Created by Tinch Minter – funded by a People Award from the Wellcome Trust

"Inside View" was a one woman show performed by Kathy Joyce and set in a multi–media live environment created by Saul Cross. It was developed from ESRC funded research on the Experiences and Dilemmas of women and health professionals in relation to pre-natal genetic screening (Lewando Hundt et al 2010).

"Inside View" was performed in London and the Midlands to varied audiences with a panel discussion and evaluation post performance. This was a multi-media live theatre production on the dilemmas and issues of pre-natal screening. The play was about the seemingly routine experience of women attending a foetal scan generally at 12 weeks. The scan is often not seen as the screening process that it is and can potentially leave women and their partners with huge decision making dilemmas on a scale never experienced in the lives of most of us. Whether or not to terminate a pregnancy.

It took place in lecture halls and conferences with a post-performance discussion made up of a multidisciplinary panel which included a social scientist, the performer, a physician, the theatre director and theatre design technologist.

Working in partnership in this manner is a complex and exciting business. It takes time as the accuracy of the material and the data translation is paramount. It would be easy enough for the artistic team to fictionalise even in the smallest way aspects of research. The opposite is the case for Santé Theatre’s work.

The script was developed by Tinch Minter from the summaries and the visual material was gathered by Saul Cross and developed in consultation with, and utilising some material from the biochemist and the clinic site along with research material on the subject.

The script was shared with the team as it was developed, undergoing several drafts both before and during the rehearsal period which was attended by some of the social scientists. The development of the performance was an iterative process involving adaptation of the script through a dialogue between the director, social scientists, and biochemist. The performances of a one woman show performed by an actor portraying every woman were followed by a panel discussion with different members of the multidisciplinary team responding to questions from the audiences in relation to both the policies, practices and ethical dilemmas of prenatal screening and also the transformation of research data into performance.

The storyline involved a pregnant woman attending a prenatal screening clinic, and followed her physical and emotional journey through the clinic. A decision was taken to leave both the woman and the audience with unresolved possibilities and outcomes as a way of focusing on every woman’s dilemma and choices.

Artistically, Bryanston had to broker these different perspectives on stage and this necessarily involved adapting and modifying the script with discussion between primarily the actor and writer with the media technologist. For example an artistic device of a favourite but flawed coffee mug was used to convey the possibility of valuing imperfection.

“Like this mug - here’s a print of the potter’s thumb. And here’s a bit of clay peeping through where the glaze didn’t stick – that’s why I brought it. It’s individual. Even the potter didn’t know for certain how the pot would come out... All the time it’s in the kiln, it changes, becomes more itself…” (excerpt from script Inside View)

The performance was played against a back projected visual environment.

An opening sequence accompanied by music with a foetal heartbeat, showed a waterfall that then transformed into the double helix of DNA. The use and reference to time both in the script but also in the visuals and sound track enhanced this theme. Set into the digitally created backdrop of the waiting room there was an interactive clock that synchronised to the duration of the time spent by a pregnant woman in a one stop first trimester screening clinic. This was accompanied by the sound of time ticking on in the sound track, and within the theatre piece were moments when time was suspended to allow the audience to have insight into the internal dialogue of the pregnant woman.

The visualisation of the foetus using an ultrasound scan was one the main motifs and informed the title, this also informed the choice to use digital technologies and to set the production entirely within a digital environment.

About the Research

The 'Inside view' performance was funded by the Wellcome Trust with the intention of stimulating and informing debate about prenatal screening during early pregnancy. The dilemmas and questions were explored from the perspectives of both health professionals and pregnant women. The performance raised questions about some of the social, ethical and cultural issues and stimulated debate. Download a research poster about this project .

The performance drew on the findings of a research project on the 'Social implications of prenatal genetic screening'. This was funded by the ESRC within the Innovative Health Technologies Programme (L21825042). This project collected questionnaires from several hundred women in two different locations both before and after birth. It also carried out interviews with women during pregnancy and postnatally. It recorded consultations within two maternity clinic sites and interviewed the staff working there. The project provided a wealth of rich narrative data from health professionals, women and their partners about prenatal screening, which was used to inform this performance.

Comments from Health Professionals

‘To see the problems mirrored by a real person helps to identify and analyse issues of new technologies.’

GP: I refer pregnant women automatically for screening – from now on, I will discuss it with them

Wellcome Trust Award - Research Team

• Professor Gillian Hundt, Warwick Medical School, University of Warwick
• Dr Claudette Bryanston, Warwick Medical School, University of Warwick
• Dr Kevin Spencer, Consultant Biochemist, Barking Havering and Redbridge NHS Trust, Harold Wood Hospital
• Professor Jane Sandall, Florence Nightingale School of Nursing and Midwifery, King’s College London
• Dr Pam Lowe, Department of Sociology and Policy, Aston University

Additional members from the ESRC project

• Professor B Heyman, St Bartholomew School of Nursing and Midwifery, City University
• Dr C Williams, Florence Nightingale School of Nursing and Midwifery, King's College London
• Ms R Grellier, based in Johannesburg, South Africa
• Ms L Pitson, Florence Nightingale School of Nursing and Midwifery, King's College London
• Dr M Tsouroufli, School of Social Studies, Cardiff University