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Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization
Reproducing Race, an ethnography of pregnancy and birth at a large New York City public hospital, explores the role of race in the medical setting. Khiara M. Bridges investigates how race—commonly seen as biological in the medical world—is socially constructed among women dependent on the public healthcare system for prenatal care and childbirth. Bridges argues that race carries powerful material consequences for these women even when it is not explicitly named, showing how they are marginalized by the practices and assumptions of the clinic staff. Deftly weaving ethnographic evidence into broader discussions of Medicaid and racial disparities in infant and maternal mortality, Bridges shines new light on the politics of healthcare for the poor, demonstrating how the “medicalization” of social problems reproduces racial stereotypes and governs the bodies of poor women of color.
306 pages, Paperback
First published February 16, 2011
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Displaying 1 - 13 of 13 reviews
July 2, 2018
Essential in understanding the vectors of power that produce the racialized, gendered, and classed Patient. Bridges wields Foucault like a knife; her ethnographic analysis is fresh and exciting. It doesn't explicitly address disability often, but this is an excellent source whose narratives of marginalized women might be "cripped"–– especially as the medicalization of pregnancy / the pathologization of raced & gendered poverty become so fully entangled with the rhetoric we recognize as ableism. I love the way Bridges reaffirmed the violence as enacted by the state, via both impersonal institutions and clinicians. It's refreshing to read an account that does not simply call to "end the stigma" attached to certain patients, but rather to attack the very systems doing the stigmatizing.
December 12, 2025
Methodology analysis （submitted as one course essay）
The researcher selects the Alpha clinic in New York City as her research site where she conducts an in-depth ethnography to detect power relations and inequality discrepancies of obstetrics and gynecology pragmatics among patients and healthcare practitioners at the Alpha clinic. The Alpha clinic is the hospital where the indignant, underclass, and poor immigrants go to seek medical services in the city of New York. The population seeking prenatal care at the clinic is diverse, as the author states that in the hospital’s waiting room, one can overhear patients speaking in different languages such as English, Spanish, Mandarin, Cantonese, Polish, Arabic, Bengali, Urdu, Hindi, and French. As a part of her ethnography, the researcher really immerses herself in the fieldwork context by conducting works at the front desk of the clinic. Also herself being a woman that grants her convenience and access to some rudimentary medical practices at the clinic, she could be permitted to observe patients and nurses’ interaction in the nurses’ triage rooms, and managed to perform some basic prenatal care assessments, such as blood pressure, weights, and urine tests. She is also allowed to observe how female patients receive services by male medical providers. In addition, she is given permission to observe patients’ consultation with nutritionists, social workers, Medicaid financial administrators, health educators, geneticists and other healthcare staff members. She conducts 120 hours long interviews with eighty patients, and 50 interviews with thirty health care providers and staff. She also does observations at another obstetrics clinic in the Lower East side of Manhattan, Sigma clinic. Since the researcher employs ethnography as the research methods, and this method is applied consistently throughout the research, I will write my critiques of research methods along with a short and brief analysis of the content chapters. There are six chapters within this book apart from the introduction and epilogue.
