Neoliberal cultural frames of individual choice inform mothers’ accounts of why they refuse state-mandated vaccines for their children. Using interviews with 25 mothers who reject recommended vaccines, this article examines the gendered discourse of vaccine refusal. First, I show how mothers, seeing themselves as experts on their children, weigh perceived risks of infection against those of vaccines and dismiss claims that vaccines are necessary. Second, I explicate how mothers see their own intensive mothering practices—particularly around feeding, nutrition, and natural living—as (...) an alternate and superior means of supporting their children’s immunity. Third, I show how they attempt to control risk through management of social exposure, as they envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable. Finally, I examine how these mothers focus solely on their own children by evaluating—and often rejecting—assertions that their choices undermine community health, while ignoring how their children benefit from the immunity of others. By analyzing the gendered discourse of vaccines, this article identifies how women’s insistence on individual maternal choice as evidence of commitment to their children draws on and replicates structural inequality in ways that remain invisible, but affect others. (shrink)

Vaccine refusal has increasingly been the focus of public health concern. Rates of children who are up to date on vaccines have declined in recent years, and vaccine refusal has been implicated in disease outbreaks. Most research on children who are not fully immunized identifies white affluent mothers as most likely to opt out by choice and Black mothers as more likely to face structural barriers that limit access to vaccines for their children. In this paper, we analyze social media (...) posts and online discussions among Black mothers to better understand their concerns about vaccines. Unlike white women who reject vaccines as a personal choice, Black mothers express unique concerns about the role of the state in their lives. Specifically, some Black mothers using social media view vaccines as a white technology and claim that white women have greater freedom in opting out of vaccines without the same risks to their families. They describe efforts to strategize interactions with pediatricians and other healthcare providers who can report them to social service agencies or block access to welfare and nutritional benefits for their families if they refuse vaccines. Black women’s experiences with structural gendered racism in interactions with healthcare and education systems shape vaccine decisions and should be taken seriously. (shrink)

Foucault's work has had a profound impact on the medical humanities over the last decade or so. However, most work to date has focused on Foucault's earlier writings rather than his later contributions on the self and governmentality. This article assesses the significance of the concept of governmentality for critical scholarship in the medical humanities, particularly in creating ethical awareness in the field of health care. It examines the context for Foucault's later work, and contributions arising from scholarship building on (...) this work. The governmentality literature, it is argued, raises novel questions about the ways we have come to think about health care in late modern societies. However, there are some limitations with this body of work which have not been fully acknowledged by scholars. The article discusses some of these limitations and offers some suggestions for a fruitful way forward. (shrink)

This article presents qualitative interview data to explore the health-related carework of low-income women caregivers with special-needs children and the implications of carework for women’s financial security. The author documents “direct” and “advocacy” carework as two types of caregiving that low-income women carry out in the context of declining government resources for poor disabled children. The author shows that the unique demands of carework responsibilities and the conditions of low-wage work combine to limit caregivers’ employment and education options as well (...) as their long-term prospects for financial stability. (shrink)