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This paper presents reflections on commonsense understanding surrounding expression of teenage pregnancy as a problem. It is suggested that ideologies of reproduction go only so far in convincingly accounting for ambiguities contained in social constructions of teenage pregnancy.
This paper presents reflections on commonsense understanding surrounding expression of teenage pregnancy as a problem. It is suggested that ideologies of reproduction go only so far in convincingly accounting for ambiguities contained in social constructions of teenage pregnancy.
This paper presents reflections on commonsense understanding surrounding expression of teenage pregnancy as a problem. It is suggested that ideologies of reproduction go only so far in convincingly accounting for ambiguities contained in social constructions of teenage pregnancy.
pregnancy: a prohlem in the ideologies of childhood and reproduction Abstract There is a commonsense assumption that 'teenage pregnancy' constitutes some sort of a social problem. A neglected aspect of this social con- struction is explored. It is suggested that ideologies of reproduction go only so far in convincingly accounting for ambiguities contained in social constructions of teenage pregnancy and that appreciation of con- temporary ideologies of childhood is also needed. Expressions of teen- age pregnancy as a problem may then be understood as a matter of social pollution, located at the intersection of ideologies of reproduc- tion on one hand and ideologies of childhood on the other. Introduction A commonsense check-list of social problems might well include teen- age pregnancy. An assumption that it constitutes a problem makes a certain sense. For, however vaguely, it conjures up various improprieties, a number of difficulties and the making of special arrangements. This paper presents reflections on commonsense understanding surrounding the expression of teenage pregnancy as a problem. In the process, the well-established analytic position that essentially social problems are construed as such only by the existence of the very rule that they break is taken as axiomatic.^ In particular, attention is paid to a hitherto neglected aspect of the social construction of teenage pregnancy. This involves discussion of the ideological framework on which commonsense understandings depend. In this connection it is pertinent to note the observation that ideology provides a pervasive world view that structures the taken-for-granted assumptions about social relationships, and moulds beliefs and behaviour.^ Regard for the nature of the ideologies circumscribing human repro- ductive behaviour will clearly go some way towards an understanding of Sociology of Health and Illness Vol. 2 No. 1 1980 R.K.P. 1980 0141-9889/80/0201-001 $1.50/1 2 Murcott the construction of teenage pregnancy as a social problem. But to rely on this alone is to overlook a significant and separate ideological sphere. It can be seen that a certain ambiguity suffuses the social construc- tion of teenage pregnancy. There is an implication that one sort of commonsense view of the issue as a problem involves invocation of ascendant reproductive ideologies;"* it may constitute some sort of a problem simply by being pre-marital. While this, of course, is a likely element in the construction, it is neither the only one, nor, it will be suggested, is it key. Anticipating the argument, the proposal here is that there is something quite distinctive in the manner in which teenage pregnancy is construed. Teenage pregnancy may in all probability entail an illegitimate preg- nancy. But it does so primarily because as a teenager a girl may not (legally) be entitled to entertain a legitimate pregnancy. Teenage preg- nancy is perhaps a special instance of illegitimacy in which questions of legitimacy have as much to do with the allowability of conception in the first place, as it has to do with the marital status of the woman concerned. In other words, a question of age is raised. Central to understanding the ambiguity surrounding teenage preg- nancy and the cornerstone of this paper is an appreciation of contemporary ideologies of childhood. Once appreciated, then it can be seen that an expression of teenage pregnancy as a problem is located at the intersection of ideologies of reproduction on the one hand, and ideologies of childhood on the other. It is perhaps necessary at this early stage to clarify one particular point. A sociology that accounts social problems as created by the rules they break is not so flippant as to disregard the reality of the conse- quences of deviance. To regard deviance as in the eye of the beholder is not to be so unsociological as to deny the felt problems of controlling and welfare agencies, any more than it is to consign expressions of suffering merely to existence 'all in the mind' of the deviant. Illegitimacy may well emerge as a problem via the extant ideologies governing sex and marriage, but the ensuing stigma is thereby no less painful and the practical problems no less severe. In its turn, teenage pregnancy may well entail a range of desperately trying circumstances. The exposition here, however, comments not at all on the practicalities as such of welfare or medical problems that teenage pregnancy poses. What is explored is, rather, over and above such problems, focussing instead of the ideological level on what uniquely teenage pregnancy con- notes. What follows is divided into two parts. Far greater attention is devoted to exposition of childhood ideologies than to reproductive ideologies, for the latter have already received suitable attention.* The social construction of teenage pregnancy 3 Besides, the thrust of the argument in this paper depends on an appreci- ation of the former. The first part works towards this and concludes by arguing that in vital respects teenage pregnancy represents a version of social pollution. In the light of this proposal, the second part resumes closer attention to the social construction of the issue considering various aspects of its public expression as a problem. Troublesome children Children neglected There is an essential paradox to ideology. This derives from its taken- for-granted character. Fither it is so pervasive that it is readily apparent. Or it is so pervasive that by this very token it is rendered invisible. A nicety of this irony is that ideologies of childhood can just as well be exposed in reflexive consideration of the treatment of children in socio- logy itself. The suggestion is, unremarkably, that the extent to which and manner whereby children are attended to by sociology is in impor- tant part formed by the nature of contemporary ideologies of childhood. The contours of ideologies of childhood can be revealed by examining this suggestion in some detail. For a start it seems that sociology has largely overlooked childhood and children. In the social scientific division of labour, children have most often been left to psychology, education, social work and policy studies. In sociology children figure rudimentarily. They appear woodenly, as the units moving through the education system in dis- cussions of social mobility or minimally, as elements in introductory teaching of 'sociahzation'. Even a book actually called Childhood: a Sociological Perspective still turns out to be about socialization. Its opening sentence leaves no doubt: This book is concerned with socialization, the process of learning the behaviour patterns that enable people to interact meaningfully.