conclusion
A Maternity That Suits?
Minutes before we left the hospital where Ramona’s son is detoxing off metha-
done to drive her to residential drug treatment, she called me over. “Kelly, take
out your camera. Take a picture of us now.” She sobbed, “I don’t want to leave
him. I don’t know when I will see him again.” She posed herself, with her son
on her lap, fussing carefully with his iv line. She was crying, yet her eyes were
hollow. Her son slept peacefully, likely as a result of his continuous opioid
replacement therapy. When I looked at the picture later, I was struck by the
uncanny resemblance of Ramona and her son to a postmortem photograph,
a memento mori. Victorian- age memento mori, like the one pictured here,
were often taken after the death of a baby or young child (fig. C.1).1 Ramona
wanted to capture this moment, a moment of likely loss. She was symbolically
preempting the rupture of custody, even as she was actively trying to write a
different future for herself and her son by entering residential drug treatment.
The radical uncertainty of an addicted pregnancy’s outcome is mediated by
both the everyday realities of poverty and addiction and the techno- scientific
interventions of care and control. Georges Canguilhem presented the copro-
duction of pathology and health as the result of responses (successes and
failures) to the experience of external pressure. Such pressure is multiply con-
strued for addicted, pregnant women. There is the pressure of the pregnancy
on her body and on her baby’s development: the pressure exerted by chemi-
cals (nicotine, cocaine, opioids, alcohol) on the mother’s body and the body of
her fetus; the pressure to acquire food; the pressure of no sleep; the pressure of
multiple sexual encounters; and the pressure of drug withdrawal. At the level
of the biological, a “normal” pregnancy is quantified with rapid efficiency in
the United States, but differences between normal signs and symptoms and
those that indicate pathology are more difficult to discern. When Canguilhem
carried his argument about environmental pressures, pathology, and health
out of the petri dish and into broader society, he made an additional obser-
vation that is of particular interest here. He claimed: “Everything happens as
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