*In this case study, the topic of abortion, relationship issues, and gender role stereotypes are mentioned and discussed throughout. In discussing these topics, I wish to state I have no desire to create or evoke negative feelings or thoughts in anyone, and if I have said something in here that any persons reads and feels is insensitive or hurtful, I implore you to reach out and communicate with me so I can address such things and work to correct the issue if possible. or at the very minimum, find a resolution that can leave all parties involved heard and fulfilled. Thank you and happy reading.
Summary of the Situation
Cecilia Kin is struggling after hearing that she is pregnant and that her unborn child may have Down Syndrome. Prior to this pregnancy, she has gone through five miscarriages and has had a one successful birth of a child who is now around a year and a half old. While she was doubtful about her ability to get pregnant again, she displayed enthusiasm, pride, and joy at the fact her pregnancy has been going so well prior to learning about the fact her unborn child may have Down Syndrome.
Her enthusiasm quickly turned to doubts, worry, and anxiety about the future, how to proceed with this knowledge, and if she can communicate her feelings to the people close to her without judgement. Her feelings of guilt, loneliness, and anger are furthered by what she feels is an imbalance in parental responsibilities and an inability to be heard in her relationship.
Facts:
-As of September 16th, Cecilia is in her 14th week of pregnancy, give or take a couple days. Cecilia is just starting her second trimester at this time.
-There is a 1:25 chance Cecilia’s child having Down Syndrome.
-Cecilia has had 5 miscarriages throughout her life.
-Cecilia and her husband have a child named Meridy that is a little over a year and a half old.
-Cecilia and her husband both work, however she carries the health insurance in her job and her husband is self-employed.
-Cecilia feels as though she takes on majority of the parental duties and household responsibilities.
-Cecilia and her husband live in a small town that her mother and some of her family also reside in.
-Based off what Cecilia has said, her mother and family are against the idea of abortion.
-Cecilia’s husband has said that she and him can handle and take care of their child if he/she/they have Down Syndrome.
-Cecilia is considering abortion but feels unable to bring the topic or her feelings up with her family and/or husband.
-Cecilia manages childcare, stays home when their child, Meridy, is sick, takes Meridy to the doctor, buys Meridy’s clothes and food.
Questions & Variables to be Considered:
-What are the household and parental responsibilities Cecilia’s husband takes on?
-What are the cultural or religious factors at play here?
-What are the state laws surrounding abortion and terminating a pregnancy, as well as what are the neighboring state laws?
-What are the available adoption centers and policies within the community and/or state?
-What are the support systems available, both on a community level and on a social welfare level, that support families with children that have special needs or need certain accommodations?
*It should be stated that the case study answers none of these questions. The reason these questions are posited is that in the hypothetical situation that we are assuming the role of a social worker in Cecilia’s case, it is important to look further into the situation and understand more about the relationships, dynamics, variables, and systems in place so that we as a social worker are able to view the situation from multiple perspectives and grasp the situation at hand more clearly. To do that, we have to know what questions to ask and where to start looking.
Issues:
1. Figuring out the financial and childcare responsibilities and resources needed for raising a child with special needs
2. The imbalance of childcare and household responsibilities between the two parties in the relationship
3. The lack of direct and open communication between the two parties in the relationship, as well as a need to address outside factors that may be affecting each of their behaviors (societal expectations, familial expectations, gender role stereotyping, etc.)
Possible Outcomes:
1. In outcome one, Cecilia takes a sick day unbeknownst to her husband and family and goes out of town to terminate her pregnancy. This is the least advisable approach and has the most potentially damaging outcome. The reason I say potentially is that technically, since Cecilia has had multiple miscarriages, she could pass off the loss of her child to her family and husband as a miscarriage, but once again, this is not advisable and is not how healthy relationships are sustained. Healthy relationships are built, developed, and sustained on trust, communication, and respect, and when such things are not utilized or kept to, it damages the relationship one way or another. I do understand that sometimes there are circumstances where women are afraid for their safety and have to seek out medical assistance regarding abortions or other such matters, however based off the knowledge we are working on, there is nothing to indicate Cecilia is in such danger or that a response requiring such secrecy is needed.