* Mostly children appear as mere beings to be socialized; pre-social; not yet competent; pre-rational; empty vessels yet to be filled. When concemed with the nature of social order, sociology takes more notice of children. In the Parsonian social system two potential sources of disruption threaten.'' One is the deviant, the other the in- completely socialized young; those who break the rules and those who have yet fully to learn the mles. Alternatively discussing an interactionist stance to 'taking the world for granted', Sharrock points out that people do recognise that the world cannot always be so taken: he adds 4 Murcott Thus, although we may assert that 'anyone' ought to be able to see certain things because they are obvious, we nevertheless exclude children and strangers from the category 'anyone', and treat them with special patience and tolerance because we classify them as people who have not yet learned how to see the world in the way we see it. . . ,^ Goffman commented some while ago on people's lively awareness of the perils of admitting children to secrets before they have learned to appreciate the significance of teamwork in managing coherent perform- ances.' He also notes that children do have 'some licence to commit gauche acts without requiring the audience to take the expressive implications of these acts too seriously', in that to a degree 'children are defined as "non-persons".''" Not only are children socially non- competent, they are also socially not visible. Socially - but also socio- logically they have not been seen." Some sociological quarters however, reveal noteworthy and interest- ing exceptions. Bossard and Boll's classic has achieved four editions in which a programme for an interpretive sociology of childhood is mapped out.'^ It is a sophisticated work, insisting that history is essential to an understanding of childhood and emphasising the significance of ideo- logy in determining child status. Yet theirs is a view in which children remain as empty vessels, a view which treats socialization as a one-way process to fill them up. More recent work challenges such a position. Denzin launches a devastating attack on sociologists for accepting unquestioningly theories of children which are simply inaccurate.'^ Failure to enter the child's world'" has meant failure to see that children are indeed social and 'rational'. Language is not an essential precursor to social competence; rather social competence is a product of social interaction itself. That language is deemed developed to a certain level of competence by the age of seven, is irrelevant for the development of social competence in a child interacting socially with others for the previous five or six years.' ' Granting fully blown, socially competent status to children allows for the proposal that they possess their own distinct culture(s), distinct, that is from adults'.'* This conceptualisation risks, however, a static view of the world. At least, of itself, it does not provide for the study of the relationship between the two (sets of) cultures in general or for the study of the translation of someone from one to the other in particular. What it does do, however, is give the world of children legitimacy, making it worthy of serious sociological attention. First, it provides for a revision of approaches to socialization. If children are after all socially competent, and thus in this sense complete rather than incomplete beings, then, socialization is to be seen in an interactive view,'"' two way rather than one way. The social construction of teenage pregnancy 5 A reciprocal interaction is soon struck between the child and the adult, such that the adult bends as much to tlie child, as the child does to the adult.'* Evidently, the imphcations do not rest with thinking about child social- ization; the theoretical repercussions carry on through to work on professional socialization." They also need to extend to explorations of the impact of experiences such as those which surround becoming pregnant as a teenager.^" Second, it provides for the pursuit of the social: The study of childhood socialization offers the most strategic setting for un- covering answers to the one question that nearly every social theory is ulti- mately couched in terms of . . . 'Namely how is society possible?' (Simmel) . . . it is here (in the child's world) in the daily interactions between children, their parents, siblings and peers, that society is made real. It is here that society, as the child comes to know it, first appears.^' Harre is similarly concerned; in order for people to be able to engage in rule governed action they must have achieved the social competence on which such abilities are founded. He is drawn to the conclusion that the origins of the kinds of social competence we find among adults is to be looked for in a world we would like to call the autonomous pre-cursor world; that is, the social world that children develop. .. .^^ He continues. We are fairly surfi that the methods by which the playground world is managed are identical with those by which the adult world is managed.^^ But by according the world of children equivalent theoretic status with the world of adults he runs an analytic risk. Pushing the question of adults he runs an analytic risk. Pushing the question of the genesis of the social back a stage neither answers it nor makes it redundant. Treat- ing the world of children as prior is naturally appropriate temporarily, but is not to be confounded with priority explanatorily. Thus, of course, the question remains on the agenda and cannot as such be further pursued here. But its emergence in this context serves to highlight a theme central to the present paper, namely, that con- siderations of children tends, one way or another, to occur in close association with consideration of order. Discussion of children, their management and their behaviour is firmly and centrally located amidst matters of morality and propriety. Exploring the problem of order, so- called, sooner or later involves regard for styles of suitable induction of new members and styles of suitable control of existing members of all ages. And concem about and for children sooner or later hinges on their part in societal orderliness, whether in the present or future. But to 6 Murcott observe that 'children' and 'order' are thus bracketed is not to say that the relationship is in any way simple or that it exists at only one level of analysis. It is more likely than not that they are related in a fairly intricate fashion. It is the keystone of the present discussion and main concern of this paper to present an example, at the level of ideology, of just such a relationship. But before doing so, further, more general con- sideration of ideologies of childhood is necessary. Part of the critique of conventional views of sociahzation involves the charge that they incorporate and refiect dominant adult ideologies of children. McKay leaves adult sociologists looking a little silly: . . . under the auspices of current formulations of socialization, the conception of children as essentially deficient vis-a-vis adults has, in practice, led to no research into children qua children. Under the formulation of the world as a process of socialization, children as a phenomenon disappear, and sociologists reveal themselves as parents writing slightly abstract versions of their own or other children.^'' In failing to treat the child's world as a distinct culture in its own right, sociologists have been guilty of ethnocentrism.^^ Topic and resource have been confused. The inferiority, relative powerlessness and invisi- bility of children socially (like slaves, women, and blacks) has carried over sociologically. Adult/child: one thing or another If this has led to no research into children as such, it has also led to extremely sparse attention to the diversities of adult ideologies of childhood. Childhood, of which in this sense adolescence is a variant, is a relatively recent invention.