REPRODUCTION AS A SITE OF POWER AND CONTESTATION: INFORMED CONSENT AND BLACK WOMEN’S NEGOTIATION OF MEDICAL DECISION-MAKING

Abstract

This dissertation examines how medicine undermines Black women’s reproductive agency. Much of the current analysis of Black women’s reproduction and maternal health emphasizes morbidity and maternal health outcomes. There has been limited scrutiny of the institutional, relational and decision-making processes in obstetrics and gynecology, however. This study fills an important gap in the research by employing informed consent (and refusal) heuristically to illuminate how medicine operates as a site of power and contestation. It thus centers medical decision making as well as the institutional practices that routinely expose Black women to medical violence. Medicine has traditionally been a site of racialized subordination for Black women, who today experience disparate rates of medically unnecessary surgical procedures and are overmedicalized. When juxtaposed with their profound medical neglect, Black women’s overmedicalization exposes the institutional and interpersonal practices of gendered racism that continue to mark Black women’s bodies for excessive surgical procedures and place them at heightened risk for negative health outcomes.

Because all women may encounter obstetrics and gynecological violence, this research focused specifically on how race impacts the medical agency of Black women. More precisely, the research applied the theoretical lenses of intersectionality and multidisciplinarity to obstetrics racism and reproductive justice. Furthermore, by interrogating the underlying processes of biological racialization, the current research presents a counter-discourse to the dominant overdetermined role of biological race in public health discourses. This analysis thus contributes to several fields of scholarly inquiry, including the sociology of race and ethnicity, the sociology of medicine, law and bioethics, and reproductive justice.