Zero Trimester: Pre-Pregnancy Care and the Politics of Reproductive Risk - Hardcover

Waggoner, Miranda R.

Hardcover

ISBN 10: 0520288068 ISBN 13: 9780520288065

Verlag: University of California Press, 2017

Inhaltsangabe

In the United States, a healthy pregnancy is now defined well before pregnancy begins. Public health messages encourage women of reproductive age to anticipate motherhood and prepare their bodies for healthy reproduction—even when pregnancy is not on the horizon. Some experts believe that this pre-pregnancy care model will reduce risk and ensure better birth outcomes than the prenatal care model. Others believe it represents yet another attempt to control women’s bodies.
 
The Zero Trimester explores why the task of perfecting pregnancies now takes up a woman’s entire reproductive life, from menarche to menopause. Miranda R. Waggoner shows how the zero trimester rose alongside shifts in medical and public health priorities, contentious reproductive politics, and the changing realities of women’s lives in the twenty-first century. Waggoner argues that the emergence of the zero trimester is not simply related to medical and health concerns; it also reflects the power of culture and social ideologies to shape both population health imperatives and women’s bodily experiences.

Über diesen Titel

Über die Autorin bzw. den Autor

Miranda R. Waggoner is Assistant Professor of Sociology at Florida State University.

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“This meticulously researched and beautifully written book not only reveals the deep roots of the modern idea of the zero trimester, but also makes clear the paradoxical consequences of anticipatory motherhood for women and infants, reproductive justice and gender equality. Sociologists, historians, and women themselves owe Miranda R. Waggoner a debt of gratitude for this lucid, engaging ethnography of the idea of ‘pre-pregnancy’ that examines what it really means to imagine all women as mothers all the time.”—Elizabeth Mitchell Armstrong, Princeton University

"Steeped in the history of women’s health and reproductive politics, The Zero Trimester breaks new ground in exposing deeply rooted assumptions about women as mothers in the new public health focus on pre-pregnancy. This well-written book will be essential reading for anyone interested in gender, medicine, and health policy."—Rene Almeling, Yale University, author of Sex Cells: The Medical Market for Eggs and Sperm

"Miranda Waggoner provides a compelling and important account of the rise of pre-pregnancy medical care and the deeply troubling consequences of the concomitant creation of the zero trimester. In the medical and cultural quest for perfect pregnancies and perfect babies, we have arrived at a place wherein all females are considered future pregnant women who are advised to reside within a medical-behavioral regime in order to protect fetuses and babies that do not yet exist and may not exist for years or decades to come (if at all). As one medical expert explains, the zero trimester begins the moment a future woman is herself conceived! The implications of pre-pregnancy care, should it become fully entrenched, are thus a vast expansion in the medical and social control of women’s behaviors and their bodies over the life course. And yet this new regime of social control does not emerge from advances in medical knowledge. Instead it is propped up largely by common sense and longstanding and limiting gender assumptions. As Waggoner warns us, anticipatory motherhood is a brave new world that has in part already arrived."—Kristin K. Barker, author of The Fibromyalgia Story

"Who knew pregnancy lasts for twelve months? Miranda Waggoner traces how pregnancy in the United States has become a twelve-month status for women. Looking back to the nineteenth century and forward to the present she shows how and why the zero trimester has been added on to the beginning of pregnancy and has become an institutionalized part of women’s reproductive health and health care in the twenty-first century."—Susan E. Bell, author of DES Daughters: Embodied Knowledge and the Transformation of Women’s Health Politics

“Miranda Waggoner has produced a sharp and compelling study of the rise of preconception care, one attentive to historical context, institutional agendas, and shifting definitions of motherhood. Her notion of the zero trimester is a useful addition to our collective knowledge about reproductive health and the production and management of risk.” —Monica J. Casper, Professor of Gender and Women’s Studies and Professor of Public Health, University of Arizona

Aus dem Klappentext

“This meticulously researched and beautifully written book not only reveals the deep roots of the modern idea of the zero trimester, but also makes clear the paradoxical consequences of anticipatory motherhood for women and infants, reproductive justice and gender equality. Sociologists, historians, and women themselves owe Miranda R. Waggoner a debt of gratitude for this lucid, engaging ethnography of the idea of ‘pre-pregnancy’ that examines what it really means to imagine all women as mothers all the time.”—Elizabeth Mitchell Armstrong, Princeton University

