The polycrisis grinds along. It’s my least favorite time of year, less so even than the pit of winter. We love it when it’s 60 degrees one day and 30 the next, my sinuses love it, my mood loves it, the hypersensitized nerve endings in my brain, barely recovered from last week’s Airborne Toxic Event, absolutely fucking love it. The constant howling wind isn’t driving us to a kind of quaint sepia-toned 19th-century madness at all. One more thing to be grimly and stiffly borne, although eventually this transitional period will resolve definitively into spring. The polycrisis will also resolve, but those futures are less clear and more terrifying.
I want to try to touch on a few recent developments to make a few kind of crackpot points that may, nevertheless, resonate, as if struck with a wooden spoon. The first is the indefinite shuttering of the PRAMS (Pregnancy Risk Assessment Monitoring System). I was, and remain (spiritually if not in practice) a perinatal epidemiologist, so this one is obviously near and dear to my heart. Quite obviously, this is Bad, another evil omen on a horizon crowded with them lately. Reading about this where most people get their news – privately-owned social media platforms – that’s probably all you’ve heard about it. It’s shut down inevitably. It’s Bad. And thus it gets sort of buffed out in the white noise of the polycrisis.
The way the US state organizes data collection, especially around pregnancy, labor, and delivery, is suboptimal. I have written about this before. I don’t think shutting PRAMS down is good, but I also don’t think that the state of data for pregnancy/maternal mortality was good before Elon’s goons lit the fuse on a cartoon bundle of TNT under the entire administrative state. The way the US does it actually makes some important aspects of maternal mortality very hard to see; other aspects that are more visible are still rather imprecise. In the absence of a coherent national monitoring system, we have to rely on health care encounters, billable outcomes, and what can be inferred (often rather obliquely) from death certificates or pieced together from sub-national bodies like state maternal mortality review committees. ProPublica recently published a great article, essentially an epidemiologic analysis, linking Texas’s state abortion ban to a marked increase in the rate of pregnancy-associated septic infection. According to the substantial companion “methods” document, they were able to do this by purchasing seven years of hospital discharge data. (They did a good job, but the extensive methodology is necessary because this is not a straightforward, or obviously a free, thing to do. I am considering writing a long post going through this analysis so if you are interested in that, let me know.)
PRAMS is part of this ecosystem. It is a survey (not a population registry) of live births (so no pregnancies ending in miscarriage, termination, or stillbirth are included). PRAMS collects critical information – in these times, one has to make sure to adequately genuflect before the data collection systems that do exist – but it’s more akin to one piece of an old puzzle missing a handful of tabs and blanks. This has been, understandably, rather overlooked in the breathless reporting on the chaos of Trump’s first month in office. A Talking Points Memo article from February 22 reported that PRAMS had been completely shuttered, indefinitely, accepting no new data after January 31 of this year. (The PRAMS page on the CDC website says that data collection for 2025 will begin in April, so I’m not sure what to make of that.) There was no official announcement of this, but according to the sources cited for the article, the CDC is informally telling partner institutions that the entirety of PRAMS is undergoing a new IRB (Institutional Review Board) review. In a follow-up article, the reporter (Josh Marshall) speculates that this new IRB review may be because the PRAMS questionnaire is being modified to comply with Trump’s executive orders, meaning that questions about race and racism, socieconomic status, gender and sexual orientation, and so forth (much of which was part of the entire raison d’être of PRAMS in the first place) are being axed for future versions of the questionnaire.
This is happening in parallel with a notable state-level development in the pregnancy health “space.” An article in The Independent reports that Missouri state representative Phil Amato has introduced a bill (written by, and I shit you not, an adoption lawyer named Gerard Harms) called the “Save MO Babies Act” that would create a state-level data registry of pregnant people “at risk for seeking an abortion.” In the revolting language so particular to pro-lifers, the bill’s authors describe it as creating “eHarmony for Babies” – and while they say participation is voluntary, the language of the bill would require MO’s Department of Social Services (Division of Maternal and Child Resources) to create and maintain two parallel databases, one of pregnant people and one of prospective adoptive parents, so that those “at risk of seeking an abortion” could be matched to adoptive parents instead. The bill also explicitly allows the state to share the data collected with outside law enforcement agencies, including federal law enforcement.
