The risk of being ‘too honest’: drug use, stigma and pregnancy

Towards a better understanding of risk-taking: key concepts, dimensions and perspectives

“…As a result, they tend not to ask for support during and after pregnancy when they have health issues such as post-partum depression (Stengel, 2014, p. 45). Stengel (2014) suggests that a less stigmatising practice could reduce such secondary risks and well-being of the women and thereby better outcomes altogether.…”

“…The pregnant women in Stengel's (2014) study in Canada showed how their risk identity as drug users and associated treatment and close supervision (such as regular drug tests) became part of their personal risk management strategy. In practice, many women were concerned about reporting health issues to social services because of their status as (former) drug user and the worries that their child would be taken from them after birth.…”

Risk in pregnancy and birth: are we talking to ourselves?

“…For example, Hammer and Inglin (2014) document differences in the relative 'riskiness' of smoking and alcohol during pregnancy, and also explore the dangers of attracting moral sanction through failures in self-control Health, Risk & Society 485 that might damage women's identity as 'good mothers' (p. 31). In fact, the observation that sociocultural beliefs about risks become internalised through self-governance and self-regulation is a feature of all the 'special issue' papers, including related papers in this issue (Chadwick & Foster, 2014;Coxon et al, 2014;Hallgrimsdottir & Benner, 2014;Jette et al, 2014;Leppo et al, 2014;Mitchell & McClean, 2014;Scamell & Stewart, 2014;Stengel, 2014;Wiggington & Lafrance, 2014). This indicates a shared assumption that there is a strong theoretical association between these related perspectives, which might be reasonable given that each reflects macro-theoretical examinations of the individual within society or culture.…”

“…In Stengel's account (2014), drug-using pregnant women found themselves categorised as 'unfeminine' and described their fears of a stigmatised future identity as parents, and also experienced the consequence of their babies being taken into care, if they trusted professionals enough to tell the truth. Several papers focus on public health issues in pregnancy and birth (Hammer & Inglin, 2014;Leppo et al, 2014;Stengel, 2014;Wiggington & Lafrance, 2014), and each draws to a greater or lesser extent on the Foucaldian concept of biopower, where observation, surveillance and control of the body are understood as 'ways of combining disciplinary techniques with regulative methods' (Foucault, 1984, p. 268). Although Foucault's theses on biopower and governmentality have been criticised as overly deterministic, with little opportunity for free will or reflexivity, Fox (1997, p. 42) argues that Foucault became more interested in reflexivity and 'practices of the self' in his later work, and sought to explore 'how we articulate our bodies and desires within a subjectivity capable of reflection'.…”

“…Only one paper Health, Risk & Society 483 (Chadwick & Foster, 2014) came from a country with a developing economy (South Africa), but even so, as the authors acknowledged, the focus was on affluent, educated and mainly white women's' perspectives of pregnancy risk. Almost all of the empirical work in the special issue collection arose from samples of privileged women; the main exception is Stengel's paper, which considered licit and illicit drug use during pregnancy (Stengel, 2014). Stengel opted not to collect demographic data; understandably, her participants expressed a strong need for anonymity, and may not have participated if such information were collected and held by the research team, but Stengel comments that contextual details within women's accounts pointed to marked levels of socio-economic deprivation operating alongside the effects of stigma.…”