2. In outcome two, Cecilia and her husband sit down and have an open discussion about the topic of whether or not to keep the child, and come to the conclusion that they may have not thought through the responsibilities and challenges of raising another child and decide they are happy with just Meridy. This approach has a much less damaging outcome, however it has potential for the development of long term resentment if both parties are not necessarily in full agreement or completely comfortable with the decision to terminate. Now, while the situation involves both parties discussing and having a say in the decision of whether to keep the child, the partner bearing the child very much has the final say as it is her body, wellbeing, and life she is putting on the line to have a child, not to mention the fact she has already had to go through a total of five miscarriages.
3. In outcome three, Cecilia and her husband sit down and have an open discussion about the topic of whether or not to keep the child or not, and come to the conclusion that they should keep the child. They seek out and research about what resources and systems are in place to help them, as well as Cecilia talks to her mother and family about seeing if some of them can help with childcare as they all live in the same town according to the case study.
4. In outcome four, Cecilia and her husband put the baby up for adoption. While not completely comfortable in their ability to raise a child with special needs, they do not wish to face backlash from their community by trying to abort and also desire to make sure their unborn child finds a good home.
Potential Biases of Parties Involved:
Cecilia’s Family: Bias against the idea of abortion
Evidence of Potential Bias: “I (Cecilia) would be SOOOO judged if the word “abort” passed my lips, even by my mom, and we are sooo close”
Reasoning for Consideration of Potential Bias: Cecilia has an intense fear and apprehension of going to even someone like her mother about the topic and consideration of abortion. This indicates her mother and family, have strong feelings against the use of abortion.
Cecilia: Bias against individuals with special needs
Evidence of Potential Bias: “I (Cecilia) can’t bear to think of standing there holding this child (child that has Down Syndrome) while HE (the husband) plays with Meridy (firstborn child that does not have special needs)“
“What would a child with Down syndrome be like?”
“How could this happen to us?”
Reasoning for Consideration of Potential Bias: Cecilia has positive thoughts and enthusiasm after getting pregnant, however such thoughts become increasingly negative upon learning of the possibility of her child having Down Syndrome. She expresses disdain at the idea that she would have to be, in her mind, stuck with the child with Down Syndrome while her husband gets to play with what she views as her healthy and normal child. She also immediately has such negative thoughts and apprehensions about the possibility of her child having special needs, without even reading about or researching what raising a child with Down Syndrome would be like, which is evident by the second quote, “What would a child with Down syndrome be like?”. Rather than doing the research and identifying potential factors, challenges, or issues she may encounter upon raising a child with Down Syndrome, she immediately runs to the idea of terminating the pregnancy and the thought processes of “What have I done wrong?” or “How could this happen to us?”. Her bias is shown by the fact that she doesn’t just see this as a potential challenge or new variable in considering the future, but by the fact that she views it as a negative event or disaster that happened to her.
Cecilia’s Husband: Bias towards certain gender roles or family dynamic stereotypes
Evidence of Potential Bias: “I’M (Cecilia) the one who arranges childcare, I’M the one who stays home if Meridy is sick, takes her to the doctor, buys her clothes, her food. He comes home to dinner and a smiling kid racing to jump in his arms.”
Reasoning for Consideration of Potential Bias: In this statement, Cecilia states that she takes on the responsibility of arranging childcare, staying home in case the child is sick, taking the child to the doctor, buying clothes and food, as well as cooking. While it is unclear if this is the complete list of Cecilia’s parental and household responsibilities, there is obvious pent-up frustration regarding the division of parental and household responsibilities that needs to be communicated about and worked through. The family dynamic picture that Cecilia depicts from their view is one of Western societal gender stereotypes putting the traditional mother figure into the role of taking on the large amount of childcare and household responsibilities.
