"You have to find a caring man, like your father!" gendering sickle cell and refashioning women's moral boundaries in Sierra Leone.

Most research on sickle cell disorders has tended to be gender-blind. This qualitative study undertaken in 2018, explores if and how sickle cell disorders become gendered in Sierra Leone through the analytical framework of a feminist ethics of care. It argues that women have to navigate moral blame when they have children with the condition. At the same time women refashion moral boundaries so that gendered norms around childhood and parenting for such children become suspended, in favour of creation of careful spaces. Parental fears of physical and sexual violence mean that gendered sexual norms are enforced for teenage boys as they are encouraged into early adulthood. In contrast, girls are kept in enforced ignorance about the consequences of sickle cell for reproduction and are encouraged to delay motherhood. This is because, as women relate, relationships and giving birth are fraught with embodied dangers and risks of violence.

"Race", ethnicity and haemoglobin disorders.

The new genetics has brought forth concerns that such developments as screening for genetic diseases will accentuate the oppression of minority ethnic groups [Bradby (1996) Genetics and racism. In The Troubled Helix: social and psychological aspects of the new human genetics, ed. T. Marteau and M. Richards, pp. 295-316. Cambridge University Press, Cambridge]. Haemoglobin disorders primarily affect minority ethnic groups in the U.K. but have been the subject of protest regarding lack of services as much as the unwelcome advent of them. This paper examines various conceptions of "race", from biological reductionism, through notions of ethnicity, racialized groups, sociological conceptions of "race", political and analytical uses of the term "Black" and so-called "new ethnicities" such as situational and plastic ethnicity in order to examine the consequences of these competing conceptions of race for a social analysis of sickle cell anaemia and beta-thalassaemia. The paper concludes that any group of people associated with the haemoglobin disorders are subject both to constraints upon their actions and opportunities for re-interpreting their social world. In conclusion it is proposed that no nomenclature classifies the phenomenon unproblematically. The notion of race as a political construct [Goldberg (1993) Racist Culture: Philosophy and the Politics of Meaning. Blackwell, Oxford] is used to suggest that attempts to construct all-embracing definitions themselves signal the potential abuses which may be attendant upon programmatic or mechanistic conceptions of the relationship between race and haemoglobin disorders.

Midwives' and senior student midwives' knowledge of haemaglobinopathies in England.

OBJECTIVE: to examine midwives' and senior student midwives' knowledge concerning sickle-cell anaemia and beta-thalassaemia. DESIGN: survey using the 'Dyson' questionnaires. SETTING: study days on 26 sites across England over three months. PARTICIPANTS: 850 questionnaires were completed by a convenience sample of midwives and senior students: 401 on sickle-cell anaemia and 449 on beta-thalassaemia. In each case just under two-thirds were qualified midwives. MEASUREMENTS AND FINDINGS: most respondents underestimated the number of ethnic groups affected by these disorders. A majority gave the wrong answers to basic questions on the inheritance of these disorder, fewer than one-third answered two simple genetics questions correctly. KEY CONCLUSIONS: in order to provide an equitable service midwives need more education in this area, particularly after qualification. IMPLICATIONS FOR EDUCATION PRACTICE: education on haemoglobinopathies was linked with improved knowledge levels and appears most effective when undertaken by counsellors in haemoglobinopathies. Such education should therefore be available, especially to qualified midwives who had not previously received it.