It has sort of become a mantra at this point, this is all bad, bad, bad. It feels like all we do, all day long, is point out and catalogue and “gentle remind” one another just how distressing and bad it all is. Curiously, it also, at the same time, feels like this prima facie badness just doesn’t, well, matter… it just doesn’t translate into meaningful rhetoric, or meaningful action, or any kind of real resistance or momentum or (maybe more accurately) inertia or inertial force that could slow the technofash acceleration. And I’m starting to think that maybe the reason it feels like it doesn’t matter how eloquently or how well we can object to our own dismemberment is that the material basis of the social sciences (and maybe the sciences in general) is shifting. When I started thinking about this, dilletantish Foucauldian that I am, I went straight to my Ian Hacking and my Alain Desrosières. Of course I did. (Reading Hacking’s famous paper I am once again struck by the weight of erudition he can bring to bear on fairly straightforward phenomena.) Hacking, in particular, focuses on how scientific and administrative practices create what he calls “human kinds” – categories that are created through being or becoming objects of a certain kind of social scientific knowledge. These are, as he says “kinds about which we would like to have systematic, general, and accurate knowledge,” human kinds are different from natural kinds (to be honest, I didn’t follow this part too closely because it’s a whole philosophical side quest that I don’t care much about) in that they are “peculiar to humans in a social setting” and constructed via particular knowledge-making practices that correspond to what we would call the “human” or “social” sciences.
Desrosières, for his part, has done more of the dirty, dusty spadework than anyone else I’m aware of of excavating the actual methods by which these categories of human kinds are made. Statistical work, as he repeats throughout the book The Politics of Large Numbers (interesting, if not necessarily fun, read) is the work of making things “hang together” (is the term his translator chooses), which involves – straight from Foucault – processes of “encoding” objects of measurement and study as members of specific classes or taxa and creating “spaces of equivalence” where different classificatory categories may be compared. What makes all this work possible is investment, no surprise there since Desrosières and his colleagues in the “convention theory” school worked in large statistical bureaux, INSEE (Institut national de la statistique et des études économiques) in Desrosières’s case. All of this stuff is interesting, but I don’t really need to get more in the weeds with it.
Both Hacking and Desrosières are expert sources on the emergence of the social sciences, like statistics, sociology, anthropology, and the like. The story goes like this: the social sciences emerged with the consolidation of nation-states and the attendant governance needs for enumeration and counting of stuff and people. Both Hacking and Desrosières can certainly be forgiven for working within the assumption that there is some kind of stable purpose or task of the social sciences across history – at the time they were writing, this was indeed the empirical case. I think we would do well not to think like this, though. The enumeration-of-badness vibe is kind of harnessed to this idea that once the social sciences emerged, they just got to doing what they do, welded as they are to state power and how much power inheres in knowing things about people and objects. I think Hacking’s basic thesis, that human kinds are made by being objects of a particular kind of historically contingent scientific knowledge, and that making up these kinds has a modifying (or “looping”) effect on the people so labeled as members of a kind, is basically correct. But my question here is, what if it’s out of date?
Are we experiencing some kind of schism in the relation of the social sciences to power? There are, after all, many other ways to know about people besides bureaucratized, state-directed statistical knowledge. Many of these ways are privatized and highly opaque. Of course, there is the palimpsest of the old statistics in the newer forms of algorithmic digital surveillance (I guarantee you that cutting-edge ML system you’re being sold is just a logistic regression under the hood) – but what I want to suggest is that maybe this administration is sinking a tranq dart in the dragging hind flank of our high-modern federal knowledge production apparatus because they don’t actually need us anymore, and they don’t care about the types of knowledge we produce.
It is an annoying cop-out to close with something so open-ended as “I want us to think about this.” But I do want us to think about this. What new forms of power/knowledge are enabled by an apparatus that is algorithmic, fragmented, privately owned and controlled as opposed to an apparatus that is bureaucratized, centralized, comprehensive and at least nominally subject to some kind of democratic oversight? What new “human kinds” are created by these forms of power/knowledge? I’m thinking in particular about the emerging human kind of “person at risk of seeking an abortion.” The MO legislation does still involve a state-level bureaucracy, but this is by no means a requirement – consider the data quietly gathered by fertility- or period-tracking smartphone apps, or geofenced data from abortion clinics. What does it mean for us politically when the state no longer sees, wants to see, makes any pretense of wanting to see the disproportionate aggregate impact of pregnancy-related deaths among Black women but does really want to see a pregnant person who might have an abortion instead of “matching” with prospective adoptive parents? As we all prepare to Stand Up for Science or whatever (more on this later, too, I assure you), I really think we ought to consider that the attacks we’re seeing now – while motivated by a dank admixture of ketamine delusion, Nazified internet fiscal conservatism, engineering hubris, and sheer malign idiocy – are also enabled in some meaningful way by the shifting material basis of social scientific knowledge production in our emerging trash economy.