Medical risk: Implicating poor pregnant women

Since 1987 the United States courts have increasingly relied on medical testimony to prosecute women labeled 'high risk' for failure to comply with medical advice when their fetuses or babies die. Drawing on fieldwork in a public prenatal clinic in Northern California, it is argued that risk does not represent scientific certainty. While the assessment and management of risk is not standardized or consistently applied in the clinic, health care providers and the legal system make decisions as if risk is unambiguous 'fact'. Consequently, labeling poor pregnant women 'high risk', implicitly and explicitly makes them accountable if they are unable to change their behavior as prescribed by health professionals. Through an examination of the dilemmas facing poor pregnant women seeking prenatal care, this paper suggests how attempts to prosecute women may discourage rather than encourage them to seek care. Overall, there is a need for understanding the complexities of risk and its usages in medical and legal settings.