Reversing Kristeva's first instance of abjection: the formation of self reconsidered.

MCCABE JL and HOLMES D. Nursing Inquiry 2011; : 77-83 Psychoanalyst Julia Kristeva defines the theoretical concept of abjection as an unconscious defence mechanism used to protect the self against threats to one's subjectivity. Kristeva suggests that the first instance of abjection in an individual's life occurs when the child abjects the mother. However, the instance of abjection addressed within this paper is the reverse of this: the abjection of the child, with a disability, by the parent, and more broadly society. Using the contemporary example of prenatal testing, the authors explore how parents of children with disabilities may be influenced in abjecting the child. The implications of abjection of the child are then used to explore normalization, routinization of care and the development of standardized care practices within health-care. Prenatal screening practices and standardized care permeate medical obstetric care and social discourses regarding pregnancy and childbirth, thereby affecting not only healthcare professionals but also parents in their position as consumers of health-care. In a time when the focus of health-care is increasingly placed on disease prevention and broader medical and social discourses glorify normalcy and consistency, the unconscious abjection of those that do not fit within these standards must be identified and addressed. [ABSTRACT FROM AUTHOR]