Current View of the Situation:
In my view of the situation, Cecilia has what I view as an obvious bias towards children and individuals with special needs. Her jump to conclusions, extreme distress, and repugnance at the idea of raising a special needs child is apparent in my opinion from evidence presented in the Potential Biases of Parties Involved section of this post. To add on to this, her thoughts about the concept of having a disabled child are centered around the idea that having a child with Down Syndrome is some sort of disaster or punishment that occurred to her, which is evident by the lines, “How could this happen to us? What have we done or not done? Haven’t I done everything I could possibly do?“. Not only that, but she repeatedly categorizes her distress and desires as her husband’s as well, and makes the assumption that her desires or feelings line up with her husband’s, which can be seen in the lines “But this is not what we want!“, “How could this happen to us?“, “I think of Meridy and that we should just be thankful we have her“, even though her husband has stated “Oh, we can handle that” and wants to keep the baby. It is important to also note that his response does not properly address his partner’s feelings or concerns and will be addressed later, but that does not take away from the fact that based off the evidence at hand, Cecilia has labeled her wants and feelings as the wants and feelings of both of them. When her husband’s line of thinking does not line up with her wants or line of thinking, her next thought is that “we should just be thankful” for the child they currently have, and shows how she tries to confine and make his feelings into hers by labeling them as “we”, “us”, or “ours” and stating what both her and her husband should do. In addition, referring back to the line her husband says, which is “Oh, we can handle that”, it can be interpreted in a multitude of ways, anywhere from being dismissive of his partner’s feelings to trying to be kind and uplifting by showing support and confidence about the situation at hand. We do not know the context or tone such words were said in, and context can be everything when interpreting how a message is intended to be received. There is not enough information there to reach a conclusion.
Now, I would like to add that I do not want you, the readers, to think I am trying to villainize one side or the other. Cecilia can be analyzed and critiqued more thoroughly because most of the information provided in the case study is based around her feelings, stressors, and wants. This leads to an imbalance of the level of critiquing made for each party involved in this case study, because we have access to the most amount of information about her specifically. The problem truthfully is, simply put, we as the reader do not know enough about the relationship and gender role dynamics of the relationship to do as in-depth of an analysis as we would like. We can infer things from the evidence, but for almost every inference involving gender role stereotypes and expectations in this case there is another possibility on the vice versa. For example, we can infer from the comment by Cecilia’s husband, “Oh, we can handle that”, that he is dismissing his partner’s concern and feelings because he thinks she is “emotional”. However, it can also be perceived as Cecilia’s husband trying to maintain confidence from societal gender role expectations of men having to always be strong, tough, and confident, when he may actually be terrified out of his mind but stuck under the belief and pressure that he has to always be confident and strong. Another inference that can be made is that he and/or other societal or familial forces have pressured Cecilia into the gender role expectation of the AFAB or mother figure in the relationship taking on the childcare and household responsibilities, however Cecilia and her husband have only been parents for around 20 months. We do not know if there has or hasn’t been discussions or plans around division of household and childcare responsibilities, and if such division of responsibilities were reversed earlier on when the child was younger. Regardless, as stated before, there are too many factors unknown to make a conclusive assessment of which gender role expectations and stereotypes are present and which are not, the only thing that can be made at this point are inferences.
What is most clear about the situation at hand however, is that there needs to be more effective, clear, and open communication between Cecilia and her husband. Oftentimes, communication is considerably more difficult than people anticipate it to be, which can easily lead to feelings of isolation and pent-up frustration as Cecilia has mentioned she is experiencing. Developing healthy communication habits is key in making sure that not only the romantic relationship between Cecilia and her husband goes well, but also the parenting partnership they have. For the short term, the optimal solution would to be to have a third party sit in and help mediate a conversation between Cecilia and her husband so they can work together to figure out how they want to approach the issue in front of them. In the long term though, I would recommend couple’s counseling, providing recommended reading of books and/or seminars that talk about and help teach healthy and honest communication methods, as well as developing a plan or system in place for what to do when a conflict does break out. A plan for when discussions get heated or conflict breaks out can help keep the situation from escalating, and such plans can be anywhere from simply removing themselves from the situation and addressing the issue at a later time, or making it that anytime one of them gets angry they have to read dad jokes out loud until they feel more calm and content, whatever works for the relationship and the people in that relationship is what really matters.
Afterword
I want to state something clearly for everyone to hear. This case study, while focused around the topics of conception, pregnancy, and abortion, also involved addressing gender role stereotypes and relationship issues. I do not want you, as the reader, to think I am being ignorant when discussing such subjects and merely trying to shout opinions from metaphorical rooftops while ignoring the prevalence of gender role stereotypes and the effect they have on not only people, but relationships as well. I especially do not wish you as the reader to think that after I have just gone so in depth into identifying key issues in the relationship in the case study above, and I truly want to address this matter because almost every person I have met in life has had at least one serious relationship that impacted their life in a very negative way and left them with an abundance of hurt, whether it was through abuse, manipulation, control and shaming, or something else entirely.
Sometimes the person who hurt them did it deliberately, sometimes not.