In the beginning, this book presents the research’s context, the Alpha clinic, by introducing how it becomes and functions as an enclave place for those poor, uninsured, immigrant, indigent patients in the city of New York. The clinic’s obstetrics and gynecological department is administered with three ilks of healthcare providers: medical doctors, midwives, and nurse practitioners. The first chapter, by providing a sufficient background information of the clinic and major players of the clinic, argues that the ancillary staff are being unfairly reproached for their lack of responsibility at the workplace, and for their laziness and ineptitude at work despite of comparative easiness of their job responsibilities. The researcher’s concluding thoughts of this chapter reach to a point that she criticizes the Alpha clinic as a working site of races and ethnicity. In chapter one, she observes the clinic, and personally “works” for several weeks as a front desk assistant for this clinic. But I have found that the concluding thoughts about this workplace being a racialized site is not sufficiently or well supported by the methods she applies to this part of analysis. First, only two ancillary staff members have been recruited for conducting in-depth observation and interviews, and as a sociological researcher, I would like to see detailed information collected by observation and interviews from more ancillary staff members of the clinic’s crew. Second, elaborations based on two ancillary staffs, Yolanda and Minnie, are not enough and I think cannot provide solid supports to this chapter’s argument. Third, I think the methods employed by the researcher is in short of a collective portrait of the Alpha clinic’ medical practitioners. The researcher conducts interviews with registered nurses, health educators, HIV counsellors, nutritionists, Medicaid financial officers, and social workers, to see how the state’s apparatus of biopolitical power control have been exercised and encompassed over the bodies of those pregnant women. In this chapter, this researcher copes with a pivotal thematic topic that exposes the disciplinary power that has encompassed and regulated the uninsured poor patient at Alpha clinic. The researcher cites Michel Foucault’s theorization in Discipline and Punish, that the significance of scaffold of the classical era which imposed massive power of the sovereign to destroying the bodies of the sovereign’s subjects, was replaced by the consummate enterprise which has exercised its power through producing docile bodies by a managing and regulating ones’ bodies and minds. Foucault’s theory lends its analytical support to the researcher’s interrogation regarding how uninsured poor people are attracted to the Medicaid - the state’s apparatus, to have their pregnant bodies subjected to the "carceral archipelago” (Bridges, 2011, p. 71). As the researcher indicates, the state’s generosity to pay the medical bills for the uninsured patients cannot outcast a more alarming reality that the Medicaid’s endeavours are more prone to execute disciplinary, surveillance, and punitive power over those pregnant poor people. The pregnant women who decide to be subjected of Medicaid tend to become under the control and regulation of biopolitical state, as most of their private information relevant to their medical treatments even including male partners’ names/contact information, his race and citizenship status, his position of employment and income, whether he supports the pregnancy, whether he physically abused the pregnant women and among others are collected by multiple healthcare-related practitioners. Regarding chapter two, I have two major critiques of this chapter’s methods. First, as the researcher conducts multiple interviews over various healthcare practitioners, it would be helpful for this chapter to list out basic information regarding how many practitioners are interviewed, what are their specific professions, and what are their primary demographics information. It would be better to provide a table for presenting the information. Without a knowledge of these medical practitioners’ information, it is likely that viewpoints and information they project to the researcher’s questions could be somewhat biased and prejudicial. The second critique I would like to elicit for this chapter concerns about a lack of comparative analysis with the researcher’s fieldwork at other clinics. As the researcher states in the introduction chapter, she conducts weeks-long observation at the Sigma clinics, and from my reading experiences and knowledge of medical practices in the US, many other clinics would also collect multiple private information of the patients for obstetrics and gynecology exams and treatments. Then how could the researcher reach a concluding thought regarding the patients at the alpha clinic that, in Foucault’s terms, their bodies are produced and reproduced under regulation, punitive control and surveillance of a state’s bio-political enterprise? It would be better to lead to such an argument by adding on a comparative perspective based on observations of other medical clinics. The third chapter concerns about in what ways the unruly bodies of these pregnant women are regulated and controlled at the Alpha clinic. The third chapter is beautifully written and the methodology the researcher utilizes is sound and valid. The researcher of this book demonstrates the following differences of prenatal care programs between uninsured