Anthropologists engaging with biopolitical theory have commonly assumed that biomedicine is a tool for enacting state-based policies to manage population health. Recent insights in medical anthropology have troubled this assumption, calling into question the role of physicians as “handmaidens” of state-based health policy. I use my position as a physician-anthropologist to critically engage with biopolitical theory as it relates to the issue of illicit substance use disorders diagnosed during pregnancy, a significant etiology for maternal morbidity and mortality in Illinois. Data informing my analysis are derived from a four-year ethnographic engagement with obstetrician/gynecologists and pregnant women using illicit substances at the John H. Stroger, Jr. Hospital of Cook County, the safety-net hospital for the Chicagoland area. I employ these data to elucidate an interpretation of biopolitical theory that centers biomedical practice not as a site of reproducing biopolitical paradigms, but as one where these paradigms may become contested as it relates to the health and well-being of pregnant women diagnosed with illicit substance use disorders. Through engaging with Foucault and his interlocutors, I use my perspective – grounded in the practice of maternal-fetal medicine and medical anthropology – to think critically about health and futurity among my pregnant interlocutors. I illustrate how state bureaucratic entities and biomedical practitioners practice foreclosure, rendering certain hopes, dreams, and health of pregnant women diagnosed with illicit substance use disorders as unlikely possibilities. I also elucidate how pregnant women diagnosed with illicit substance use disorders live enclosed lives, or how life is maintained and experienced once certain futures, possibilities of existing otherwise, are foreclosed. I refer to the relationship between foreclosing and enclosing practices as the performance of treatment for illicit substance use disorders. These findings break new ground in anthropological interpretations of biopolitical theory by rethinking the role of biomedicine within biopolitical paradigms. My interpretation of biopolitics can be used in the future by medical social scientists interested in the relationship between the state, biomedical practice, and the health of marginalized individuals.

Creator

• Premkumar, Ashish

DOI

• https://doi.org/10.21985/n2-egz2-8t10

Subject

• Cultural anthropology

Language

• en

Alternate Identifier

• etdadmin_upload_965675
• http://dissertations.umi.com/northwestern:16433

Keyword

• anthropology of reproduction
• pregnancy
• opioid use disorder
• illicit substance use disorders
• biopolitics
• medical anthropology

Date created

• 2023-01-01

Resource type

• Dissertation

Rights statement

• In Copyright