'No bump, no care'
Supporting women in their reproductive journey
Towards the end of last year, I was interviewed by the Italian journalist Jessica Mariana Masucci, for an article in the December issue of Il Foglio Review about No Bump, No Care, the non-profit launched recently by Susi Ferrarello, who was my guest on Episode 14 of the Careful Thinking podcast. The new initiative supports people in their reproductive journey and ‘gives access to professionals in different fields working for the wellbeing of women in perinatal care.’ Susi was also interviewed for the article, as were Nicole Miglio and Valeria Bizzari who, like her, are philosophical counsellors associated with the project.
In a recent post, I mentioned Susi Ferrarello’s latest book, The Phenomenology of Pregnancy and Motherhood: Ethical, Social, and Psychological Perspectives, one of whose chapters, also bearing the title ‘No Bump, No Care’, explores problems that women may encounter in the first trimester of pregnancy, including ‘alienation, objectification and loss of identity’, and in which Susi highlights the ways in which mindfulness and phenomenology can provide resources to address these issues and enhance the emotional wellbeing of expectant women and their partners. The process of writing the chapter, and indeed the book as a whole, with its distinctive juxtaposition of personal narratives (both Susi’s and those of other mothers) and insights from philosophy, was clearly one of the inspirations for launching No Bump, No Care.
I was honoured to be asked by Susi to be involved with the project, as a consultant on issues related to the wellbeing of fathers in the perinatal period, on the basis of my research on men’s participation in care for children and their experience of perinatal bereavement. (You can find a full list of professionals associated with No Bump, No Care here.) I also felt honoured to be the only man, the only non-philosopher - and the only non-Italian - to be interviewed by Jessica Masucci for her article.
Jessica is the author of Il fronte psichico - Inchiesta sulla salute mentale degli italiani (Nottetempo, 2023). For readers of Italian, I recommend Jessica’s Substack, Stati di salute, in which she writes about the intersection of healthcare, politics and current affairs.
Jessica Mariana Masucci
Jessica has kindly given me permission to post an English translation of part of the article here, both as a way of promoting the valuable work being done by No Bump No Care, and to highlight some of the issues around reproductive care that it seeks to address.
In translating the article (with some help from Google Translate ), I was intrigued to see that Jessica renders ‘no bump, no care’ into Italian as niente pancione, nessun interesse, literally ‘no belly, no interest’, or ‘no concern’. Apparently, the Italian word cura, which dictionaries suggest as a literal translation for ‘care’, has overtones of medical care which wouldn’t be appropriate in this context. I was reminded of my conversation with the Sorbonne philosopher Christine Leroy, in Episode 7 of the podcast, in which she explained that there are three possible equivalents for the English word ‘care’ in French: soin, like the Italian cura, has medical connotations, while attention and sourci, rather like interesse in Italian, suggest concern, but not care in the broader sense that the word has in English. As a consequence, some French feminist philosophers have chosen to adopt the English word ‘care’ untranslated, for example rendering ‘care ethics’ as l’éthique du care. The ambiguity of the word ‘care’ in English, meaning both ‘caring for’ and ‘caring about’, might be misleading at times – but it can also be quite useful. It would be interesting to know from international readers whether similar difficulties in finding an exact equivalent for ‘care’ and ‘care ethics’ exist in other languages.
My translation of part of Jessica’s article follows (images added by me):
The issues that surround people's reproductive health are a political battleground, yet we find it difficult to establish a connection between our individual experience and the collective, social dimension. The slogan ‘the personal is political’ is not an article of modern faith but it is unavoidably relevant. It seems that it just needs to find its ways into the open, and they can be unexpected.
Nicole MiglioIt was precisely when Nicole Miglio, an author and philosophical counsellor, was looking for a way to make her recent personal experience political, that she and another philosopher began to conceive the idea for a project. Miglio was forced to terminate a much-desired pregnancy because of pathologies that made survival impossible. ‘I experienced a kind of spiritual void’, she says, ‘because naturally the hospital and biomedical knowledge deal with the level of minimal health, beyond which there is an experience of immense loneliness that people can experience in these reproductive processes, understood in a very broad sense, that I discovered only by talking about it’. Friends and acquaintances had approached her, telling her about miscarriages, and pregnancies that perhaps ended well but started very badly; in all these experiences the common feature was ‘this great void of articulation’, of searching for meaning.