^* If a mediaeval child survived past the stage of needing the care of its mother or nurse, it straight away entered the adult world. There was little point in pinning too much on the out- come of a pregnancy when the chances were that the child (not to mention the mother) might soon be dead. By the same token any scope for the development of ideologies of the state of being a child was severely limited. While the variations in the content of ideologies of childhood since then have been sketched^'' contemporary conceptions of children are merely glimpsed. Snippets of empirical material tell us that children are wonderful;^* that children are essential to married life;^' and that if you have a little trouble with children that's forgotten, but the joy and pleasure is never forgotten.^ The social construction of teenage pregnancy 7 Doctors view children as a special type of patient,^' and a common- place of hospital life is the reputation of children's wards as specially happy, specially poignant, and of paediatrics as specially satisfying a specialty. Childhood becomes apparent as a special state, qualitatively differ- ent. The equivalence of children to servants persists;^^ they are inferior, lacking in full citizenship. In the past children have been sent as servants to other households,^' consorted with servants, and been consigned to their quarters and their care.'" Middle-class Edwardian parents demanded respect from their children in the same way that they demanded it from their servants.'^ The inferiority of children occurs in contem- porary adult ideologies as a metaphor for inappropriate adult behaviour. The inadequacies of social workers' clients are attributed to immaturity. Oversight of doctor's work is unacceptable, for only children need supervision whereas professionals are adult.'* And when the young themselves are reproved for bad behaviour they are told to grow up and not be so childish. What emerges, then, is a collection of conceptions in which a particu- lar feature is emphasised. The temporal and biological progress of child to adult is glossed over, and what is continually stressed is an essential difference between children and adults. To be a child is not so much to be a potential adult, as it is to belong to a category quite apart. It is the contrast not the continuity between childhood and adulthood which receives continual emphasis.''' And it is this then that is part of the ideological context in which to understand the social construction of teenage pregnancy. Girls in trouble For in a sense, teenage pregnancy constitutes a problem precisely because it expresses an ambiguity not catered for in the sharp con- ceptual contrast. It is a contradiction in terms'* and carries overtones of a nineteenth century horror of precocity." Child and adult are mutually exclusively conceptuahsed. It is impossible simultaneously to be adult and child. What is more, it is adults who bear and beget children; a child cannot beget or bear a child. Yet that is precisely what a preg- nant teenager is about to do. Teenage pregnancy offends a morality which can identify children only by separating them from adults. On top of this, teenage pregnancy confronts a perennial issue in childhood ideologies. This is the version of the familiar question about human nature as to whether people are essentially savage to be tamed in society, or whether they are intrinsically good and at risk of cor- ruption.'**' Are children inherently good, wonderful, angelic, or are they 8 Murcott monstrous, wicked and bad? Further research is obviously needed to establish the contemporary focus which this question takes. But there is a clear impression that, at a public level at least, the essential innocence of children is in the ascendant. Children are more often characterized as victims than offenders; and when caught doing wrong may be absolved of responsibility by being designated victim of someone else's inadequate care. The greatest opprobrium is reserved amongst prisoners not for the murderer but for child 'molesters'."' Innocence connotes purity and that version of non-knowing that is virginal."^ To be sexually knowledgeable is to have lost innocence. A girl's pregnancy is proof of her loss of innocence, and thereby raises doubts about her status as a child. If these assumptions regarding the nature of contemporary dominant ideologies of childhood are warranted, and an agitation engendered by teenage pregnancy does indeed signify an affront to moral categories, the whole issue moves into a discussion of social pollution. Teenage pregnancy can be construed as two of Mary Douglas' four varieties of such pollution. One is that danger arises 'in the margins of the lines', the second is the danger from internal contradiction, when some of the basic postulates are derived by other basic postulates, so that at certain points the system seems to be at war with itself."' Adulthood constitutes the margin of childhood, and, likewise, child- hood constitutes the margin of adulthood. This is a necessary corollary of the definition of one state in terms of the negative of the other. Challenging the boundary of each, teenage pregnancy takes on an alarming aspect. Furthermore, teenage pregnancy stands at the inter- section of two increasingly contradictory postulates. One is the observa- tion of the falling age of menarche, the other the simultaneous exten- sion of the statutory period of education. Biologically a child becomes an adult earher and earlier, socially a child becomes an adult later^nd later. Douglas later analyses 'examples of social structures which rest on grave paradox or contradiction. In these cases exaggerated avoidances develop around sexual relations.'"" The suggestion here is that the particularities of the social construction of teenage pregnancy might fmitfully be seen as expression of such exaggerated avoidance. By reviewing features of the social construction of teenage pregnancy, this proposal is explored in the second part of the paper. Constructing teenage pregnanpy At this point, the discussion doubles back on itself. At the outset it was The social construction of teenage pregnancy 9 remarked that teenage pregnancy can, in an everyday sort of way, readily be construed as one of a familiar catalogue of contemporary social problems. But it was immediately suggested that although regard for reproductive ideologies would lend support to this construction it is in important ways insufficient. Attention is now turned to this part of the argument. A problem in the process of construction As a precursor, there is a matter of identification to consider. Interest in this paper revolves around the social construction of teenage preg- nancy. To be able even to make such a statement assumes that the focus of interest is already singled out. Yet it is the very identification of a phenomenon which lies at the heart of exploration of its social construction. To put it another way, that teenage pregnancy as such is identified at all though not always formally defined (see below) is itself a significant starting point."' It can only be so, with the assump- tion that its designation is understandable, for whatever purpose, without requiring further elucidation. What renders it understandable is the persistence of an ideological framework which both constructs the phenomenon and is in turn reinforced by that self same construction. While it needs to be said that the actual designation teenage preg- nancy, as such, perhaps relatively rarely occurs, reference is made frequently enough to variants on the main theme."