patients and those with private medical insurances (Bridges, 2011, p. 77 - 78): 1) privately insured patients receive medical examinations six to eight weeks after giving birth, but their healthcare providers do not evaluate their psychological, social, nutritional, alcohol and drug intervention needs, and contraceptives treatments, unless they conditionally request to do so; 2) women who are Medicaid recipients are required to be administered with glucose challenge test; 3) patients with Medicaid are required to test constantly for sexually transmitted pathogens such as gonorrhoea, chlamydia, and syphilis; and 4) the privately insured women are not required to be vaccinated for Hepatitis B or to be screened for tuberculosis. For writing this chapter, the researcher makes inquiries into existing legal and policy documents, and operates interviews for both medical professionals and patients who receive prenatal care at the Alpha clinic. A midwife at the Alpha clinic states: “We have to work within the system here. It’s very limiting. We do a million tests that probably don’t need to be done on these nice, healthy women. And we see them sometimes more often than I would like. It’s a weird system. . . . It’s a burden on them, I feel like” (Bridges, 2011, p. 89). The researcher further points out, a woman under prenatal care has to go through standardized medical procedures on which the healthcare professionals employ as a monopoly, as the obstetrics renders a woman under surveillance of “a nine month clientage” (Bridges, 2011, p. 90-91) through which the woman’s prenatal care needs are defined, categorized, assessed, helped, counselled, and addressed by medical and health providers. The researcher draws a concluding definition of such micro-phenomena - technocracy model of pregnancy. There are few alternative treatment and care plans for the vast majority of uninsured, pregnant women, and they have to accept Medicaid, whilst they are enforced to “conscripted” into a regime of biomedicine. Those poor women have few choices apart from choosing Medicaid. The fourth chapter denotes, the prenatal care assistance program and site at the Alpha clinic is comprehended as a policy effort to ameliorate and alleviate the country’s history of racial inequality and racism. The assistance program and site ensure that individuals of racial minority backgrounds are entitled to receive quality and appropriate pregnancy and childbirth care services. Since the program took effect, it has been celebrated and lauded for its purposes of reducing racism and racial inequality in healthcare professions. However, as the researcher points out affirmatively, racism and racial inequality still prevail among prenatal and pregnancy care professionals at Alpha hospital, since a patient’s racial identity still overdetermines her health conditions and medical and healthcare providers still harbour racist beliefs against these patients with racial minority backgrounds. The researcher suggests that medical doctors and other healthcare providers should be inquired about their knowledge and values of racial minorities, however, the research identifies a resistance from the medical doctors and healthcare professionals as the medical professionals’ personal beliefs and values are legitimated as individual privacy. Healthcare providers’ beliefs and biases towards their patients of racial minorities represents a vivid and accurate perspective of the culture of racism and racial inequality in a larger society. The research sends out an alert that racism and racial inequality existing among uninsured patients of racial minority backgrounds should be placed with alarming concerns and should be carefully addressed and intervened. The fourth chapter’s research methods are sound and valid, but I have only one question regarding the process of data collection, especially data collected from medical doctors and other medical professionals at the Alpha hospital. It is commonly acknowledged that detecting racist attitudes and beliefs appears to be comparatively less difficult, but it is also common for people who originally garner and harbour racist personal knowledge and beliefs to make a lot of efforts to hide from identification or they would try to disrupt and confound the researcher’s detection. For example, a doctor, who has been treating poor women of racial minority backgrounds and who has also garnered a slew of racial biases and prejudices against his or her patients, would incline to reveal more positive information or even tell lies about his or her experiences of treating racial minority patients. In the fifth chapter, the researcher engages in an in-depth observation and interviews at the Alpha clinic. This section of the book is to concern about the Alpha patient population that demonstrates the social origins of race-related medical conditions, as according to the research experiences and fieldwork at the Alpha clinic the author draws some concluding remarks that certain types of medical conditions such as sickle cell anaemia, hypertension, and diabetes occur disproportionately among the black persons (Bridges, 2011, p. 152). The Medicaid guidelines demand every pregnant and insured women of poverty, at the beginning of their prenatal care, to be assessed for “risks” of health problems, and risks concerning their genetic, nutritional, psychological-social, and personal medical historical factors are taken into strategic prevention and interventions (Bridges, 2011, p. 