The threat of cancer and the effects of risk-reducing surgery can have a significant impact on family planning and family life. In this qualitative study, we examine intersecting experiences of BRCA carrier status, subsequent risk-reducing surgery, and motherhood by analyzing in-depth interviews with 16 Jewish, Israeli mothers (ages 36–57) who underwent risk-reducing mastectomies and/or oophorectomies. Time emerged as a prism through which the BRCA motherhood experience could be viewed. In the “Findings” section, we present concepts of BRCA time and maternal time through three subthemes: (a) objective and subjective fertility clocks and BRCA: the child who won’t be born; (b) synchronizing the clocks: the “correct” tempo and chronology; and (c) back to the future: intergenerational coalescence of time. We discuss the notions of time and existential health threats and subjective time in the primary mother–infant relational system within the context of the cultural ideal of the “motherhood myth.”
AmbrosiniA.StanghelliniG. (2012). Myths of motherhood: The role of culture in the development of postpartum depression. Annali dell’Istituto Superiore di Sanità, 48, 277–286. doi:10.4415/ANN_12_03_08
2.
ArendellT. (2000). Conceiving and investigating motherhood: The decade’s scholarship. Journal of Marriage and Family, 62, 1192–1207. doi:10.1111/j.1741-3737.2000.01192.x
3.
ArèsI.LebelS.BielajewC. (2014). The impact of motherhood on perceived stress, illness intrusiveness and fear of cancer recurrence in young breast cancer survivors over time. Psychology and Health, 29, 651–670. doi:10.1080/08870446.2014.881998
4.
AryaS. T.DibbB. (2016). The experience of infertility treatment: The male perspective. Human Fertility, 19, 242–248. doi:10.1080/14647273.2016.1222083
5.
Barak-BrandesS. (2016). Ideologies of motherhood in contemporary Israeli TV commercials. Communication, Culture & Critique, 10, 58–75. doi:10.1111/cccr.12143
6.
Birenbaum-CarmeliD. (2016). Thirty-five years of assisted reproductive technologies in Israel. Reproductive Biomedicine & Society Online, 2, 16–23. doi:10.1016/j.rbms.2016.05.004
7.
Birksted-BreenD. (2009). “Reverberation time,” dreaming and the capacity to dream. The International Journal of Psychoanalysis, 90, 35–51. doi:10.1111/j.1745-8315.2008.00118.x
8.
BrunerJ. (1990). Acts of meaning. Cambridge, MA: Harvard University Press.
Central Bureau of Statistics. (2016). Society in Israel. Available from http://www.cbs.gov.il (Hebrew)
11.
DaganE.GoldblattH. (2009). The twilight zone between health and sickness: A qualitative exploration with asymptomatic BRCA1 and 2 mutation carriers. Women & Health, 49, 263–279. doi:10.1080/03630240903158321
12.
DeanM. (2016). “It’s not if I get cancer, it’s when I get cancer”: BRCA-positive patients’ (un)certain health experiences regarding hereditary breast and ovarian cancer risk. Social Science & Medicine, 163, 21–27. doi:10.1016/j.socscimed.2016.06.039
13.
DeanM.RauscherE. A. (2017). “It was an emotional baby”: Previvors’ family planning decision-making styles about hereditary breast and ovarian cancer risk. Journal of Genetic Counseling, 26, 1301–1313. doi:10.1007/s10897-017-0069-8
14.
de-Vitry SmithS.DietschE.BonnerA. (2012). Parents’ experience of time distortion following diagnosis of a serious or lethal fetal anomaly. International Journal of Childbirth, 2, 212–221. doi:10.1891/2156-5287.2.4.212
DorganK. A.DuvallK. L.HutsonS. P.KinserA. E. (2013). Mothered, mothering, and motherizing in illness narratives: What women cancer survivors in Southern Central Appalachia reveal about mothering-disruption. Journal of Appalachian Studies, 19, 59–81.
17.
DouglasS. J.MichaelsM. (2005). The mommy myth: The idealization of motherhood and how it has undermined all women. New York: Simon & Schuster.
18.
EllingsenS.RoxbergÅ.KristoffersenK.RoslandJ. H.AlvsvågH. (2015). The pendulum time of life: The experience of time, when living with severe incurable disease—A phenomenological and philosophical study. Medicine, Health Care and Philosophy, 18, 203–215. doi:10.1007/s11019-014-9590-9
19.
FisherC.O’ConnorM. (2012). “Motherhood” in the context of living with breast cancer. Cancer Nursing, 35, 157–163. doi:10.1097/NCC.0b013e31821
20.
Fogiel-BijaouiS. (2002). Familism, postmodernity and the state: The case of Israel. Journal of Israeli History, 21, 38–62. doi:10.1080/13531040212331295852
21.
GibbonS.JosephG.MozerskyJ.zur NiedenA.PalfnerS. (Eds.). (2014). Breast cancer gene research and medical practices: Transnational perspectives in the time of BRCA. London: Routledge.
22.
GordonO. K. (2010). Positive results: Making the best decisions when you’re at high risk for breast or ovarian cancer. Amherst, NY: Prometheus Books.
23.
LincolnY.GubaE. G. (1985). Naturalistic inquiry. Thousand Oaks, CA: Sage.
24.
HagerT. (2011). Making sense of an untold story: A personal deconstruction of the myth of motherhood. Qualitative Inquiry, 17, 35–44. doi:10.1177/1077800410389442
25.
HallowellN. (2000). A qualitative study of the information needs of high-risk women undergoing prophylactic oophorectomy. Psycho-Oncology, 9, 486–495. doi:10.1002/1099-1611(200011/12)9:6<486::AID-PON478>3.0.CO;2-Y
26.
