About MARIAL Faculty, Fellows, and Staff Calendar of Events Research and Publications Fellowships Work-Family Resources Virtual Exhibitions	YAYA REN Department of Anthropology Emory University Project title: "Families in Crisis: The Making of a Family Person in the Neonatal Intensive Care Unit (NICU)" This MARIAL Project is centered on understanding how the youngest in American Society comes to achieve the status of a person through its initiation into a particular family. Bringing changes to the family structure, a new baby is often integrated into the social world through common ritual practices such as baby showers, christenings, naming ceremonies, and birth announcements. However, what happens to this integration process when expectations of a successful birth are replaced with the heartache of a premature one? Born too early, premature infants are unprepared for a life outside the womb. Most premature infants cannot survive without modern life support technology and neonatal medical treatment. As young as 23-24 weeks, the smallest of premature infants can weigh less than 1500g (about a handful of grapes) and are no bigger than a palm pilot. Premature bodies often are not yet well-developed enough to perform many basic functions, such as suckling, breathing, blinking, and crying, that we take for granted in newborn full-term infants. While under NICU treatment, premature infants inhabit open-elevated beds, immobilized in a spread eagle position, and sometimes glowing from the red hue of heat lamps under Saran Wrap covered beds. Hauntingly silent, the neonate often cannot yet move, suckle, swallow, or even cry. Despite the fact that most premature infants will survive the NICU and some may not even show any signs of disabilities, this period of time is nevertheless extremely stressful and disturbing for most parents. Families are emotionally unprepared for the sight of a premature infant under NICU treatment. In confronting the realities of a premature birth, families are often faced with many difficult decisions regarding the course of a neonate’s treatment, including the possibility of withdrawal of treatment from those sickest. Furthermore, families must also prepare for the possibility of caring for a disabled infant who may need continued high-cost medical care and treatment. This project will examine the social and cultural processes which affect the manner in which a liminal premature body comes to be accepted as a person and as the newest member of a family in the face complicating and competing medical, legal, economic, political, and social realities. More general theoretical questions I will consider include: Are common ritual practices adequate in managing new and difficult circumstances of a premature birth? How are premature infants accepted, rejected renegotiated, reinvented, and reconciled in the course of unfamiliar and unusal circumstances? Are new rituals generated under such out of the ordinary circumstances? If so, how? At the same time, I will also take into consideration how the physiological development of the neonatal body itself affects a family’s conceptualization of their baby as an infant-person rather than as an unfamiliar foreign body. Third, I will consider potential political, economic, and legal constraints and hurdles that families of premature infants face when making difficult treatment decisions. How much does neonatal care cost and who will pay for it? What political agendas drive crucial definitions such as “handicapped” “premature” and “infant”? Do parents have a right to withdraw care from a premature infant? What does the “best interest of the child” standard really mean and what constraints does it place on a family’s autonomy in deciding difficult treatment decisions? This project explores the relationship between family social ecology and the regulation of stress physiology, with special attention to the ways in which ritualization of family life moderates the physiological impact of economic status. In Decatur, Georgia, I will study childhood physiological reactivity in "middle class" families, and its relation to two proxies for broader elements of family social ecology: family routines and self-perceived economic status. I view measurable family routines as proxies for the small-scale daily ritualization of family life. I view the measurement of self-perceived, relative economic status as a much more focused way to understand the influences of "socioeconomic status," a gigantic and often vaguely-conceptualized amalgamation of status-related markers, on physical and mental health. The parents' workplace is arguably the most important mesosystem affecting the daily life of the child within the domains explored in this project. Thus, in relation to these other variables, I will include in the daily activity logs a specific category for "work-related activity," and examine the extent to which families report that various aspects of the workplace are relevant to their conceptualizations of economic security and time allocation.