154). Diseases may be socially constructed, and for the Alpha patients, a body that equates the conditions to be included into attending to “risk-assessments” is not a fixed categorization, since what accounts for pathologies is being fluid and unstable (Bridges, 2011, p. 158). As the research states, Alpha patients as a specified population are most likely to be provocatively included as constituting risks and pathologies. The researcher offers an example demonstrating how the Alpha patient population are automatically defined and classified as having health risk factors. Women’s testing for STDs and STIs informs through evidence-based studies that economic disparities and poverty would result in prostitution. And this policy (Bridges, 2011, p. 159) implies unfair assumptions that every woman who belongs to the Alpha patient population could be a prostitute, and therefore, the policy unfairly considers every Alpha clinic’s female patient that she is possible to engage in prostitution. The fifth chapter is provocatively well-written and I think her data collection and data analysis are well-grounded on a good knowledge of relevant theories and literature of poverty, medicalization, and pathologization. Herein, I have one critique of this chapter’s methods. In the first blush, the researcher’s data collection involves interviews with medical doctors, nurses, midwives, and the front desks, but I think she ignores the importance of a possible literature analysis of the Alpha clinic’s internal policies and guidelines, on the basis that she addresses the guidelines and policies mandated by the Medicaid. I consider this minor approach useful and also accessible for the part of the researcher, since a literature analysis of the clinic’s internal policies and protocols would depict an incisive and detailed picture that manages to profile how the clinic complies to or maybe diverge from the guidelines of the Medicaid. In the sixth chapter, the researcher states, that racism has become more implicitly demonstrated in public spaces - race and racism are not something to be easily detected and in the United States as it once was, and explicit racism are not demonstrated as they were several decades ago (p. 248). In public spaces, racial minority people are no longer dehumanized and reduced to “a fraction of their racial Other” (Bridges, 2011, p. 248), and institutional suppression based one’s racial minority ascription is no longer something one could easily point out and say something about (Bridges, 2011, p. 248). The days when jurists and lawmakers could readily discuss the appropriateness of subjection of the Black people to the white people were long past (Bridges, 2011, p. 248). In the sixth chapter, the research methods the author employs is sound and robust, as she interviews patients from various racial minority backgrounds, in order to extract “the logics” of race among the Alpha patient population. However, here is my major criticism of this chapter’s methodology. The researcher writes intensively for several pages on how the concept of wily patients exhumed from the medical pragmatics at the Alpha clinic and its interconnectedness with poverty, immigrant status, and racism. She observes the ways the patients’ names are called out by the front desk staff, and she collects valuable data regarding how the patients who lack linguistic skills to understand or speak English fluently are reprimanded and mistreated by the staff members of the clinic. Also, she interviews multiple patients of colour as a way to detect and rationalize in what ways the concept of welfare queens is constructed. This part’s writing is excellent, and I really enjoy reading it. However, I find her approach a little bit flawed, as there is little evidence to prove that the researcher conducts observation and interviews with medical doctors and midwives at the Alpha clinic. What if the medical doctors including the midwives think differently with regards to whether to equate poor, uninsured, pregnant women as wily patients? Or else, is it possible that the medical doctors are reluctant to label those black women as welfare queens by providing professional healthcare services and situating themselves within less racist and biased personal values? I am curious to know about this aspect.
I think with a collective delineation of the clinic’s healthcare providers, it would be more beneficial to this book’s readership to grasp why the Alpha clinic is considered as a haven for those uninsured poor people in New York City, and how it can also be described as a racialized working site. In addition, I think it would be better to do a comparative analysis here before drawing a conclusion on the technocratic model of pregnancy and childbirth care for women with Medicaid at the Alpha clinic. I need to state that the research’s lacking in a comparative approach, between women who solely rely on Medicaid and those women who have private insurances, is not proficient for the readership to detect and examine power relations and inequalities of prenatal care and childbirth care. A dearth of a comparative analytical framework would not placate a possible research bias. As far as I know based on my research and reading experiences, a technocratic model of pregnancy and childbirth care does not only probe into and administer biopolitical forces onto poor and uninsured women but also exercises technocratic ruling and regulations over women who are private insurances of less coverage.
