Research Project

McCabe, Kate

Doctoral Dissertation Improvement Grant: Medical State Collaborations in Reproductive Health Care

Principal Investigator
McCabe, Kate
Funding Source
National Science Foundation

Abstract

In recent years, policy makers, medical professionals, and state actors such as law enforcement and child welfare agents have come together to address the issue of substance-using pregnant women. Researchers have noted that this collaborative approach to managing the behaviors of pregnant women has reconfigured treatment and clinical goals to align with punitive state responses. Specifically, reproductive health providers have become centrally implicated in the process of reporting non-normative pregnancy behaviors to the state, resulting in what some scholars have termed the “criminalization of pregnancy.” This study seeks to understand how these disparate systems collaborate with one another in order to protect “at-risk” fetuses and neonates by disciplining pregnant women. This research asks: how does the co-mingling of punitive state systems and medical systems reconfigure reproductive health care, alter treatment agendas and medical risk assessments, and affect maternal-infant health outcomes? To answer these questions this study employs a multi-level analysis to assess macro, meso, and micro-level factors that mutually shape interventions on pregnant women. To assess macro-level processes, the Co-PI has conducted a systems-level analysis to understand the ways in which policy domains (including drug policy, child welfare policy, and maternal-fetal health policy) shape medical agendas and encourage medico-legal collaborations. At the meso-level, the Co-PI is conducting a year-long ethnographic study of a Labor and Delivery unit to uncover how day-to-day medical practices, formal procedures, and risk assessments are carried out and to what extent the state is invited into or intervenes upon these processes. At the micro level, in-depth, semi-structured qualitative interviews will be conducted with medical professionals and women directly affected by medically-initiated state sanctions to understand how medical-state collaborations impact care outcomes and patient well-being.