What to Expect When You’re Not Expecting Pregnancy, Miscarriage, and Constructing Risk at Advanced Maternal Age

Abstract

Existing research has explored the rhetoric surrounding women’s health, fertility, and motherhood, as well as the effect of medical discourse practices on patients’ understanding and decision-making in reproductive and other health contexts. I build on this work to examine the use and impact of common language surrounding pregnancy and miscarriage, especially for older mothers—particularly the terms advanced maternal age, blighted ovum, and expectant management. Drawing from rhetorical and autoethnographic methods, I argue that these terms function constitutively to shape sense-making about processes that otherwise exist only sub-clinically, and do so in ways that reify risk but also clearly demarcate the limitations of medical care. Broadly, this research contributes to our understanding of the ways that medical rhetoric shapes experience and understanding about reproductive health-related issues, and it also provides a foundation to more effectively communicate with pregnant women, and especially older mothers, about their care options.