The Unborn in Bioarchaeology: Personhood, Care, and Pregnant Person-Infant Health Through a Structural Violence Lens

Abstract This chapter highlights the relevance of the bioarchaeology of the fetus to the interrogation of current pressing social justice issues including inequities in health of pregnant people and infants, discrimination against marginalized pregnant people, reproductive rights, stigma surrounding pregnancy loss, and ethical issues of the use of fetal remains in legacy collections. Historically overlooked, fetal remains are now recognized as critical indicators of health of the pregnant person, environmental stress, and social conditions. The chapter discusses methodological advances in identifying fetal remains and estimating gestational age, and the interpretation of burial contexts to infer cause of death and social attitudes toward pregnancy loss. It also critically examines the representation and treatment of fetuses in mortuary and anatomical contexts, highlighting how marginalized individuals—particularly babies of unmarried and poor parents—were disproportionately represented due to systemic inequities. Ethical considerations surrounding the use of fetal remains in anatomical collections are addressed, with calls for informed consent, transparency, and cultural sensitivity in teaching and research. Using a social justice framework, the chapter analyzes how factors such as race, gender, class, and colonization shaped pregnant person and fetal health outcomes and their use in anatomical contexts.