Pregnancy, Medicaid, State Regulation, and the Production of Unruly Bodies

Bridges, Khiara M. | January 1, 2008

This paper represents a concretization of thoughts generated during a year and a half of anthropological fieldwork in the obstetrics clinic of a large, public hospital located on the . As a condition of receipt of Medicaid coverage of prenatal care expenses, poor, uninsured pregnant women are compelled to meet with a battery of professionalsnamely nutritionists, social workers, health educators, and financial officerswho inquire into areas of women’s lives that frequently exceed the realm of the medical. This paper argues that, as a result, Medicaid mandates an intrusion into women’s private lives and produces pregnancy as an opportunity for state supervision, management, and regulation of poor, uninsured women. In essence, the receipt of Medicaid inaugurates poor women into the state regulatory apparatus. Further, this paper argues that because the regime of prenatal care provided by the state-qua-Medicaid is one delivered within a highly technological, biomedical paradigm of pregnancy, poor women are produced as possessors of “unruly bodies.” Because the uninsured poor are universally produced as such, I argue that the consequence is a medicalization of poverty. As a result, the poor are treated as biological dangers within the body politic. The paper begins with a presentation of Michel Foucault’s notion of biopolitics and an explanation of its relationship to the regime of prenatal care at peration in . A detailed description of the apparatus of professionals that initiates women’s prenatal care at Alpha follows in Part Three. Part Four continues with a description of the highly-technological care that is delivered as a matter of course at Alpha. A brief conclusion follows in Part Five.