I understand and have seen much of the effects that gender role expectations have on people in our society and the pressures it creates. I have seen AFABs (assigned female at birth) in my life be talked down to and ridiculed endlessly by their partners and I have seen AMABs (assigned male at birth) be shamed and punished for showing vulnerability or for simply having a brief moment where their mask of confidence slips off. I’ve seen AFABs be blown off and called emotional or “on their time of the month” in relationships and I have seen AMABs be called weak and ignored for admitting that their partner hurt them. It is a conundrum that does not affect one, it affects all. There are so many issues and difficulties individuals encounter in relationships that can be contributed or connected to the presence of gender role stereotypes and expectations.
I find it of utmost importance to bring these things up because, at least in my mind, it would be ridiculous to talk about relationships and gender role stereotypes and not properly address the harmful ways gender stereotypes can and oftentimes do, impact us as people in and throughout our lives. It is through the active efforts of recognizing, addressing, and the deconstructing of the gender role stereotypes, expectations, and biases that exist within the ourselves and the relationships we enter that we create a more healthy and safe space for growth, love, and acceptance, both for others and for ourselves.
Thank you tremendously for reading this, and I hope you have a great day today.
Comments
9 responses to “Case Study: Cecilia’s Choice”
Lane,
WOW, you did an amazing job at this case study analysis! Not only did you present the case study and the unknown answers to questions that should be asked to make an overall conclusion but you also added disclaimers, communication, gender roles, expectations, and bias. I also learned new acronyms AFAB and AMAB by reading your blog, I do suggest adding a description of what it means in the section when first used in the current view of the situation as I did not know what it meant when first came across it.
Hi Savannah, looking back, I think you are absolutely spot on about putting a box for definitions of key words or acronyms that aren’t always used in day to day life. AFAB and AMAB are words that is regularly used in my vocabulary, so I must admit, it did not occur to me at first to elaborate more on them. I appreciate you input and feedback, I was really glad with how this post turned out once I finished it!
Hello Lane,
I like how you explored the nuance of Cecelia’s choice of words and underlying assumptions in your View of the Situation section. When I read that case study, two things stood out to me in her wording: overwhelm and isolation. This is big news that has implications for many areas of her life, and the way she jumps from one topic to the next in her narrative suggests she’s trying to tackle everything at once. Cecilia also mentions feeling “alone” and that she “can’t really tell anyone” because “who could begin to understand”?
As you point out, her wording is pretty focused on what she believes or assumes the people in her life will do, probably because of that sense of isolation. That can just make it worse though, because as Brene Brown wrote in *The Gifts of Imperfection*, “Shame needs three things to grow out of control in our lives: secrecy, silence, and judgment.” Cecilia’s kind of doing all three out of the fear that her mother will judge her. That is certainly plausible, but Mom could also turn out to be a key source of support, at least for some options. People’s judgments often gain nuance when it’s somebody we know.
The human mind is great at extrapolation, but when faced with a challenge that can lead to rumination and catastrophizing. One of the approaches to psychotherapy is what we call cognitive therapy, where the therapist encourages the client to monitor and examine their thoughts for traits like “does this help me fix the problem or just make me feel worse?” and “Do I know this or am I assuming?”*
I think that approach or something like it, combined with some resourceful casework, could help Cecilia gather her thoughts and approach this in a more organized manner: connect with other parents of special-needs kids, learn what it’s really like and how those parents manage, and take an inventory of family and community supports for each option.
* this may also tie into gender roles, as those provide a template or “schema” for us to use when predicting what people will do. Maybe her husband really doesn’t do much to care for Meridy, or maybe Cecilia’s stressed and her mind is defaulting to stereotypes. That’s something we could inspect once she’s had a minute to breathe.
Hi Aaron, I like how you elaborated on the thought processes of Cecilia and some of the potential solutions or helpful resources that could assist Cecilia in helping her develop strong, direct, and healthy communication habits as well as what can help make her feel more comfortable with sharing and communicating with the people in her life. You also brought up the point of how the issue at hand seems large and out of control from Cecilia’ perspective, and you pointed out ways of understanding and tackling the dilemma ahead of herself. And last but not least, I think while communication habits are something that Cecilia is going to be working towards, I believe that her husband should be developing those communication skills as well alongside her. The two of them are sharing a life together, so developing the right tools that work best for clear, efficient, and productive communication between them is better when both parties are involved in the learning process.
