Preterm Premature Rupture of the Membranes (PPROM), Pregnancy Loss, and the Choice of Motherhood

Abstract

Preterm premature rupture of the membranes (or preterm prelabour rupture of the membranes, PPROM) refers to the amniotic sac breakage of a pregnant woman before the gestational week of thirty-seven. It serves as the major cause of fetal and neonatal complications despite recent medical advances. This article argues that PPROM, which has almost exclusively been discussed in the medical community, should be examined as an important topic of reproductive justice and motherhood studies. In doing so, it reveals that PPROM has been overlooked in feminist conversations because of its marginalized status at the intersection of class and race, the lack of reliable resources, the successful birth of a child as the social norm, and the possible affirmation of fetal personhood if loss is involved. This article argues for the concept of “relational choice” to process PPROM-affected women’s experience of loss beyond the limited boundary of fetal viability. Based on the considerations to validate women’s experience of pregnancy loss, the “relational choice” perspective combines choice feminism, which enables pregnant women to take a stance through ambiguous boundaries, with relational autonomy, which acknowledges the multiple ways social forces influence individual agency. The relational choice model offers a way for women to interpret the unique meaning of pregnancy loss to each woman and choose to recognize themselves as mothers while they challenge the various social issues around PPROM and pregnancy loss. Overall, this article advocates for women’s agency during and after pregnancy and the active inclusion of PPROM within feminist discourses.