The dynamics of cooptation in a feminist health clinic

I examine the process of cooptation in a feminist health clinic, focusing on how the State shapes and absorbs the challenges of grassroots health activism. A familiar picture of of organizational change accompanies the clinic's decision to secure State funding: the erosion of collective decision-making, an immersion in service delivery to the exclusion of other activities, and a dependency on continued funding which decreases the political autonomy of the organization. Using Gramsci's analysis of hegemony, I demonstrate how the State's effect on this organization stemmed from both direct pressures for particular changes and the influence of dominant ideology and social relations in structuring the clinic staff's response to those pressures. Additionally, I explore the factors that laid the groundwork for a reversal of cooptive patterns and a revitalization of the clinic's social movement orientation and political goals.