Bioethics Blogs

Kelly Ray Knight’s addicted.pregnant.poor by Kirsten Bell


By Kelly Ray Knight

Duke University Press, 2015, 328 pages

addicted.pregnant.poor is the sort of ethnography you start reading and don’t put down again until it’s finished.  From its opening pages—where Knight recounts the story of trying to get into the hotel room of Ramona, her extremely high, heavily pregnant and possibly comatose informant—to the last, this is a gripping book that aims to understand what forms of life are possible for poor, pregnant addicts living in daily rent hotels in the Mission district of San Francisco.  Not since Lisa Maher’s Sexed Work have I read a book that so intimately, sympathetically but unflinchingly portrays the intersections between gender, poverty and drugs.

Given that Knight is dealing with one of the most stigmatized and demonized of all populations: pregnant women who ‘harm’ their ‘innocent unborn babies’ through the ingestion of chemistry-altering substances, I would imagine that there was a strong temptation to sanitize the content.  However, she resists such tendencies, painting instead a nuanced portrait that resists the ‘victim/perpetrator’ dichotomy characterizing mainstream media and policy discourse on addicted pregnancy (the mutually contradictory identities women are expected to inhabit as both ‘innocent victims’ and ‘responsible perpetrators’ are intensively discussed).  The result is an honest and often harrowing account of women who have quite literally fallen through the cracks.

Knight presents no easy answers for how they got there or how they might escape the cycle of poverty, addiction and sexual exploitation, although gentrification lurks as a kind of background specter and she is attentive to the ways in which the overlapping and conflicting economies of rich and poor are “reshaping the US urban map and creating new challenges for civil society, urban development, and urban health” (p.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.