"Steeped in the history of women’s health and reproductive politics, The Zero Trimester breaks new ground in exposing deeply rooted assumptions about women as mothers in the new public health focus on pre-pregnancy. This well-written book will be essential reading for anyone interested in gender, medicine, and health policy."—Rene Almeling, Yale University, author of Sex Cells: The Medical Market for Eggs and Sperm

"Miranda Waggoner provides a compelling and important account of the rise of pre-pregnancy medical care and the deeply troubling consequences of the concomitant creation of the zero trimester. In the medical and cultural quest for perfect pregnancies and perfect babies, we have arrived at a place wherein all females are considered future pregnant women who are advised to reside within a medical-behavioral regime in order to protect fetuses and babies that do not yet exist and may not exist for years or decades to come (if at all). As one medical expert explains, the zero trimester begins the moment a future woman is herself conceived! The implications of pre-pregnancy care, should it become fully entrenched, are thus a vast expansion in the medical and social control of women’s behaviors and their bodies over the life course. And yet this new regime of social control does not emerge from advances in medical knowledge. Instead it is propped up largely by common sense and longstanding and limiting gender assumptions. As Waggoner warns us, anticipatory motherhood is a brave new world that has in part already arrived."—Kristin K. Barker, author of The Fibromyalgia Story

"Who knew pregnancy lasts for twelve months? Miranda Waggoner traces how pregnancy in the United States has become a twelve-month status for women. Looking back to the nineteenth century and forward to the present she shows how and why the zero trimester has been added on to the beginning of pregnancy and has become an institutionalized part of women’s reproductive health and health care in the twenty-first century."—Susan E. Bell, author of DES Daughters: Embodied Knowledge and the Transformation of Women’s Health Politics

“Miranda Waggoner has produced a sharp and compelling study of the rise of preconception care, one attentive to historical context, institutional agendas, and shifting definitions of motherhood. Her notion of the zero trimester is a useful addition to our collective knowledge about reproductive health and the production and management of risk.” —Monica J. Casper, Professor of Gender and Women’s Studies and Professor of Public Health, University of Arizona

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The Zero Trimester

Pre-Pregnancy Care and the Politics of Reproductive Risk

By Miranda R. Waggoner

UNIVERSITY OF CALIFORNIA PRESS

Copyright © 2017 The Regents of the University of California
All rights reserved.

ISBN: 978-0-520-28806-5

Contents

Acknowledgments, 
1. Someday, Now: Preconceiving Risk and Maternal Responsibility, 
2. From the Womb to the Woman: The Shifting Locus of Reproductive Risk, 
3. Anticipating Risky Bodies: Making Sense of Future Reproductive Risk, 
4. Whither Women's Health? Reproductive Politics and the Legacy of Maternalism, 
5. Get a Reproductive Life Plan! Producing the Zero Trimester, 
6. Promoting Maternal Visions: Gender, Race, and Future Baby Love, 
7. Governing Risk, Governing Women: Anticipatory Motherhood and Social Order, 
Notes, 
Bibliography, 
Index, 

CHAPTER 1

Someday, Now

PRECONCEIVING RISK AND MATERNAL RESPONSIBILITY

Having a healthy pregnancy is no longer contingent on being pregnant in the first place. In February 2016, the federal Centers for Disease Control and Prevention (CDC) released a statement urging women of reproductive age to avoid alcohol if they were not using birth control, lest they harm a pregnancy that might or might not be present. The idea was vast: the CDC indicated that about 3 million American women were putting potential pregnancies at risk, but any woman between 15 and 44 years old was defined as "pre-pregnant," thus targeting, in effect, about 61 million American women. This measure attracted considerable social commentary and ridicule, but it hardly represented a new idea in public health. In 1981, Surgeon General Edward Brandt issued a warning that women "considering pregnancy" should refrain from alcoholic beverages. Since 1992, Kentucky has required bars to post warnings that drinking alcohol prior to conception can cause birth defects when, in fact, it cannot. The idea of pre-pregnancy health promotion surged after 2006, when the CDC released a report recommending improvement of the pre-conception health and health care of U.S. women of childbearing age. Alcohol was just one of many pre-pregnancy risk factors listed in this report, and public health warnings issued since 2006 have not been limited to drinking.