Susi Ferrarello
Susi Ferrarello, associate professor of philosophy at California State University and also a counsellor, spoke with Nicole Miglio about what to do, after reflecting on the title of a chapter in the book she was writing. It was an essay on the phenomenology of pregnancy, and the chapter in question was ‘No Bump, No Care’. ‘While writing, I realised that attention is paid to reproductive problems in the perinatal period only when the pregnancy is visible,’ says Ferrarello. According to the philosopher, social attention is absent in other phases, such as in cases of spontaneous abortions, stillbirths or other issues regarding reproductive processes. Miglio calls it the ‘great constellation of processes which occur but are unwanted at that time’, from difficulties with assisted fertilisation, to voluntary terminations of pregnancy, to perinatal bereavements, to the desire not to have children; these are just some of the possible events.
‘No Bump, No Care’ was founded this year. It’s a non-profit that offers remote consultations in multiple languages, and with professionals from various disciplines who work across different time zones, from Milan to Sydney. The first two sessions, free of charge, are philosophical consultations with one of the founders, in which they try to identify the heart of the problem that the person presents to them. Often very practical needs - carving out time for oneself after the birth of a child, to give an extremely common example - are linked to existential needs, such as the search for one's own identity, fragmented by the reproductive process. ‘There can be emotional but also practical problems,’ Ferrarello says, ‘partners who become abusive, strong dysmorphia in relation to oneself’, or the question can be ‘where to live, in cases where the employment situation is fragile’. The starting-point is to approach people in a non-pathologising way, addressing the gaps created by a medicalised view of reproductive health. ‘It's a structural void’, Miglio emphasises, ‘people who are going through reproductive processes are not alone or in difficulty by chance, there is a whole system that basically barely supports us, or doesn’t do so in the ways we need.’
After the first two sessions, the client is then directed to the appropriate professional among those collaborating with the project: other philosophical counsellors or psychotherapists, lawyers, personal trainers. Other categories are to be added soon, such as activists who are experts in obstetric violence issues. These subsequent sessions are paid for according to differential rates, based on the client's income.
Valeria Bizzari
Among the very first to receive the invitation to work with ‘No Bump, No Care’ is an Italian philosopher living in Belgium. Valeria Bizzari is a phenomenologist who undertakes research at the Husserl archives in Leuven, teaches at the university, and has her own private counselling practice.
Philosophical counselling, in Belgium as elsewhere, is not a profession regulated by an organisation or a register, it does not follow a single code of conduct, but even so there are reference texts. In Italy, Bizzari recalls, the associations in this sector can be counted on the fingers of one hand; unlike the situation in central European countries, where this profession is better known to the public, in our country philosophical counsellors, rather than working in private offices, are called in for group sessions in contexts such as prisons, libraries, hospitals. By comparison with psychotherapy, the treatments are on average shorter and more concentrated; no intervention is made with regard to any psychopathologies or disorders - for which the client is invited to seek a mental health specialist - but one of the points that make this alternative interesting is the possibility of using the tools of philosophy to explore the link between the individual’s problems and the context in which she is embedded, with the aim being resocialisation.
And then there are the philosophical games that are played during the sessions. I asked Bizzari to let me try one. Imagine yourself, she told me, inside Plato’s mythical cave and draw it as it comes, in a pre-reflective way. I jotted down a sketch on the interview notepad. It came out more like a bonfire on Ferragosto* than a meditation on the nature of reality (‘And is it dark outside? I see you drew the stars, the moon,’ she asked me. ‘Of course, otherwise what would be the point of lighting a fire,’ I replied). No two caves are ever alike, each person drawing it differently from another.