* What is notable about these variants is that the phenomenon each discusses is left effectively undefined. Logically, teenage pregnancy, or some allied referent, may connote any of the following and more besides: - an eighteen year old, married mother of a child aged thirteen months who is 5 months pregnant - a girl, three months pregnant, who is due to marry her boy-friend, the father-to-be, on her sixteenth birthday in a fortnight's time - a fourteen year old schoolgirl referred for a termination of her pregnancy. The point need not be laboured; patently, each of these may be con- strued as dramatically different types of event, amenable to markedly differing attributions of meaning. An examination of a number of different approaches to, and com- mentaries on, teenage pregnancy reveals that specificity of this kind is rare. Instead a distinct gestalt emerges which can accommodate im- precise designation, ambiguity, and elision. Intentionally or otherwise, a consequence is to play down doubts or queries, and the potential for an overall encompassing image is fostered. Thus in their discussion of 10 Murcott 'social and behavioural development' the Court Report on child health services lists adolescents' main problems. Here is included reference to 'casualties' such as 'unwanted pregnancies'. In the succeeding section, entitled 'Pregnancy' the observation that Sexual intercourse before marriage is quite common . . . substantial numbers of young people are sexually active for several years before seeking advice on contraception. is to be found. While the section after that, on 'Abortion' opens with The majority of pregnant girls are very vulnerable."'' Unwanted pregnancy, and/or abortion in adolescents are explicitly stated as constituting a problem. But it is by association that circumstances discussed as leading to these events are also presented as part of the problem. A similar sort of confiation is to be found in a DHSS report on family planning services. Even though its author is sensitive to the problematic -- she writes of ' "unwanted" children'"* using quotation marks - she also clearly identifies 'unwanted pregnancies'"' (without quotation marks) as a problem. While at one level, she may be making careful distinction between unwanted children and unwanted preg- nancies, she reports that the DHSS was particularly concerned about those likely to have unwanted children. Her researches identify those at comparatively high risk as women 'marry(ing) under the age of twenty (and) girls who conceive before marriage' who in any case tend to be working class. Unwanted pregnancies, pre-marital conceptions and married young are by implication being bundled together as a problem. Earlier hesitation at the designation 'unwanted' gives way in the face of correlations which pin-point the issues and shape more confidently the look of those issues as problems. A paper by Teper which 'examines recent demographic trends in teenage pregnancy' provides further and subtle illustration.'"^ The author does not 'need' to define teenage pregnancy in any formal sense, for right at the beginning of her paper she clearly refers to births to teenage girls and presents figures for girls 'aged less than 20 years at last birthday' .' ' Here then, is a literal denotation of teenage pregnancy. But as the paper proceeds - and with no explicit discussion a problematic import of teenage pregnancy is introduced, and Teper concludes by writing: Earlier maturity, the unacceptability of abstinence from sexual intercourse for many years.. . inaccessible contraceptives for the situation in which coitus may occur raise new and complex issues for parents, teacher, doctors, administrators, etc. - and, in fact, for society as a whole.^^ (my emphasis) The social construction of teenage pregnancy 11 Her election to refer obliquely to 'complex issues' rather than perhaps 'problems' may reflect an attempt to refrain from moral judgements. Yet her own earlier handling of her argument has already given form to the phenomenon, when she noted that fifteen to nine- teen year old women have contributed nearly 12% of all pregnancy events in the population. They accounted in a disproportionately large way for the total number of pre-marital conceptions and for illegimate births." These kinds of treatment of the phenomenon express the social con- struction of teenage pregnancy as a potential social problem. This is not to say that such construction is not unequivocal or does not contain ambiguities. Yet located in the pattem of presentation overall, these can fade. What may emphasise the potential for overriding such prob- lematics is the ideological context in which commentary is 'read' off. By way of elaborating this point, it is perhaps helpful to rehearse what is meant by reproductive ideologies. Busfield introduces the con- ceptualisation by outlining beliefs which 'constitute the social reality in which reproduction takes place.''" Dominant reproductive ideologies of contemporary society link marriage and children firmly together; i.e. 'if you are married you should want to have children' and 'if you want children you should ensure that you are married first.' In this light, reference to pre-marital conception and/or to illegitimacy, immediately signifies that the matter in hand is of a realm contrary to dominant morahty, and thus belonging to a category of moral and social problems. An overall effect is created by presentation of the issue in the manner described in such a way as to make available a reading of what is said which reflects and can be interpreted in accord with major reproductive ideologies. In this way, Teper's comments just quoted are couched in language used innocently enough, but in a context in which depiction of the statistically normal (or abnormal) can readily slip over into coincidence with the morally normal (or abnormal). It is not so much that agenda are hidden, as that social, moral categories are those to hand, those taken-for-granted and sensible as appropriate to use when discussing demographic events. Demography is not a neutral enterprise; inevitably it is socially located. Issues are identified as worthy of focus prior to, and beyond demography. Teenage pregnancy, as such, and thus identified as self-evidently meaningful a category becomes so, because it already has significance socially. A paper des- cribing demographic trends of teenage pregnancy need not deal at all as Teper's initially does not in that kind of discussion that explicitly identifies the phenomenon as a variety of social problem. It need not, for the task is already done, located in the dominant ideologies which 12 Murcott provide the benchmarks within which demographers and policy makers can work, and identify the problems with which they may deal. Ideologies surrounding reproduction, however, do not fully provide the benchmarks for construing teenage pregnancy rather than, say, 23- year-olds' pregnancies as worthy of concern. Association of teenage pregnancy with other phenomena which reproductive ideologies create as problems, goes only so far in accounting for its construction as a problem. The main point here is that the phenomenon is construed as a problem in the light, not only of ideologies of reproduction, but also of childhood. The remainder of the discussion then is devoted to explora- tion of the intersection of these two ideologies. Construction skewed Social construction of the issue as a potential problem contains more than one element. It is not just that teenage pregnancy of itself poses some sort of a problem. There is in addition, a problem in that the incidence of teenage pregnancy is increasing." Commentary is provided in the Consultative Document Prevention and Health: Everybody's Business, .. . what seems to have happened since 1968 is that there was an initial rise in the total of recorded extra-marital conceptions at all ages, that this steadied off after 1971, fell in young women of twenty and over but is still increasing in school girls under sixteen (though the total involved is small in proportion to the total number of school girls).'* the enclosure of the last remark in parentheses is intriguing in the light of what follows later in this section. While Court does not so much profess direct concern about the increase as remark that . . . in recent years, there has been growing concern about the number otpreg- nancies occurring in young girls, particularly in those under sixteen year of age." Teper's paper, to which reference has already been made, presents a beguiling demographic analysis which addresses this aspect directly. Her main contention is that the rate of teenage pregnancy is not only rising, but that it effectively 'rose' by remaining relatively steady between 1968 and 1971, even though the number of girls in the relevant age groups decreased. By the same token extrapolation to likely events in the first half of the 1980s leads her to comment: The teenagers of the next 15-20 years are already born and it is inevitable that The social construction of teenage pregnancy 13 the number of young women at risk of teenage pregnancy in the next few years will far outnumber those who have been at risk in the recent past.'