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

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Pregnancy In and Out of Prison

An analysis of medical articles written in the past three decades on pregnancy in prison reveals the ways in which medical doctors and social researchers conceptualized a tension between the role of a prisoner, the role of the patient, and the role of a mother. Many scholars write that there was a strong cultural contradiction between being expected to provide care and nurturance for infants and children, and being forced to submit to totalitarian regimes of power in an overwhelmingly hostile environment. In the “free” world, mothers face the cultural contradiction between the expectation to practice what Sharon Hays calls “intensive mothering” and another expectation to fulfill the 1960s and 1970s feminist dreams to be careerists on equitable footing as men in work environments. 57 In prison, mothers subvert both roles, which can only be attempted in the “free” world, and are thus further shamed by their inability to perform “good” mothering. In reading elaborations on the tensions within performativity, it becomes clear that the medical researchers also place pregnant prisoners and incarcerated mothers in a zone of indistinction, yet within this zone they argue for an increased medical presence and other social programs in the women’s lived experience as a way of coping with the stressors of prison life and maintaining a sense of individuality.

While many of these authors recognize the larger social injustices of the prison systems and the public policies and corporate structures that have led to increased rates of incarnation, these factors seemed too large and imposing to address at the medical level. (In one instance, completely ignoring the sociological factors that contribute to an expanding definition of criminalization, a medical researcher took the position that the increasing rates of female incarceration further enhance his argument that medical intervention is even more necessary within prison.58) Still, the prevailing notion remains one of complacency in the belief that the knowledge of medicine can work in tandem with the authority of law, and that it can achieve shared goals of creating “good” citizens and mothers.

One article written for the International Journal of Obstetrics and Gynaecology notes the irony that prisoners have better health outcomes than women in the “free” world of the same low socioeconomic status.59 Although the authors do not mean to imply that more women should be incarcerated as a means to achieve better birth outcomes, they do suggest that life is so chaotic and unstable out of prison that in terms of preventing stillbirth or low birth-weight for infants “imprisonment may have a beneficial effect.”60 This sort of rhetoric legitimates medicine’s existence in prison systems, yet it also provides a very narrow scope of conceptualizing medical advocacy that refuses to examine the larger structural inequities and public policies within the “free” world that fails to provide adequate health care access and that contribute to increased criminalization of women inmates.

Through this normalizing discourse, the following quote from the concluding statements of Judith Wismont’s qualitative study of pregnant inmates in 2000 can be contextualized:

The rapidly rising number of women imprisoned in the United

States underscores the urgency to better understand their experiences.

HCPs (Health Care Professionals) must talk with pregnant incarcerated

women to more fully understand the experience of childbearing in

prison. A way must be found to help imprisoned women cope more

effectively with the role diffusion/confusion they experience as they

live two diametrically opposing roles—those of inmate and mother.

Incarcerated mothers must be assisted to identify their strengths and

set personal goals. Correction authorities must be encouraged to

establish care guidelines that recognize the unique needs of pregnant

incarcerated women.61

Although Wismont attempts to employ techniques of “phenomenological reduction” to express “scientific exactness” for which she strives, her account of women’s accounts of pregnancy within prison is unable to present a narrative with “all subjective influences removed.”62 As a health care professional herself, she believes in the duty she and her colleagues have to listen to the narratives of their incarcerated patients (which could be read as increased surveillance of their affect) as a means to grapple with an assumed tension they experience in maintaining the roles of expecting inmates. Furthermore, she implies that medical professionals should act as witnesses (surveyors) and life coaches (discipliners) to encourage inmates to achieve goals (presumably to aid in their normalization process and reintegration into “free” society). Speaking to an audience interested in midwifery and women’s health issues, she advocates for their increased attention to women’s needs in prison and calls for the policy change in correctional facilities through the logos of medical advice.

Likewise, writing to a medical audience in perinatology, Steven Safyer and Lynn Richmond also participate in a similar medical discourse to normalize mothering in prison:

With the pressures overburdening the criminal justice system,

increasingly precious resources need to be invested in community

programs that will provide pregnant women with a structured

environment, prenatal care, good nutrition, and most critically,

drug treatment, with transitional assistance to self-sufficiency…

At the very least, programs need to be developed and sustained

that integrate jails and prisons with health, educational, and social

services in the community.63

Although the authors recognize the sociological barriers for mothers attempting to access resources in (and outside of) prison, they continue to place responsibility on individual inmates to get to a place of “self-sufficiency.” This truncated perspective of accountable mothering can easily be read as a means to not only perpetuate dependency upon state welfare programs (including medical care) but also a sense of distrust that women are not able to be suitable mothers without such a “structured environment.” Even these researchers who recognize the “complex stories of unfinished lives, of victimization and abuse, of poverty and exploitation, of cyclical and generational obscurity, of classism and sexism, and of stigma and shame,” still suggest more invasive interventions creating “good” mothers through parenting classes, mentorship classes, drug addiction support, and community-based programs.64

Moreover, many medical professionals and social researchers are interested in the familial effects of incarceration among inmates with infants and children. Tracking the high school dropout rate and other markers of educational difficulties among teenage children of incarcerated mothers seems to indicate a persistent correlation between maternal incarceration and negative effects upon children’s mental health and scholastic achievement.65 Thus, both in and out of prisons, the lives of past and present offenders are being tracked for the potential long-term political impact that they and their offspring may have on other spheres of social welfare programs.

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