Bodies in a Zone of Indistinction: a history of the Biomedicalization of Pregnancy in Prison

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Biomedicalization Normalized

To better understand the inroads that medicine has made upon the prison system, it is important to first trace the ways in which medicine and law legitimate each other. Charting trajectories of power in the twentieth century, Michel Foucault describes how the judicial arm of the State becomes normalized into society through medicine:

I do not mean to say that the law fades into the background or that the

institutions of justice tend to disappear, but rather that the law operates

more and more as a norm, and that the judicial institution is increasingly

incorporated into a continuum of apparatuses (medical, administrative,

and so on) whose functions are for the most part regulatory.51
As law becomes hidden through medical imperatives, Foucault also argues that medicine augments its authority through law. This exchange allows both spheres of influence to validate each other’s existence and grow in power and prestige, and together their presence within prison systems makes it difficult to separate out the imperatives of the state and of medicine.

The medicalization of certain biological processes, such as pregnancy, has been used as a means of social control. Defining this process in terms of medical ideology, collaboration, and technology, Peter Conrad writes, “Simply stated, medical ideology imposes a medical model primarily because of accrued social and ideological benefits; in medical collaboration doctors assist (usually in an organization context) as information providers, gatekeepers, institutional agents, and technicians; medical technology suggests the use for social control of medical technological means…”52 Applying these overlapping categories to the medicalization of childbirth in prison, the combination of the pervasive ideology that medicine as advantageous to expecting mothers and the growth of medical technology in obstetrics lend themselves to supporting health care professionals as institutional agents for prisons. As institutional agents, health care professionals are placed at times in a difficult position to balance and uphold both medical imperatives to regiment health and healing and the imperatives of the prison to discipline and punish.

More recently, biomedicalization has become the new language through which scholars discuss a societal transformation occurring “…from the inside out through old and new social arrangements that implement biomedical, computer, and information sciences and technologies to intervene in health, illness, healing, the organization of medical care, and how we think about and live ‘life itself.’”53 To provide a few examples of this trend, in more recent years, the modes of risk and surveillance during the pregnancy process have expanded from basic Leopold’s Maneuvers to encompass imaging technologies of MRIs, intravaginal ultrasound, 3D/4D ultrasound, and telemedicine. Explaining this phenomenon, Ian Whitmarsh and David Jones write: “The state increasingly defines citizens by their biology, through prenatal testing, newborn screening, and government use of biometrics to determine medical access. Governance here is a mix of commerce and civic institutions acting on an individual subject.”54 Through these methods, Whitmarsh and Jones argue that recent applications of technology and knowledge allow women’s bodies to be seen more closely; and through such techniques of surveillance, public policies can be manifested upon the body.

Likewise, within the prison system, the authority of the medical establishment has gained traction in implementing their specialized knowledge upon women’s bodies. To this end, Elizabeth Grosz describes the power of such knowledge and how it shapes systems of governance:

… knowledge is one of the conduits by which power is able to seize

hold of bodies, to entwine itself into desires and practices: knowledge

devises methods for the extraction of information from individuals

which is capable of being codified, refined, reformulated in terms of

and according to criteria relevant to the assessment of knowledge. As

legitimized and sanctioned knowledge, discourse are then able to feed

back into the regimes of power which made them possible and to enable

power to operate in more subtle or systematic, more economical or

vigilant, forms.55
Medicine, as legitimized and sanctioned knowledge, forms a conduit of power through which to shape the prison system. Similarly, Agamben states, “…the biopolitical horizon that characterizes modernity, the physician and the scientist move in the no-man’s land into which at one point the sovereign alone could penetrate.”56 In the no-man’s land of prison, the pregnant inmate remains a zone of indistinction in which the physician and the scientist have begun to tread. The recent movements in medicine to advocate for prenatal care in penitentiaries, a ban on shackling practices, and prison nursery/residency facilities not only increase this zone of indistinction but also reflect larger societal trends in adopting and projecting the biomedicalization of pregnancy upon prison systems (the Sovereign).

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