* Inevitably there is a lag; figures available to Court whose report was published in 1976 only went up to 1974. More recently available dat a" suggest for the first time since 1968 (when figures for legally terminated pregnancies could become available) a downturn in the premarital conception rate for those under sixteen as well. The number of births to this group (the under sixteens) has been falling since 1974, but in 1976 abortions, too, began to drop.. .. First figures for 1977 suggest that the fall will continue.*' The point here is not just to indicate difficulties and delays in availability of up to date figures. Rather it is consideration of the process of con- struction which is instructive. Not only does such consideration iden- tify the style and content of what is said, it also permits awareness of what is not said. Furthermore, construction of the issue in certain ways allows for preclusion of its being constructed in others. Amongst the number of things that might have been said about teenage pregnancy, it is increase in its incidence which is remarked. The question that arises is how it is that commentators concentrate on this rather than on an opposite construction which registers astonishment that the incidence is so small. By 1974, in England and Wales of the order of 10,000 conceptions were to girls of sixteen and under.*' This represents approximately 1,500 live births and 8,500 terminations. A very different complexion can be put on these data if seen in the light of two sets of factors so far not mentioned, in the commentaries con- cerned. Douglas and his colleagues appear to be rare among commentators on the issue. For they treat an increase in teenage pregnancies as underlin- ing the known decline in age at menarche.*^ Expressing a similar form of argument. Gill regards the increase in teenage pregnancies as a corol- lary of the falling age at first marriage.*' Even while the reasons for the falling ages of menarche and/or marriage remain unknown, if these factors are taken together, an increase in the incidence of teenage preg- nancy seems no more remarkable than the observation that the lower end of the relevant distribution curves has shifted downwards to the younger age groups. That the height of sexual powers,*" at least for males, appears to coincide with the age at which a girl may legally have sexual intercourse indeed the suggestion is that were the legal age lower, so would be the age of maximum sexual activity may be awkward, unfortunate or inconvenient, It also makes it very surprising that the rate of teenage conceptions is not far greater. There is a second set of factors that have, in only a limited way been 14 Murcott mentioned. What is known of teenage sub-cultures, of adolescent behaviour and of adolescent sexual behaviour in particular*' could well leave us astonished that every third or so teenager is not pregnant. Parker's work, in part of central Liverpool, indicates that indeed pre- nuptial conceptions are the norm for that area. While the boys' deviant activity did appear to alter as they got older, the attitude to sex and the style of relationship with girls remained fairly similar from the age at which interest in either first started. Their dropping out of group activities in general and of stealing car radios in particular was a con- sequence of, not a prelude to, going steady with and/or getting married to their (pregnant) girl-friends.** While Parker's work is illuminating on related issues of attitudes to sex and marriage, stereotypes of 'good' and 'bad' girls and so on, it was not designed to consider adolescent sexual activity. Indeed, the literature on youth in contemporary society is notable for concentrating on the more unusual or flamboyant forms of deviant behaviour where youth- ful sexual behaviour is dealt with inter alia.^'^ The corollary of this concentration on especially disadvantaged groups, is the provision of very little evidence about the life-style and attitudes of 'i-espectable' working class youth and virtually nothing about suburban/middle class teenagers. Yet Gill points out that 'illegitimacy and pre-nuptial concep- tions . . . have increased fastest in recent years among women from the upper end of the social class continuum.'** Perhaps most significant of all in the present context, is the almost total neglect of the contemporary culture and life styles of girls.*' With a single exception''" we still have to rely on the now dated work of Jephcott,'" which while portraying well the general adult aspirations of girls towards marriage and domesticity deals virtually not at all with the sexual attitudes, knowledge and behaviour while teenagers. Yet this must of course be the sphere to which we look for explanation of the relatively low incidence of adolescent pregnancy. Standing as a critique of proponents of a 'generation gap' MxiTtgham's essay on the contemporary mass dance reveals youth reproducing their parents' lives, demonstrating 'a continuity with the world of their parents' generation.' He provides a compelling picture of Saturday night as the high spot of alienated youth' s week: Youth in pursuit of itself turns the dance into a convention of courtship, dating and sexual bargaining. The mass dance is electric with it, and we can measure the obsession through the amount of time given over to preparing for the dance, the peculiar drama and tension in the dance-hall which is ubiquitous.'' The agendum of the occasion is barely hidden, leaving onlookers t o wonder again t hat the incidence of teenage pregnancy is so low. The social construction of teenage pregnancy 15 The point is, of course, that the prevailing ideologies of childhood cannot cater for those who are neither adult nor child yet at the same time are both adult and child. Not only have such ideologies led socio- logical attention to focus only on youth's behaviour in respect of matters of order. It also means that conceptual space for teenagers is decidedly cramped. Court is interesting in this respect, for attempts are made to allow that young people may legitimately enjoy a measure of autonomy. Not only are they inclined to behave in a 'different' way, 'sex before marriage is common' (see quotation above) but Court goes on to make allowance for the possibility that sexually active young people do not use contraception not only from fear or ignorance but also from choice. So when discussing counselling services, recommenda- tion is made that such services 'take account of the adolescent's desire to do his (sic) own thing'. For counselling to be successful. Court adds, recognition is needed that 'for some young people sex is an activity undertaken in its own right and and not in the context of family life or preparation for parenthood' ." The tentative air of Court's commentary contributes to the suggestion that of itself, teenage is a morally problematic category for which appropriate behaviour is not clearly spelled out. What is more clearly available is the view that teenage is important as some sort of a staging post in the construction of appropriate and orderly adult behaviour, and as such is located firmly on the child side of the child/adult divide. This, and the implications for the social construction of teenage preg- nancy, is explored in the next section. Professionalised construction That teenage pregnancy is constmed as a problem on the increase is endorsed by a consideration of the kind of perspectives routinely employed when looking at each of children,''" human reproduction and welfare problems. It is