This was an amazing breakdown of this case study. I think you did a great job of looking at all the options and looking at everything without bias, while addressing biases that might occur. Each question that you had you answered. I also loved the part about having to read dad jokes when things get heated in an argument. I think it is important to know when discussions are turning into heated arguments and having a way to cool both parties down.
Thank you so much Lillian. I try to put the note about not intending to be harmful or evoke negative feelings at the beginning of my post because while I always work to analyze without bias, no one is perfect. We all make mistakes or slip ups, and I put those heads up about how it is more than okay to reach out and communicate with me if someone feels there are issues in the post or if someone feels I am acting or writing with bias. It is important to be open to feedback and never stop working on improvement so your words about the case study being analyzed without bias really made me happy and relieved.
Hey Lane. I love how you broke down this case study. Pregnancy and all of its challenges, as you pointed out, are not just about the mother and child(ren) but also the relationship between the parents and their families. Communication between Cecelia and her husband is completely lacking at this point in their relationship and your suggestion of couples counseling would certainly be recommended in this case and could probably include discussions involving informing them what it is like to have a child with Down syndrome, what it could mean, various options about childcare, and the programs available that could help them should their child be born with Down syndrome. It may also be worth exploring Cecelia’s thoughts and feelings related to her bias towards individuals with disabilities. Did she always have them or is this unique to her because she is afraid of the challenges that come with the possibility of having a child with special needs? As an older sibling of a girl with Down syndrome, I have an understanding of where Cecelia may be coming from. Some children with trisomy 21 develop heart conditions, hearing loss, may experience blindness and ear infections, and can experience sleep apnea. There are some that grow up to remain completely dependent for the rest of their life while others need assisted living but are moderately self-sufficient. In the case of my own sister, she is very stubborn and at nearly 13 years old still cannot read and has difficulties with writing, but she is extremely clever, has excellent musical pitch, and can communicate her wants and needs well (when she wants to). Another person with Down syndrome may have strengths in other areas and struggles under similar circumstances. Every individual is unique, even amongst people with Down syndrome, so this could be one other thing to sit down with Cecelia and her husband about while talking about what it means to raise someone with Down syndrome, especially if they do eventually agree to keep their child.
Brianne, you bring up some awesome points that now that I am reading them, I wish I addressed more and dived deeper into the factors and things to consider when raising a child with Down Syndrome within my post. I do think that the decision and commitment around having a child with Down Syndrome is huge, and something that should be discussed and contemplated before a decision is set on. I do not wish to communicate the idea that deciding not to have a child with Down Syndrome is bad or good, I think it really and truly is a question of whether they can and/or want to handle it and I believe their choice would be valid either way. You’re line of thinking is logical, and from what it sounds like, you are perceiving the logical reasons and difficulties around the having of a child with Down Syndrome. In my post, I was not trying to imply or say that there are not reasons or difficulties to consider when having such a child, what I was addressing was more focused around Cecilia’s attitude, thought processes, and mindset around having a child with special needs. From the conclusion I ended up on, she was more concerned on not the logical difficulties that you know of, but rather the fact that her child was “different” or has “special needs”. She even states, “What would a child with Down syndrome be like?” before going on further down a line of negative thinking and problem seeking. If she knew more about what the raising of a child with Down Syndrome was like and had done research after learning that it was a possibility, much of what I wrote would be vastly different, but she instead jumps to assumptions and looks for more reasons against the idea of keeping a child with special needs rather than researching what it entails and what resources are at her disposal. My conclusion and view was that her focus is on the fact the child is not, in her eyes, normal, rather than the fact that there are certain needs and level of attention a child with Down Syndrome needs. When you stated that you have an idea of where Cecilia might be coming from, it makes sense to you, because of your experience, for there to be apprehension and consideration around the raising of a child with Down Syndrome, but Cecilia does not have or know those specific challenges that you are aware of, which in my eyes means that her reasoning and feelings is based out of bias, not logic and consideration.
You have set a great precedent for us all! This is such a well organized and informative presentation of the case study. I liked your graphics and how it was visually organized to. (I obviously need to take some time to learn more about blogging.) I also like how you always are very conscious of others thoughts, opinions and feeling. You opened with that statement and ended very well with it. I believe that you are going to make an amazing Social Worker. You are so thorough and make sure you do not come from a place of judgement. Your sections on potential biases and possible outcomes speaks to that. Thanks for your amazing work.