Thanks for reading. :)
The researcher selects the Alpha clinic in New York City as her research site where she conducts an in-depth ethnography to detect power relations and inequality discrepancies of obstetrics and gynecology pragmatics among patients and healthcare practitioners at the Alpha clinic. The Alpha clinic is the hospital where the indignant, underclass, and poor immigrants go to seek medical services in the city of New York. The population seeking prenatal care at the clinic is diverse, as the author states that in the hospital’s waiting room, one can overhear patients speaking in different languages such as English, Spanish, Mandarin, Cantonese, Polish, Arabic, Bengali, Urdu, Hindi, and French. As a part of her ethnography, the researcher really immerses herself in the fieldwork context by conducting works at the front desk of the clinic. Also herself being a woman that grants her convenience and access to some rudimentary medical practices at the clinic, she could be permitted to observe patients and nurses’ interaction in the nurses’ triage rooms, and managed to perform some basic prenatal care assessments, such as blood pressure, weights, and urine tests. She is also allowed to observe how female patients receive services by male medical providers. In addition, she is given permission to observe patients’ consultation with nutritionists, social workers, Medicaid financial administrators, health educators, geneticists and other healthcare staff members. She conducts 120 hours long interviews with eighty patients, and 50 interviews with thirty health care providers and staff. She also does observations at another obstetrics clinic in the Lower East side of Manhattan, Sigma clinic. Since the researcher employs ethnography as the research methods, and this method is applied consistently throughout the research, I will write my critiques of research methods along with a short and brief analysis of the content chapters. There are six chapters within this book apart from the introduction and epilogue.
In the beginning, this book presents the research’s context, the Alpha clinic, by introducing how it becomes and functions as an enclave place for those poor, uninsured, immigrant, indigent patients in the city of New York. The clinic’s obstetrics and gynecological department is administered with three ilks of healthcare providers: medical doctors, midwives, and nurse practitioners. The first chapter, by providing a sufficient background information of the clinic and major players of the clinic, argues that the ancillary staff are being unfairly reproached for their lack of responsibility at the workplace, and for their laziness and ineptitude at work despite of comparative easiness of their job responsibilities. The researcher’s concluding thoughts of this chapter reach to a point that she criticizes the Alpha clinic as a working site of races and ethnicity. In chapter one, she observes the clinic, and personally “works” for several weeks as a front desk assistant for this clinic. But I have found that the concluding thoughts about this workplace being a racialized site is not sufficiently or well supported by the methods she applies to this part of analysis. First, only two ancillary staff members have been recruited for conducting in-depth observation and interviews, and as a sociological researcher, I would like to see detailed information collected by observation and interviews from more ancillary staff members of the clinic’s crew. Second, elaborations based on two ancillary staffs, Yolanda and Minnie, are not enough and I think cannot provide solid supports to this chapter’s argument. Third, I think the methods employed by the researcher is in short of a collective portrait of the Alpha clinic’ medical practitioners. The researcher conducts interviews with registered nurses, health educators, HIV counsellors, nutritionists, Medicaid financial officers, and social workers, to see how the state’s apparatus of biopolitical power control have been exercised and encompassed over the bodies of those pregnant women. In this chapter, this researcher copes with a pivotal thematic topic that exposes the disciplinary power that has encompassed and regulated the uninsured poor patient at Alpha clinic. The researcher cites Michel Foucault’s theorization in Discipline and Punish, that the significance of scaffold of the classical era which imposed massive power of the sovereign to destroying the bodies of the sovereign’s subjects, was replaced by the consummate enterprise which has exercised its power through producing docile bodies by a managing and regulating ones’ bodies and minds. Foucault’s theory lends its analytical support to the researcher’s interrogation regarding how uninsured poor people are attracted to the Medicaid - the state’s apparatus, to have their pregnant bodies subjected to the "carceral archipelago” (Bridges, 2011, p. 71). As the researcher indicates, the state’s generosity to pay the medical bills for the uninsured patients cannot outcast a more alarming reality that the Medicaid’s endeavours are more prone to execute disciplinary, surveillance, and punitive power over those pregnant poor people. The pregnant women who decide to be subjected of Medicaid tend to become under the control and regulation of biopolitical state, as most of their private information relevant to their medical treatments even including male partners’ names/contact information, his race and citizenship status, his position of employment and income, whether he supports the pregnancy, whether he physically abused the pregnant women and among others are collected by multiple healthcare-related practitioners. Regarding chapter two, I have two major critiques of this chapter’s methods. First, as the researcher