UCSF

Institutions of incarceration are widely understood for their punitive, depriving, and at times even violent characteristics. Yet prisons and jails also provide medical care and other services that people marginalized by poverty, addiction, racism, and other forces of structural inequality might not otherwise have. This dissertation investigates the everyday contours of care in an urban women's jail in California. Based on six years of clinical work as an Ob/Gyn in the jail's clinic; ethnographic fieldwork throughout the jail and its surrounding community; and over 40 interviews with jail workers, medical staff and inmates, I describe how this jail was constituted by caregiving relationships which were inextricably linked to disciplinary structures, particularly for pregnant women. Deficiencies in the public safety net, market shifts, and trenchant problems in the criminal justice system meant that cycling between jail and the streets was a normative rhythm of everyday life for many of the urban poor. Recidivism was less a statistic and more an intimate relationship between inmates and jail workers. First, I describe how the medical triage system upon entry to jail diagnosed the deficiencies of people's lives on the streets. Next, I explore the quotidian rhythms of the jail medical clinic, and how health providers cultivated ambiguity as a form of caregiving to a patient who is also a prisoner. I then focus on reproduction as a key site where the deficiencies of public services and their substitution with incarceration were made visible. Custody and medical apparatuses in jail managed the figure of the pregnant inmate, with her gestating fetus, both as worthy of tender care and as a liability threat to the institution. Pregnant women similarly experienced jail with ambivalence, even desiring the relative safety of this punitive space. The ambiguity surrounding pregnant, incarcerated women, combined with their experiences of marginality outside, produced jail as a place--often the only place--where these women could enact a normative ideal of motherhood. Particularly for marginalized, reproducing women, jail has become an integral part of America's social and medical safety net.