common to each of these three that their social construction has evolved in such a way as to place them within the orbit of the professionally expert. The sorts of experts involved range, of course, from social workers to school counsellors, and doctors to probation officers. Common, in tum, to the various activities of these professionals is a view of events which sees 'Time 2' not merely as subsequent to, but also consequent on 'Time 1'. Medical activities of diagnosis and thera- peutics, prognosis and prevention enshrine and foster this style of thinking. That childhood as well as human reproduction is subject to 'medicalisation' will be pursued below. For the moment it is important 16 Murcott to note that, in tum, a medical view, resonates with a psychological view in which the development of adult personality is seen as par excel- lence a product of earlier experiences. This is the very perspective which pervades so much of social work and administration studies, and underpins what is professionalised in policy making. The resonance continues and is revived daily in policy work. Policy makers are charged with doing rather than reflecting. What is done now, is done in the name of providing for what happens in future, based on a diagnosis of events in the past. This orientation is lent additional emphasis in dominant orientations to childhood. Not only is concern for a child's welfare expressed in part in terms of the consequences for her or his future well-being, this is also reinforced by the firm location of childhood in the domain or morality and societal order discussed earlier. A child's present and future welfare, then, is also that of 'society's' welfare. This can be illustrated by further examination of the emphasis on and concem about an increase in the incidence of teenage pregnancy. The problems presented to the policy makers by pregnant teenagers are seen not as simple but compound. There is a readiness to think of those already once extra-niaritally pregnant as some kind of continuing social (and/or medical) casualty. Late presentation for ante-natal care associated with illegitimate teenage pregnancy may involve (unspecified) medical and social difficulties for mother and child later.^' The theoreti- cal implications of the tone in which Bone discusses family planning services needed to deal with 'the problem' of unwanted pregnancies provides another example. (Those she identifies as at risk have been referred to above); Preventive work is directed towards those at risk . . . the implications of all the evidence is that the services should concentrate on the wives of manual workers in general, and on the ones amongst them who marry early or conceive before marriage in particular. Indeed to be most effective they must seek* to arrest premarital conceptions... .'* Versions of this theme of developing, compounded problems appear in discussions of sex education: if adequate morals and appropriate atti- tudes are inculcated in adolescents then a variety of later problems are arrested, and the very fabric of society remains intact. So runs the argument in the section on 'Moral Aspects of Health Education' in a pamphlet published by a Government Department (of Education and Science) and currently available.'''' It should be made clear to (young people) that an attitude which treats the sexual act as trivial weakens society . . . by indulging in promiscuous sexual The spcial construction of teenage pregnancy 17 experiences, and thus to fail to associate affection and sexual desires, is to invite disaster in later sex-life. The developmental view remains; inexorably yesterday influences today and both affect tomorrow. Dominant ideologies of childhood stress a view of socialization as a one-way process lending immense potency to the presumption that early experiences 'fix' later pattems. Reinforcement of these sorts of considerations is provided by the possibilities for a 'medicalised''" construction of teenage pregnancy. That a range of human reproductive activity is increasingly subject to revised construction as a medical matter is a familiar proposal. Any phenomenon which can be shown to have some sort of biological basis can be regarded as available for incorporation into the province of medicine.*" Whilst a trend towards the 'medicalisation' of reproductive activity is not unequivocal*' and contains dilemmas and debates,*^ teenage pregnancy may readily enough be seen as an example of this more generally 'medicalised' sphere. There is, however, more than that involved. The youth of the preg- nant woman makes for more than just a special case of pregnancy. It means that special features may be introduced which are associated with the young, no matter what the case. Court reports on health services for children, and yet it is this report in which teenage preg- nancy finds a place in a catalogue of other than medical problems. Court is quite clear: The adolescent's main problems are not those of ill-health but of emotional adjustment to the adult world, particularly with regard to education and work, sex and integration into the community as an individual.... That there are casualties is shown by the prevalence in adolescence of psychiatric disorder, un- wanted pregnancies, abortions, sexually transmitted diseases and drug and alcohol abuse."^ 'Medicalisation' is hinted at, too, in the metaphorical use of 'casualties' terminology that obliquely serves to keep discussion in a medical arena. 'Medicalisation' of human reproduction may well already be on the agenda, but the case of teenage pregnancy illustrates its inter- section with the potential for an extension of 'medicalisation' to child- hood. Furthermore a parallel can be detected between the uncertainties of 'medicalisation' of these two spheres. Lay and professional perspectives contain irresolution as to whether pregnancy is to be regarded as 'nor- mal' or an 'illness'.** Childhood can be seen subject to similar irresolu- tion. On the one hand it is regarded as a natural development capable of proceeding without medical oversight; on the other it may be regarded as inherently frail and potentially sickly, thereby demanding special 18 Murcott medical attention. That the enterprise is perilous and unstable is well demonstrated by Davis and Strong who reveal the repertoire of tech- niques for normalising a population cast in doubt by the very act of screening.*' In another form, the line between disease and misbehaviour is viewed as ill defined; hyperkinesis as the medicalisation of naughti- ness has not gone unchallenged.** The potential for the 'medicalisation' of childhood in an important sense is also the 'medicalisation' of the whole of society. The eugenic loop of argument that traces one generation's problems simultaneously backwards and forwards via the state of the pregnant mother and the quality of ante-natal care she receives, is a telling example of a prime concem for national health.