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ABSTRACT
In many parts of Africa, antenatal care is primarily an auditory affair. Midwives evaluate the health of the fetus in utero by listening into the womb with an ear carefully attuned to the sound of heartbeats – of the pregnant person and the fetus(es). These midwives are aided by inexpensive and portable technologies – the fetal stethoscope being the most common – that amplify resonance. With a focus on South Africa, this article examines listening devices themselves as well as the conceptual questions those devices raise. In particular, it explores two main areas of inquiry: first, the deployment of sound in the development of of fetal personhood, and, second, the particular kinds of sonic relation that are established through listening in environments of antenatal care. A close examination of antenatality in African contexts invites a reconsideration of conventional notions of sound – especially those having to do with transduction, vibration, and resonance.
Acknowledgements
I would like to thank Jairo Moreno for first suggesting this topic to me and for setting me on this path. I would also like to express my heartfelt gratitude to Catherine Appert and Sidra Lawrence for inviting me to present an earlier version of this work at the Society for Ethnomusicology annual conference in 2015. Veit Erlmann served as a discussant to our panel and I thank him, too, for his typically encyclopedic remarks. A huge thanks as well to the following individuals who read and commented upon my paper at critical moments: Lyndsey Hoh Copeland, Helen Kim, Roy Sablosky, Jasmin Schädler, and Jim Sykes. Finally, I would like to thank the three anonymous readers whose comments helped me greatly improve this piece.
Disclosure statement
No potential conflict of interest was reported by the author.
Notes
1. Following Mol (Citation2002), Rice (Citation2013, 51) advocates maintaining a focus on “actual medical practices, rather than abstract concepts, at the center of efforts to understand disease.”
2. I have only found several brief mentions, in passing, in nineteenth-century periodicals: one in the Natal Witness and Agricultural and Commercial Advertiser and one in The Journal (a newspaper based in Grahamstown).
3. I will mostly refer to pregnant women in this article, particularly in cases where the people under discussion are almost exclusively cis-women. At other points in the article I will refer more generally to “pregnant people” to recognize that not all pregnant people are women. On this topic, see, for example, Stritzkeand and Scaramuzza (Citation2016).
4. Intriguingly, in 1917 the botanist E. P. Phillips mentioned that a plant known in Sesotho as semameloana, or “the small one who listens,” was used by Basotho healers to concentrate pain on one side of the body to aid in chest auscultation (Phillips Citation1917). Very little information exists on this plant or how it was used, however. See Moteetee and van Wyk (Citation2007).
5. This lyric was composed by the mission-educated composer Enoch Sontonga in 1897.
6. I am adapting the first definition of “transduction” as offered by the Merriam-Webster online dictionary: “the action or process of converting something and especially energy or a message into another form” (<https://www.merriam-webster.com/dictionary/transduction>, accessed 5 May 2019). On transduction in relation to sound specifically, see Sterne (Citation2003); Helmreich (Citation2007, Citation2015).
7. Interview with Marianne Littlejohn (Cape Town, 6 October 2015).
8. Interview with midwife (Cape Town, 7 October 2015). This midwife asked to remain anonymous.
9. “Of all births, 60% take place at primary level Community Health Centres and District Hospitals, 25% at regional hospitals and 15% at tertiary hospitals” (Wium, Vannevel, and Bothma Citation2019, 28).
10. Physicians (particularly male physicians) cannot be allowed sole domain over antenatal care. Nor can positivistic science monopolize discourse on the topic, especially when so much scientific literature continues to be motivated by finding ways to persuade Africans to abandon “harmful,” “traditional” practices, thus replicating centuries-old colonial logics.
11. Interview with midwife (Cape Town, 6 October 2015). This midwife asked to remain anonymous.
12. Thornton says that spirits “flow across the landscape,” but the figure of “flowing” seems inexact to me here. Note also that Thornton presents a more detailed cartography than what I have reproduced. He observes that the sangoma’s model of the body also incorporates aspects of “body” and “spirit.”
13. In (Peircian) semiotic terms, one would say that the association is “iconic.”
14. Elsewhere, Descola (Citation2013, 201) provides the following partial definition: “the idea, common in Africa, that social disorders are capable of provoking climatic catastrophes, and also in the medical theory of signatures that bases the etiology and therapy of illnesses upon the apparent resemblances between, on the one hand, substances or natural objects and, on the other, symptoms and parts of the human body” (my emphasis). But he actually lumps several disparate examples under the rubric of “analogism.” In addition to Africa, he provides the example of Europe in the “Middle Ages and the Renaissance,” when a “great chain of being” connected all the elements of the cosmos (201). Can Zulu antenatal practices in contemporary South Africa be compared with premodern European thought? That “analogy” seems far-fetched.
15. If one considers that vibrations from the horn are finally converted into energy processed by the nervous system, then indeed stethoscope listening includes electrical energy transduction, as well.
16. Interview with Xoli Makabane (Johannesburg, 21 October 2015).
17. This scientific reasoning was related to new styles of philosophical reasoning as well. Of particular interest, here, is Erlmann’s (Citation2011) illuminating work on Descartes’ writing on the fetus. The fetus, as it turns out, presented numerous problems for Descartes’ famous theory of subjective dualism.
Additional information
Notes on contributors
Gavin Steingo
Gavin Steingo is Assistant Professor of Music at Princeton University. He is the author of Kwaito’s Promise: Music and the Aesthetics of Freedom in South Africa (Chicago, 2016), which was awarded the Alan P. Merriam prize from the Society for Ethnomusicology. Steingo is co-editor (with Jim Sykes) of Remapping Sound Studies (Duke, 2019). With Jairo Moreno, he edits the book series “Critical Conjunctures in Music and Sound” for Oxford University Press.