Experimental Conception Hospital

In the past medical practitioners were in the same boat as their patients when it came to diagnosing early pregnancy. If you’ve ever wondered ‘am I pregnant?’ you’ll know that it’s not always that straightforward to ascertain. Some people, of course, know it straight away: their symptoms are really strong and when they do a pregnancy test it’s confirmed. Others experience things differently. They might not be sure at all but getting a positive pregnancy test sorts it out for them. Those that get a negative result may have to wait a little longer to find out but, eventually, a negative is a negative and they can be sure. The ambiguity of early pregnancy is capped for us, in a way that it wasn’t in the past, by reliable tests and sonography.

Just like their patients, modern medical practitioners also have a wait before they can rely on the tests and scans. In that wait they may well feel for their patients, recognizing that the wait isn’t very easy especially if they’re waiting like this every month for years indefinitely. They don’t, though, endure the wait in quite the same way; they have lots of patients and no doubt their own preoccupations. The cap provided by modern testing technologies means that they are removed from a considerable predicament which medical practitioners faced in the past. Of course, practitioners’ concerns are different from those of their patients. Whilst some of them worried about pregnancy diagnosis because they wanted to help their patients, others worried for themselves – for their medical reputations – and others worried for society at large. After all, if you can’t diagnose pregnancy it is hard to establish paternity and so ensure correct title and property transfer, those things which underpinned social, economic and political life. In societies which put a lot of store in blood lineage, a woman’s curiosity about her condition and her future were much less important than male anxieties about whether their children were their children.

Sadly we don’t have as much historical evidence as we would like about the feelings of ordinary people who were trying to conceive and not having much luck. But what we do have is quite extensive evidence of the difficulty that practitioners report about trying to diagnose pregnancy. Looking at that evidence exposes as age-old some of the perplexities within the experience of trying to conceive and, because of this, thinking about those difficulties in the past may help us to think through our own today. Sometimes it’s easy to think that in our modern times we are peculiarly impatient, peculiarly unused to desires not being realized, peculiarly anxious to know about our futures; it’s easy to imagine that people in the past accepted unknowns more readily than us. However, that’s not what the archive shows. People in the past were just as eager as we are to know things and they thought hard about how they could to come to know them.

The Experimental Conception Hospital is a fictional laboratory invented in relation to a legitimacy case in 1825-6. It is an extraordinary idea about how conception might be pinpointed in a time before the relationships between menstruation, ovulation and the processes of conception were fully known. Our project has been working on this fantasy institution in different ways, writing an account of it for publication but also making art work which takes a different look at the Hospital. We have put together a little 5 minute film (below). The images are part of a long piece of artwork which Anna Burel is making to present the Hospital’s 100 female experimental subjects. They are in different stages of undress and take up different postures. They are waiting, queueing perhaps. They are faceless, wearing masks. They are just numbers. The sound gives the full text of the Hospital’s description, detailing how it will be arranged. It is a dream institution which will resolve the questions of law raised by the difficulties of pregnancy diagnosis. It is imagined from a male perspective and gives no thought at all to the people incarcerated and experimented on. It is a dark Gothic science-fiction, an erotic fantasy about walling up women.