*'' A desire for a nation to be fit and healthy focusses and refocusses on the quality of its offspring. A society con- cemed to be prosperous is concemed with its health and its fitness, and for its future. Its future lies in its children who must be physically fit and otherwise prepared as heirs to what has already been achieved, and champions of what is yet to be achieved. Resonant of the White House Childrens Charter of 1930,** how apt to find that the formal title 'Fit for the Future'of the Court Report celebrates just this concem. Teenage pregnancy symbolises the intersection of a range of potent and mutually reinforcing orientations. Medicine and other professional- ised activities rely on a developmental view. Teenage pregnancy enters the medical and welfare sphere in three ways; first as an example of human activity already under medical aegis, second by being socially constructed as a variety of social and welfare problem, and third as an ambiguous example of childhood, itself equivocally professionalised. So it receives attention out of proportion to its incidence, for it repre- sents practical expression of that which ideologically, so to speak, cannot exist. Concluding remarks It remains here only to sum up. This can be done, providing a fresh statement of the import of this paper in briefly recounting the natural history of its evolution. The initial impetus for developing the argument presented here derived from being puzzled less that teenage pregnancy is largely con- strued as a social problem but rather that construction is skewed in the way described. It was this sort of concem with the size of the problem that hinted at potential for a moral panic. Examination of literature on teenage pregnancy, illegitimacy etc. in particular, and reproductive behaviour more generally, provided insufficient account as to what might give rise to this potential. The social construction of teenage pregnancy 19 So the research had to take place beyond the boundaries of identifi- cation of the issue itself both literally in turning to other sectors of the literature, and analytically in recognising the import of more than one ideological framework. Thence the proposal emerged that urgent preoccupation with the increase in the size of the problem may occur because, quite simply, the under-age pregnant are children. So the sugges- tion is that the social construction of teenage pregnancy is informed by, and at the same time reflects, attention bom of contradiction where an orderly view of the world comes under threat, and a world more sullied than ordered is glimpsed. First Received: July 1979 Department of Sociology Finally accepted: September 1979 University College, Cardiff Notes 1. This paper is a revised and re-written version of 'It's a Nine Days' Wonder': teenage pregnancy, a problem in the process of Construction which was given at the BSA Medical Sociology Group Annual Conference at Warwick Univer- sity, September 1977. Acknowledgements are due to colleagues in both the Department of Sociology, and in the David Owen Centre for Population Growth Studies, University College, Cardiff. I am grateful for their suggestions, to Paul Atkinson, Rita Austin, Tony Coxon, Sara Delamont, Robert Dingwall, Sally Macintyre and Phil Strong, to the anonymous referee for the care with which s/he offered full and constructive commentary; and I should like to thank Bill Hudson for his help and encouragement in the preparation of this paper. 2. Cf. R. C. Fuller and R. R. Myers, 1941, 'The Natural History of a Social Problem', ASR June pp. 321-8; H. S. Becker, 1966, Social Problems: a Modern Approach, Wiley. 3. Leonore Davidoff er a/. 1976, 'Landscape with Figures: Home and Community in English Society', in Juliet Mitchell and Ann Oakley (eds) The Rights and Wrongs of Women, Penguin, p. 142. 4. Joan Busfield 1974, 'Ideologies and Reproduction', in Martin P. M. Richards (ed.) The Integration of a Child into a Social World, Cambridge University Press. 5. Busfield 1914, ibid. 6. M. D. Shipman, 1972, Childhood: A Sociological Perspective, N.F.E.R. p. 7. 7. Talcott Parsons, 1951, The Social System, R.K.?. 8. Peter Worsley, 1977, Introducing Sociology, Penguin, p. 554. 9. Erving Goffman, 1958, The Presentation of Self in Everyday Life, Social Science Research Centre Monograph No. 2, University of Edinburgh. 10. ibid. p. 56. 11. Cf. Marcia Millman, 1975, 'She Did it All for Love: a feminist view of the sociology of deviance' in Marcia Millman and Rosabeth M. Kanter (eds) Another Voice: Feminist Perspectives on Social Life and Social Science Anchor Doubleday. 20 Murcott 12. James H. Bossard and Eleanor Stoke Boll, 1966, The Sociology of Child Development, Harper and Row, 4th Ed. 13. Norman K. Denzin, 1910, Developmental Theories of Self and Childhood: some conceptions and misconceptions, revised version of a paper presented to the Language and Behaviour Session of the 65th Annual Meeting of the ASA, September 1st, 1970, as 'The Children of Symbolic Interactionism'. 14. His advocacy of participant observation to achieve this raises some nice, and probably not insurmountable, problems both of research tactics and of the self-same substantive issues with which he is concerned. 15. David Hall et al., 1976, 'Experience as an Interactive Process' in Margaret Stacey (ed.) The Sociology of the NHS, Sociological Review Monograph No. 22, University of Keele, p. 148. 16. Robert McKay, 1973, 'Conceptions of Children and Models of Socialization' in Hans Peter Dreitzel (ed.) Childhood and Socialization, Recent Sociology No. 5, CoUier-Macmillan; Rom Harre, 1975, 'The Origins of Social Com- petence in a Pluralist Society', Oxford Review of Education Vol. 2, pp. 151- 158; Peter and Iona Opie, 1977, The Lore and Language of School Children, Paladin. 17. Cf. McKay 1973, 'Conceptions of Children '. 18. De nz i n 191Q, Developmental Theories. . . . p . 18. 19. Cf. Robert Dingwall 1977, The Social Organisation of Health Visitor Training, Croom Helm. 20. The management of a spoiled identity which teenage pregnancy may involve in- cludes a familiar repertoire of techniques. That in important respects a teenager is also a child provides an additional dimension. Although children are to an extent a socially disadvantaged category, there is a key difference between them and other such categories. Black cannot tum to white, women cannot turn to men (people whose sex is surgically changed, and those reared as a member of an inappropriate gender cf. Harold Garfinkel 1967 Studies in Ethnomethodology, Prentice Hall, constitute limiting cases of just such a rule), but young does tum to old. Children may be a disadvantaged category, but membership is provisional and probationary. Not only are pregnancies finite, but so too is teenage. In both respects teenage pregnancy is an interestingly transient phenomenon where repair work and reconstruction is readily available. 21. Denzin 1910, Developmental Theories. . . . pp. 2-3. 22. Harre 1975, 'The Origins . . .' pp. 151-2. 23. ibid. p. 151. 24. McKay 1973, 'Conceptions of Childhood ' p . 28. 25. Cf. Denzin 1910, Developmental Theories . . . p. 17. 26. Frank Musgrove 1964, Youth and the Social Order, RKP; Phillipe Aries 1973, Centuries of Childhood, Penguin. 27. Cf. Aries ibid.; Bossard and Boll 1966, Sociology of Child Development. . . 28. A. G. Davis and P. M. Strong 1976, 'Aren't Children Wonderful - a study of the allocation of identity in development assessment' in Margaret Stacey (ed.) The Sociology of the NHS, Sociological Review Monograph No. 22, Keele. 29. Joan Busfield and Michael Paddon, 1977, Thinking about Children: Sociology and Fertility in Post-War England, C.U.P. p. 134. 30. ibid. p. 139. 31. P. M. Strong, 1978, Personal Communication. 32. Musgrove 1974, Youth . . . p. 36. The social construction of teenage pregnancy 21 33. Peter Laslett, 1965, The World We Have Lost, Methuen. 34. Jonathan Gathorne-Hardy, 1974, The Rise and Fall of the British Nanny, Arrow Books. 35. Paul Thompson, 1977, The Edwardians: the Remaking of British Society, Paladin. 36. Eliot Freidson, 1975, Doctoring Together, Elsevier. 37. So stark a conceptual contrast is maybe curious in a society in which there is no clear point, no readDy identifiable set of rites de passage, at which a child becomes an adult. The rituals exist, initiation as an apprentice, school prize- givings, the keys to the door on either 18th or 21st birthday; but they exist incompletely and sporadically. Such indeterminacy nevertheless leaves a range of professionals with the practical question of determining when a child is a child and not an adult. Coming of age occurs legally in different guises up until the age of 24. Compiling a list identifying significant ages. Freeman finds himself having to start at age 5, provoked into remarking that 'the concept of childhood lacks legal precision', and concludes that 'the time has surely come for a reassessment of the principles underlying child law and an injection of rationality'. Michael Freeman 1977, Children: Coming of Age, Legal Action Group Bulletin, June 1977, pp. 137-138. 