The Social Effects of Gestational Diabetes in "High-risk Ethnic Groups"

This ethnographically-informed doctoral study examines the social effects of gestational diabetes (GD) in "high-risk ethnic groups" in order to elucidate how contested categories of disease, risk, and race cross-articulate in authoritative texts, clinical practice, and everyday realities of women of colour. The questions that guide this dissertation study are organized around truth discourses, strategies of intervention, and modes of subjectification: What kinds of discourses are employed to constitute knowledge about GD, risk, and race/ethnicity? What types of subjects are constructed through discourses on GD in "high-risk ethnic groups?" How are race-based risk discourses accomplished locally in the clinical setting? How do women respond to, engage with, and resist race-based risk discourses and practices pertaining to GD? And how do such discourses and practices shape women's subjectivities from diagnosis to post-partum? Study methods include discourse analysis of three authoritative texts, participant observation in two diabetes education centres in Southern Ontario, and interviews conducted with twelve women of colour in a three time sequence (after diagnosis, before delivery and post-partum). Data generated from these multiple sources were analyzed and interpreted through Foucauldian theoretical concepts of biopower, governmentality, and subjectification. The findings reveal that discourses are neither neutral nor value-free but infused with racial and moral assumptions. Race-based risk discourses are accomplished in the clinical setting through a variety of strategies that reproduce racial logics by rendering power relations invisible. However, women in this study engaged with and resisted disciplinary practices in enabling and constraining ways that contributed to the formation of an emergent type of racialized subject. I argue that discourses and disciplinary practices participate in the processes of racialization and subjectification which may paradoxically produce unintended effects of contributing to the problem of diabetes. I conclude by calling for greater reflexivity beyond racialization and medicalization.Ph.D