HamiltonR. (2012). Being young, female, and BRCA positive. The American Journal of Nursing, 112, 26–31. doi:10.1097/01.NAJ.0000421021.62295.3b
27.
HaysS. (1996). The cultural contradictions of motherhood. New Haven, CT: Yale University Press.
28.
Hesse-BiberS. (2014). The genetic testing experience of BRCA-positive women: Deciding between surveillance and surgery. Qualitative Health Research, 24, 773–789. doi:10.1177/1049732314529666
29.
Hesse-BiberS.AnC. J. (2016). Genetic testing and post-testing decision making among BRCA-positive mutation women: A psychosocial approach. Journal of Genetic Counseling, 25, 978–992. doi:10.1007/s10897-015-9929-2
30.
HusserlE. (1964). The phenomenology of internal time-consciousness. Bloomington: Indiana University Press.
JowseyT. (2016). Time and chronic illness: A narrative review. Quality of Life Research, 25, 1093–1102. doi:10.1007/s11136-015-1169-2
33.
KatzR.LowensteinA. (2015). Generational solidarity in Europe and Israel. Canadian Journal on Aging, 34, 342–355. doi:10.1017/S0714980815000197
34.
Kestler-PelegM.LavendaO. (2018). Anxiety and defensiveness as predictors of maternal child-centrism. Feminism & Psychology, 28, 331–348. doi:10.1177/0959353518757255
35.
Kestler-PelegM.Shamir-DardikmanM.HermoniD.GinzburgK. (2015). Breastfeeding motivation and self-determination theory. Social Science & Medicine, 144, 19–27. doi:10.1016/j.socscimed.2015.09.006
36.
KirkmanM.WinshipI.SternC.NeilS.MannG. B.FisherJ. R. W. (2014). Women’s reflections on fertility and motherhood after breast cancer and its treatment. European Journal of Cancer Care, 23, 502–513. doi:10.1111/ecc.12163
37.
LaveeY.KatzR. (2003). The family in Israel: Between tradition and modernity. Marriage & Family Review, 35, 193–217. doi:10.1300/J002v35n01_11
38.
LøgstrupK. E. (1997). The ethical demand. Notre Dame, IN: University of Notre Dame Press.
39.
LuborskyM. R. (1994). The identification and analysis of themes and patterns. In GubriumJ. F.SankarA. (Eds.), Qualitative methods in aging research (pp. 189–210). Thousand Oaks, CA: Sage.
40.
Mahat-ShamirM.PossickC. (2017). The experience of women carriers of BRCA mutations following risk-reducing surgery: A cultural perspective. Health Care for Women International, 38, 344–360. doi:10.1080/07399332.2016.1267182
41.
MavaddatN.PeockS.FrostD.EllisS.PlatteR.FinebergE.. . . EastonD. F. (2013). Cancer risks for BRCA1 and BRCA2 mutation carriers: Results from prospective analysis of EMBRACE. Journal of the National Cancer Institute, 105, 812–822. doi:10.1093/jnci/djt095
42.
MeissnerW. W. (2008). Self and time. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 36, 707–736. doi:10.1521/jaap.2008.36.4.707
43.
MishlerE. (1986). Research interviewing: Context and narrative. Cambridge, MA: Harvard University Press.
44.
MoustakasC. E. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage.
45.
MurphyE. (2000). Risk, responsibility, and rhetoric in infant feeding. Journal of Contemporary Ethnography, 29, 291–325. doi:10.1177/089124100129023927
46.
RobertsH. (Ed.). (1991). Women’s health matters. London: Routledge.
47.
RowleyE. (2007). On doing “being ordinary”: Women’s accounts of BRCA testing and maternal responsibility. New Genetics and Society, 26, 241–250. doi:10.1080/14636770701701774
48.
RubinL. R.Werner-LinA.SagiM.CholstI.SternR.LilienthalD.HurleyK. (2014). “The BRCA clock is ticking!” Negotiating medical concerns and reproductive goals in preimplantation genetic diagnosis. Human Fertility, 17, 159–164. doi:10.3109/14647273.2014.940003
49.
SmithK. R.EllingtonL.ChanA. Y.CroyleR. T.BotkinJ. R. (2004). Fertility intentions following testing for a BRCA1 gene mutation. Cancer Epidemiology, Biomarkers & Prevention, 13, 733–740.
50.
VadaparampilS. T.ScherrC. L.CragunD.MaloT. L.PalT. (2015). Pre-test genetic counseling services for hereditary breast and ovarian cancer delivered by non-genetics professionals in the state of Florida. Clinical Genetics, 87, 473–477. doi:10.1111/cge.12405
51.
Werner-LinA. (2008). Beating the biological clock: The compressed family life cycle of young women with BRCA gene alterations. Social Work in Health Care, 47, 416–437. doi:10.1080/00981380802173509
52.
WoodsonA. H.MuseK. I.LinH.JacksonM.MattairD. N.SchoverL.. . . LittonJ. K. (2014). Breast cancer, BRCA mutations, and attitudes regarding pregnancy and preimplantation genetic diagnosis. The Oncologist, 19, 797–804. doi:10.1634/theoncologist.2014-0057
53.
YefetK. C. (2016). Born to be a mother: Anatomy, autonomy, and substantive citizenship for women in Israel. Harvard Journal of Law & Gender, 39, 257–257.
54.
ZiegertK.FridlundB.LidellE. (2009). “Time for dialysis as time to live”: Experiences of time in everyday life of the Swedish next of kin of hemodialysis patients. Nursing & Health Sciences, 11, 45–50. doi:10.1111/j.1442-2018.2009.00429.x
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