38. Cf. Robert Dingwall, 1977, The Social Organisation of Health Visitor Training, Croom Helm. 39. Cf. Musgrove 1974, Youth . . . p. 55. 40. It is worth noting that other socially disadvantaged categories 'suffer' a similar dualistic characterisation. Negroes are happy but simple; blacks good dancers but over-sexed; women are temptresses and virginal; the savage superior in being unsullied by civilization and inferior by virtue of being uncivilized; country people are both exemplary in their virtue and idiotic in their threat to townsfolk. (Raymond Williams, 1973, The Country and the City, Paladin.) 41. A moral panic flared up in the UK in the late summer of 1977, when the activities of Paedophile Information Exchange (PIE), a pressure group one of whose aims is to seek abolition of the age of consent, were widely reported in the media. PIE attracted the criticism of Members of Parliament, and of a bishop for its 'disgusting views' (Sunday Times 4 September 1977, p. 3). 42. Cf. the Victorian and Edwardian unease surrounding the nature of the relation- ship between the Nanny and the fast-growing boy in her charge. J. Gathorne- Hardy 1914, The Rise... 43. Mary Douglas 1970, Purity and Danger: an analysis of concepts of pollution and taboo. Pelican ed. p. 147. 44. ibid. p. 172. 45. Identification of the issue is, of course, specific in time and place, and perhaps coincident with its identification IM a problem. While pre-marital pregnancy is self-evidently contrary to dominant contemporary morality, its condemnation is not universal. Not only are the complexities of trends in illegitimacy still being unravelled (Cf. Peter Laslett 1977, Family Life and Illicit Love in Earlier Generations, C.U.P.) the relation of variations in rate to differential strength of condemnation remains a matter for conjecture. Hints are provided by Chamberlain that pre-marital intercourse and a resulting pregnancy carries somewhat different connotations in rural areas. (Mary Chamberlain 1977, Fen women: a portrait of women in an English Village, Virago) and Emmett docu- ments the way in which a politeness of 'not knowing' what is publicly available 22 Murcott to know suspends the judgement of a strict chapel moral code in the face of high rates of illegitimacy and 'forced' marriages. (Isobel Emmett 1964, A North Wales Village, RKP). Whilst Macintyre presents evidence of variations in constructions of pregnancy in both these married and unmarried which under- lines themes subsidiary to dominant morality. (Sally Macintyre 1977, Single and Pregnant, Croom Helm). 46. Juliet Cheetham 1977, Unwanted Pregnancy and Counselling, RKP, Court 1976, Fit For the Future: the Report of the Committee on Child Health Services (The Court Report) HMSO cmnd. 6684, Derek GUI 1970 et al. 'Pregnancy in Teenage Girls' Social Science and Medicine. Vol. 3 pp. 549-574. J. A. McEwan et al. 1974, 'Pregnancy in girls under seventeen'. Journal of Biosocial Science Vol. 6, No. 3; J. S. Robertson and Griselda Can 1970 'Late bookers for ante-natal care' in Gordon McLachlan and Richard Shegog (eds) In the Beginning, Nuffield Provincial Hospitals Trust; Sue Teper 1975, 'Recent Trends in Teenage Pregnancy in England and Wales', Journal of Biosocial Science Vol. 7, pp. 141-152. 47. Court 1976 Fit for the Future. . . . pp. 167-8. 48. Margaret Bone 1913, Family Planning Services in England and Wales, (an enquiry carried out on behalf of the DHSS) OPCS. HMSO. p. 9. For a criticism of the disinclination of researchers to define terms such as unwanted pregnancy Cf. Paula Hass 1974, 'Wanted and unwanted Pregnancies: a fertility decision making model'. Journal of Social Issues, Vol. 30 No. 4, pp. 125-167. 49. ibid. pp. 67-8. 50. Teper 1975, 'Recent Trends . . .'. 51. ibid. p. 142. 52. ibid. p. 151. 53. ibid. p. 149. 54. Busfield 1974, 'Ideologies . . .' p. 11. 55. Cf. J. W. B. Douglas 1971 et al. All Our Future, Panther ed., Derek G. GiU 1970, Looking Ahead: Some Social and Individual Consequences of Mass Acceptance of the Two Child Family in Britain, Annals of the New York Academy of Sciences Vol. 175, Article 3, pp. 847-867. 56. DHSS 1976, Prevention and Health: Everybody's Business, Consultative Docu- ment HMSO, p. 42. 57. Court 1976, Fit for the Future . . . p. 167. 58. Teper 1975, 'Recent Tr ends. . . ' p. 145. 59. National Council for One Parent Families 1977. 'Facts 2: Pregnancy Outside Marriage', reported in New Society 1 September 1977, p. 444. 60. New Society 1 September 1977, p. 444. 61. Court 1976, Fit for the Future . . . 62. J. W. B. Douglas ef fl/. 1911, All our Future . . . p . 145. 63. Gilietal. 1970 ' Pregnancy . . .'. 64. Cf. Musgrove 1974, Youth . . . p. 150. 65. Michael Schofield 1973, The Sexual Behaviour of Young Adults, Allen Lane, Cf. also T. R. Fyvel 1963, The Insecure Offenders: rebellious Youth in the Welfare State, Penguin, Peter Willmott 1969, Adolescent Boys of East London, Pelican. Revised ed. 66. Howard J. Parker 1974, View from the Boys, David and Charles. 67. E.g. Ian R. Taylor 1971, 'Soccer Consciousness and Soccer Hooliganism', in Stanley Cohen (ed.) Images of Deviance, Penguin. Stanley Cohen 1911, Folk Devils and Moral Panics, Paladin ed. The social construction of teenage pregnancy 23 68. Gill 1970, Looking Ahead . . ., p. 857. 69. Cf. Geoff Mungham and Geoff Pearson (eds) 1976, Working Class Youth Culture, RKP, also Carol Smart 1976, Women, Crime and Criminology: a Feminist Critique, RKP. 70. Angela McRobbie and Jenny Garber 1975, 'Girls and Subcultures' in Resistance through Rituals, Working papers in Cultural Studies, Centre for Contemporary Cultural Studies, Birmingham; but for a view of adolescent sexual attitude and behaviour in an American cultural context Cf. Prudence Mors Rains 1971, Becoming an Unwed Mother: a Sociological Account, Aldine Atherton. 71. Pearl Jephcott 1942, Girls Growing Up, Faber. 72. Geoff Mungham 1976, 'Youth in Pursuit of Itself in Mungham and Pearson (eds) Working Class . . . p. 85. 73. Court 1976, Fit for the Future . . . pp. 167-8. 74. Cf. Peter W. G. Wright 1976, The Birth of Child-Rearing as a Technical Field, presented at BSA Annual Conference, Manchester. 75. Gill etal. 1970, 'Pregnancy . . .', McEwan etal. 1974 'Pregnancy . . .'. 76. Bone 1973, Family Planning . . . p. 67. 77. DES 1966 Health in Education (Education Pamphlet No. 49) Department of Education and Science HMSO. 78. ibid. p. 53. 79. Cf. Renee C. Fox 1977, *The Mediealisation and Demedicalisation of American Society', Daedalus. Vol. 106, No. 1. Winter. 80. Eliot Freidson 1910, Profession of Medicine, Dodd Mead, p. 251. 81. William R. Rosengren 1964, 'Social Class and Becoming 111' in A. B. Shostak and W. Gomberg (eds) Blue-Collar World: Studies of the American Worker, Prentice Hall, Hilary Graham 1977, 'Images of Pregnancy in Ante-natal Litei-ature' in Robert Dingwall et al. (eds) Health Care and Health Knowledge, CrotJhi tteim. 82. Sally Mteintyre 1976, 'To Have or Have Not' in Margaret Stacey (ed.) The Sociology of the National Health Service, Sociological Review Monograph No. 22j University of Keele; Sir Norman Jeffcoate 1976, 'Medicine versus Nature', Journal of the Royal College of Surgeons of Edinburgh Vol. 21, No. 5, pp. 263-267; M. G. Kerr 1975, Problems and Perspectives in Reproductive Medicine, Inaugural Lecture No. 61, University of Edinburgh; Iain Chalmers 1976, 'British Debate on Obstetric Practice', Paediatrics Vol. 58, No. 3, pp. 308-312. 83. Court 1976, Fit for the Future . . . p. 167. 84. Rosengren 1964, 'Social Class . . .', Graham 1977, 'Images of Pregnancy . , .'. 85. Davis and Strong, 1976, 'Aren't Children Wonderful. . .'. 86. Peter Conrad 1916, Identifying Hyperactive Children, Lexington Books. B7. Cf. Anne Murcott 1977, 'Blind Alleys and Blinkers: the Scope of Medical Sociology', Scottish Journal of Sociology, Vol. 1, No. 2, pp. 155-171. B8. Reprinted in Bossard and Boll 1966, The Sociology of Child Development. ..
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