conducts multiple interviews over various healthcare practitioners, it would be helpful for this chapter to list out basic information regarding how many practitioners are interviewed, what are their specific professions, and what are their primary demographics information. It would be better to provide a table for presenting the information. Without a knowledge of these medical practitioners’ information, it is likely that viewpoints and information they project to the researcher’s questions could be somewhat biased and prejudicial. The second critique I would like to elicit for this chapter concerns about a lack of comparative analysis with the researcher’s fieldwork at other clinics. As the researcher states in the introduction chapter, she conducts weeks-long observation at the Sigma clinics, and from my reading experiences and knowledge of medical practices in the US, many other clinics would also collect multiple private information of the patients for obstetrics and gynecology exams and treatments. Then how could the researcher reach a concluding thought regarding the patients at the alpha clinic that, in Foucault’s terms, their bodies are produced and reproduced under regulation, punitive control and surveillance of a state’s bio-political enterprise? It would be better to lead to such an argument by adding on a comparative perspective based on observations of other medical clinics. The third chapter concerns about in what ways the unruly bodies of these pregnant women are regulated and controlled at the Alpha clinic. The third chapter is beautifully written and the methodology the researcher utilizes is sound and valid. The researcher of this book demonstrates the following differences of prenatal care programs between uninsured patients and those with private medical insurances (Bridges, 2011, p. 77 - 78): 1) privately insured patients receive medical examinations six to eight weeks after giving birth, but their healthcare providers do not evaluate their psychological, social, nutritional, alcohol and drug intervention needs, and contraceptives treatments, unless they conditionally request to do so; 2) women who are Medicaid recipients are required to be administered with glucose challenge test; 3) patients with Medicaid are required to test constantly for sexually transmitted pathogens such as gonorrhoea, chlamydia, and syphilis; and 4) the privately insured women are not required to be vaccinated for Hepatitis B or to be screened for tuberculosis. For writing this chapter, the researcher makes inquiries into existing legal and policy documents, and operates interviews for both medical professionals and patients who receive prenatal care at the Alpha clinic. A midwife at the Alpha clinic states: “We have to work within the system here. It’s very limiting. We do a million tests that probably don’t need to be done on these nice, healthy women. And we see them sometimes more often than I would like. It’s a weird system. . . . It’s a burden on them, I feel like” (Bridges, 2011, p. 89). The researcher further points out, a woman under prenatal care has to go through standardized medical procedures on which the healthcare professionals employ as a monopoly, as the obstetrics renders a woman under surveillance of “a nine month clientage” (Bridges, 2011, p. 90-91) through which the woman’s prenatal care needs are defined, categorized, assessed, helped, counselled, and addressed by medical and health providers. The researcher draws a concluding definition of such micro-phenomena - technocracy model of pregnancy. There are few alternative treatment and care plans for the vast majority of uninsured, pregnant women, and they have to accept Medicaid, whilst they are enforced to “conscripted” into a regime of biomedicine. Those poor women have few choices apart from choosing Medicaid. The fourth chapter denotes, the prenatal care assistance program and site at the Alpha clinic is comprehended as a policy effort to ameliorate and alleviate the country’s history of racial inequality and racism. The assistance program and site ensure that individuals of racial minority backgrounds are entitled to receive quality and appropriate pregnancy and childbirth care services. Since the program took effect, it has been celebrated and lauded for its purposes of reducing racism and racial inequality in healthcare professions. However, as the researcher points out affirmatively, racism and racial inequality still prevail among prenatal and pregnancy care professionals at Alpha hospital, since a patient’s racial identity still overdetermines her health conditions and medical and healthcare providers still harbour racist beliefs against these patients with racial minority backgrounds. The researcher suggests that medical doctors and other healthcare providers should be inquired about their knowledge and values of racial minorities, however, the research identifies a resistance from the medical doctors and healthcare professionals as the medical professionals’ personal beliefs and values are legitimated as individual privacy. Healthcare providers’ beliefs and biases towards their patients of racial minorities represents a vivid and accurate perspective of the culture of racism and racial inequality in a larger society. The research sends out an alert that racism and racial inequality existing among uninsured patients of racial minority backgrounds should be placed with alarming concerns and should be carefully addressed and intervened. The fourth chapter’s research methods are sound and valid, but I have only one question regarding the process of data collection, especially data collected from medical doctors and other medical professionals at the Alpha hospital. It is commonly acknowledged that detecting racist attitudes and