One specific point on which Bizzari immediately found herself in harmony with the ‘No Bump, No Care’ manifesto is the attention to the body in her phenomenological research. She teaches a course in the philosophy of embodiment and ensures that students, even in their first year, are encouraged to talk about the relationship between the body and society. In her work for Miglio and Ferrarello’s non-profit, she mostly sees people who have problems with accepting their bodies after giving birth. One of the challenges is to be able to change the paradigm of the problem, moving from the notion of the biological body to that of the political body, applying this to reproductive issues and those related to the perinatal period. ‘Through communication, using social media, and the concepts and definitions that we have’, Bizzari insists, ‘we have to overturn this model of an isolated, imperfect and vulnerable body’. Two of her clients were experiencing a similar situation; they became mothers at quite a young age and had a difficult experience in the period after giving birth, so much so that they were unable to talk about it, especially with other mothers.
As she says these words, the first image that comes to mind is the poster hanging in the waiting room of the obstetrics clinic of the hospital near my house, in which a photography studio advertises sessions dedicated to women with visible bumps. I ask her if we are living in a period in which even the bodies of pregnant women are made into performances.
‘Exactly,’ she replies. ‘When you have a bump, everyone notices it, they take a certain kind of care, but the moment your body returns to normal, no one takes seriously any issues you may have related to motherhood.’
The clients Miglio works with the most are people who are childless and want children, or parents who have experienced a loss. She notes a ‘shifting of motherhood to pregnancy’ and gives the example of the spread of 3D ultrasound scans with no diagnostic purpose, but which only serve to display the baby. As long as the pregnancy is progressing, everyone is interested, but when the pregnancy ends or a therapeutic abortion becomes necessary, the person is excluded from the category of almost-mothers. ‘I also think of friends and acquaintances who have undergone assisted reproduction and already felt like mothers at the beginning,’ adds Miglio, ‘there is this conflict between desire and external imposition, which is very complicated to manage.’ Ferrarello intervenes to summarise: ‘In today’s political and social climate, there is no distinction between pregnancy and motherhood, once you are pregnant you must immediately be a mother and there is no difference, even philosophically, between the experience of being pregnant and becoming a mother, which in turn is different from giving birth to a child.’
Martin Robb
Further evidence in favour of their view of parenting from a relational perspective is the presence of British researcher Martin Robb. Robb teaches at The Open University and has been studying men's mental health, particularly where paternity is involved, for more than twenty years. For ‘No Bump, No Care’ he doesn’t meet clients directly but has the role of consultant to the consultants: when one of the counsellors or one of the other professionals needs to better understand some aspects from the male point of view, she knows she can consult him, perhaps asking for an ad hoc bibliography. Robb's recent research has focused on the ways fathers experience perinatal grief. His study found that men are less likely to seek help from support services and continue to experience the social expectations of being a strong, stoic male role model. Even after experiencing perinatal grief, ‘men are still expected to go back to work and carry on, to support their family. There are a lot of unmet needs.’ One interesting experiment was to observe the dynamics of football matches organised by grieving fathers themselves. Something about playing sports together seemed to help them, to make them feel like they were part of a community. ‘What they were doing was validating their identity as fathers. Even though they had only been fathers for a few days or weeks, that was how they saw themselves, even though society refused to recognise it,’ Robb explains.
In reproductive processes, understood as processes made of relationships and not only of biological material, the social, political and biopolitical aspect emerges by itself. It emerges when philosophical counsellors meet and talk to an American mother who panics over coming to the end of breastfeeding in a country where, among other things, two years ago there was a very serious crisis due to the shortage of children’s powdered milk on supermarket shelves; it emerges when an entrepreneur from southern Italy tells them about the hospital that took four weeks to schedule an abortion for her when her foetus had no heartbeat. In the end she was admitted to the emergency room for a haemorrhage, with her family believing it was appendicitis. ‘The work,’ says Miglio, ‘was just talking, saying, but what have you lost? Have you lost a child? Have you lost a pregnancy? Is there a difference between the two things?’
It’s what they themselves have described as a swarming mass of experiences, which goes far beyond a flat, normative and depoliticised vision of reproducing or not reproducing.
To seek help or advice from No Bump, No Care, please fill out the contact form, which you can find here.
Note
*Ferragosto is a public holiday in Italy, celebrated on 15th August and coinciding with the Feast of the Assumption.
The header image is the painting ‘Motherhood’ (2019) by Israeli artist Hodaya Levin. I’m grateful to Hodaya for giving me permission to use it.