You don’t need criminal law to make cops: Reading carceral care work into reproductive healthcare policies in Vancouver

This paper presents a critical review of the health and social policy regulating clinicians in Vancouver Canada. For this review the authors investigated how policy embeds carceral thinking in healthcare delivery dispensed in the lead up to, during, and up to one year after pregnancy, including reproductive technologies that facilitate conception, planned and emergency abortion, labour and birth, and child welfare services. Clinical care in all these areas becomes carceral when clinicians are implicated in work that coerces, criminalizes, or punishes patients. State investments in control and punishment affect Canada's health systems by committing healthcare and service providers to a carceral continuum that cycles patients through material deprivation, situational vulnerability, surveillance, and punitive measures. The authors engage with policies that reference structural conditions of carceral care work in limited ways. They next show how and what kinds of carceral care work policy instruments make possible. Finally, the authors demonstrate that the absence of consideration for lived experience enables policies to sustain carcerality through health and service systems. The net result is that pregnant and parenting people, particularly from communities already targeted for surveillance, criminalization, and incarceration, can face unique forms of policing at the hands of health and service providers, from compromised reproductive autonomy to loss of child custody, with far-reaching health implications for themselves and their children.