beliefs appears to be comparatively less difficult, but it is also common for people who originally garner and harbour racist personal knowledge and beliefs to make a lot of efforts to hide from identification or they would try to disrupt and confound the researcher’s detection. For example, a doctor, who has been treating poor women of racial minority backgrounds and who has also garnered a slew of racial biases and prejudices against his or her patients, would incline to reveal more positive information or even tell lies about his or her experiences of treating racial minority patients. In the fifth chapter, the researcher engages in an in-depth observation and interviews at the Alpha clinic. This section of the book is to concern about the Alpha patient population that demonstrates the social origins of race-related medical conditions, as according to the research experiences and fieldwork at the Alpha clinic the author draws some concluding remarks that certain types of medical conditions such as sickle cell anaemia, hypertension, and diabetes occur disproportionately among the black persons (Bridges, 2011, p. 152). The Medicaid guidelines demand every pregnant and insured women of poverty, at the beginning of their prenatal care, to be assessed for “risks” of health problems, and risks concerning their genetic, nutritional, psychological-social, and personal medical historical factors are taken into strategic prevention and interventions (Bridges, 2011, p. 154). Diseases may be socially constructed, and for the Alpha patients, a body that equates the conditions to be included into attending to “risk-assessments” is not a fixed categorization, since what accounts for pathologies is being fluid and unstable (Bridges, 2011, p. 158). As the research states, Alpha patients as a specified population are most likely to be provocatively included as constituting risks and pathologies. The researcher offers an example demonstrating how the Alpha patient population are automatically defined and classified as having health risk factors. Women’s testing for STDs and STIs informs through evidence-based studies that economic disparities and poverty would result in prostitution. And this policy (Bridges, 2011, p. 159) implies unfair assumptions that every woman who belongs to the Alpha patient population could be a prostitute, and therefore, the policy unfairly considers every Alpha clinic’s female patient that she is possible to engage in prostitution. The fifth chapter is provocatively well-written and I think her data collection and data analysis are well-grounded on a good knowledge of relevant theories and literature of poverty, medicalization, and pathologization. Herein, I have one critique of this chapter’s methods. In the first blush, the researcher’s data collection involves interviews with medical doctors, nurses, midwives, and the front desks, but I think she ignores the importance of a possible literature analysis of the Alpha clinic’s internal policies and guidelines, on the basis that she addresses the guidelines and policies mandated by the Medicaid. I consider this minor approach useful and also accessible for the part of the researcher, since a literature analysis of the clinic’s internal policies and protocols would depict an incisive and detailed picture that manages to profile how the clinic complies to or maybe diverge from the guidelines of the Medicaid. In the sixth chapter, the researcher states, that racism has become more implicitly demonstrated in public spaces - race and racism are not something to be easily detected and in the United States as it once was, and explicit racism are not demonstrated as they were several decades ago (p. 248). In public spaces, racial minority people are no longer dehumanized and reduced to “a fraction of their racial Other” (Bridges, 2011, p. 248), and institutional suppression based one’s racial minority ascription is no longer something one could easily point out and say something about (Bridges, 2011, p. 248). The days when jurists and lawmakers could readily discuss the appropriateness of subjection of the Black people to the white people were long past (Bridges, 2011, p. 248). In the sixth chapter, the research methods the author employs is sound and robust, as she interviews patients from various racial minority backgrounds, in order to extract “the logics” of race among the Alpha patient population. However, here is my major criticism of this chapter’s methodology. The researcher writes intensively for several pages on how the concept of wily patients exhumed from the medical pragmatics at the Alpha clinic and its interconnectedness with poverty, immigrant status, and racism. She observes the ways the patients’ names are called out by the front desk staff, and she collects valuable data regarding how the patients who lack linguistic skills to understand or speak English fluently are reprimanded and mistreated by the staff members of the clinic. Also, she interviews multiple patients of colour as a way to detect and rationalize in what ways the concept of welfare queens is constructed. This part’s writing is excellent, and I really enjoy reading it. However, I find her approach a little bit flawed, as there is little evidence to prove that the researcher conducts observation and interviews with medical doctors and midwives at the Alpha clinic. What if the medical doctors including the midwives think differently with regards to whether to equate poor, uninsured, pregnant women as wily patients? Or else, is it possible that the medical doctors are reluctant to label those black women as welfare queens by providing professional healthcare services and situating themselves within less racist and biased personal values? I am curious to know about this aspect.
