Social Science & Medicine 65 (2007) 1351–1363 Caretaking as articulation work: The effects of taking up responsibility for a child with asthma on labor force participation Stefan Timmermans a,Ã , Betina Freidin b a Department of Sociology, 264 Haines Hall, 375 Portola plaza, UCLA, Los Angeles, CA 90095-1551, USA b Brandeis University, 415 South Street, MS 050, Waltham, MA 02454, USA Available online 21 June 2007 Abstract A well-established quantitative literature has documented the financial toll for women’s caretaking. Still, we do not know much about the process by which women end up taking on an extensive caretaking role and what they do on a daily basis. Based on in-depth interviews with a convenience sample of fifty caretakers of school aged children with asthma and nine health professionals in the USA, this study examines how health professionals socialize mothers into an intensive caretaking role for their children with asthma, how mothers negotiated and perform that role, and the impact of care work on their labor force participation. Care providers assign broad caretaking tasks that require further articulation work to get the job done. Although mothers care for their children in varied ways, caring for a child with a chronic disease remains a time-consuming activity. Mothers pay a price for the indeterminate nature of articulation work by scaling back their involvement in the paid labor force. r 2007 Elsevier Ltd. All rights reserved. Keywords: US; Asthma; Care work; Employment; Qualitative research Introduction In an era of evidence-based medicine, many health care interventions have been scripted in protocols and guidelines that instruct clinicians how to best diagnose and treat patients (Mykhalovskiy & Weir, 2004). Yet much residual work remains to be done by patients and their caretakers. While a physician may request that a drug be taken three times a day as needed, someone has to make sure the prescription is filled, monitor for bodily symptoms, and then administer or take the drug, and keep an eye on possible side effects. Gerson and Star refer to this kind of work as articulation work. ‘‘Articulation consists of all the tasks needed to coordinate a particular tasky No matter how detailed the requirements are, they must be aligned with or tailored to a set of implementa- tion conditions that cannot be fully specified ahead of time’’ (Gerson & Star, 1986, p. 258). Articulation work is the work done by invisible armies of nameless secretaries, support staff, technicians, administrative and other help, editors, and other backstage workers (Daniels, 1987; Shapin, 1989; ARTICLE IN PRESS www.elsevier.com/locate/socscimed 0277-9536/$ - see front matter r 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2007.05.027 Ã Corresponding author. Tel.: +1 310 206 6526; fax: +1 310 206 9838. E-mail addresses: stefan@soc.ucla.edu (S. Timmermans), Betina@brandeis.edu (B. Freidin).