I think with a collective delineation of the clinic’s healthcare providers, it would be more beneficial to this book’s readership to grasp why the Alpha clinic is considered as a haven for those uninsured poor people in New York City, and how it can also be described as a racialized working site. In addition, I think it would be better to do a comparative analysis here before drawing a conclusion on the technocratic model of pregnancy and childbirth care for women with Medicaid at the Alpha clinic. I need to state that the research’s lacking in a comparative approach, between women who solely rely on Medicaid and those women who have private insurances, is not proficient for the readership to detect and examine power relations and inequalities of prenatal care and childbirth care. A dearth of a comparative analytical framework would not placate a possible research bias. As far as I know based on my research and reading experiences, a technocratic model of pregnancy and childbirth care does not only probe into and administer biopolitical forces onto poor and uninsured women but also exercises technocratic ruling and regulations over women who are private insurances of less coverage.
Thanks for reading. :)
February 12, 2021
First ethnography I’ve ever read, and it was for school, BUT it was extremely eye opening and informational. Makes me wonder how the apparent racialization of patients in a medical setting might change (for the better or worse?) if our country were to adopt a nation-wide universal health care system.
May 20, 2025
Read this book for class and honestly loved it. The way it was broken down into race and class and then intertwined and asserted that both coexist and perpetuate the other with such vivid ethnographic detail was amazing
September 2, 2020
whew this book really challenged me! both the level at which it was written and the ideas within.
July 6, 2025
fantastic book on how programs that ostensibly are supposed to support pregnant women end up exceptionalizing and pathologizing their bodies… as well as how race is reproduced by societal & physician racism and certain cultures are seen as producing unhealthy/unruly bodies
February 16, 2021
the middle was challenging to get through, but the topics Bridges tackles are so incredibly important
Read
November 6, 2022Chapter 5, WOW. The most important piece of the book personally.
April 6, 2025
a lot of khiara bridges' work isnt listed on goodreads but she everything she writes is ingenious and comprehensive. khiara bridges you are everything i want to be as an academic
September 14, 2024
3,75
I read this book for my thesis and I found it very interesting. Although a bit dense at times, it was easy to follow along and the ethnographic vignettes balanced the theoretical parts out. I really recommend reading this book to anyone who is interested in the influence of race and racism in the medical world.
The book touched less upon the role of gender and/or sex and their intersections with race than I expected but I think taking on this intersectional approach would have been too big of a project for this book/research.
Nevertheless, this book was a great way of delving into the topic of racism in obstetric (pregnancy) care and I recommend it to anyone!
I read this book for my thesis and I found it very interesting. Although a bit dense at times, it was easy to follow along and the ethnographic vignettes balanced the theoretical parts out. I really recommend reading this book to anyone who is interested in the influence of race and racism in the medical world.
The book touched less upon the role of gender and/or sex and their intersections with race than I expected but I think taking on this intersectional approach would have been too big of a project for this book/research.
Nevertheless, this book was a great way of delving into the topic of racism in obstetric (pregnancy) care and I recommend it to anyone!
May 27, 2013
Throughout her ethnography, Bridges deconstructs the concepts of “race as a social construction” by examining the processes by which race is materialized, socialized, and embodied through the physical bodies of pregnant women. It is important to note that Bridges does not analyze constructions of race through just any pregnant women’s bodies, but rather poor, racial minority pregnant women.I recommend this book for anyone interested in work within the U.S health system, reproductive health, and race relations.
April 13, 2014
Excellent ethnography. I read a lot of ethnographic work, I really appreciated the fact that the author including her feelings to her study. Its book like these that can lead to policy change if those involved would bother to read it.
August 25, 2022
hugely enlightening. i still regularly quote this book today, 3 or so years after reading it
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