In late 2012, for instance, Texas initiated a public-awareness campaign, called Someday Starts Now, for improving the health of the state's babies. In television spots, young women performed everyday activities — chatting with friends, exercising — accompanied by a looming bubble box filled not with dialogue, but rather with numbers indicating a long-in-the-future baby's due date, sometimes years away. This approach had the visual effect of dangling future motherhood above the women's heads. The campaign's associated website stated, "your health today is important — and even more important to the baby you might have someday." The text further offered: "If there's a baby in your future, even if it's months or years from now, today matters. Take control. Stop smoking, eat right and exercise and do something about your stress." After seeing this television spot, one blogger wrote, "Texas is Reminding Me I'm Just a Baby Vessel Again."

The CDC and Texas campaigns represent but two illustrations of a growing tendency in medicine and public health to mark the beginning of healthy and responsible motherhood not at the birth or adoption of a child, not during pregnancy or at conception, but rather at an earlier point in time: pre-pregnancy. Similarly, in its recommendations for healthy pregnancy behavior, the March of Dimes — a national organization committed to improving birth outcomes in America — points directly to the three months prior to conception, claiming that a proper pregnancy today should actually last twelve months.

These public health statements are jarring. Perhaps because of the invariant biological fact that a typical human pregnancy lasts about nine months, it is disconcerting to read that it instead should be thought of as a lengthier process. Given feminist progress over the past half century, the thought of women of reproductive age as primarily mothers-in-waiting seems problematic. Also given that the focus on pregnancy health for more than a century has been on pregnancy behaviors, the thought of focusing on health behaviors prior to pregnancy is astounding. At the same time, these public-health assertions are somewhat expected. The sentiment that healthy babies stem from fit, responsible women echoes age-old societal preoccupations with women's bodies, behaviors, and reproductive outcomes. Anticipating and hedging future risk is reflective of our contemporary age of risk aversion and individualized responsibility for health. Concerns about the health of future generations have long manifested in cultural and political anxieties around family planning, fetal health, and women's roles in society.

Pre-pregnancy care is a framework that emerged as the new panacea for ensuring healthy pregnancies and healthy infants in the United States in the twenty-first century. It now is a dominant medical and cultural schema for reducing risks to healthy pregnancies, and it includes prescriptions for both health care and self-care. To have good pre-pregnancy health is to render pregnancy less risky, the thinking goes, and might improve the overall health of women, children, and society. What is emphasized, then, in contemporary health discourse is that for any woman of childbearing age, in the case of pregnancy health, someday is now.

Such messages are not coming only from health organizations. The notion of pre-pregnancy care has also entered the marketplace — touted as the fix for population health issues ranging from obesity to autism. Women today can buy vitamins specially marketed for the pre-pregnancy period as well as advice books such as Get Ready to Get Pregnant: Your Complete Prepregnancy Guide to Making a Smart and Healthy Baby. Newspapers run headlines such as, "Start taking care of your baby before you get pregnant" and "Don't focus on getting healthy while pregnant — do it before conceiving." Even tabloids have expanded their surveillance rhetoric and routinely conjecture about whether celebrities are potentially planning a pregnancy through monitoring their day-to-day behaviors (e.g., "She was seen avoiding alcohol! She might be thinking about getting pregnant!").

What accounts for this current moment in which birth outcomes are defined in terms of a woman's whole adult life — well before she ever decided if and when to get pregnant and have a baby? What accounts for the contemporary reproductive landscape in which, as in the Texas health campaign, due dates are projected onto non-pregnant women and a healthy pregnancy is defined as lasting longer than nine months? How is it that now, in the twenty-first century, young women are essentially asked to act as responsible mothers before motherhood is their imminent reality?

This book confronts these questions by tracing the shifting boundaries of pregnancy health risk and maternal responsibility in America at the turn of the twenty-first century — by examining how and why the trend and task of perfecting pregnancies has extended at the front end of three trimesters. It proposes that this pre-pregnancy care model introduces a "zero trimester" — a concerted focus on the months or years prior to conception in which women are urged to prepare their bodies for a healthy pregnancy. The term "zero...

Details zur Ausgabe

• Verlag: University of California Press
• Erscheinungsdatum: 2017
• Sprache: Englisch
• ISBN 10: 0520288068
• ISBN 13: 9780520288065
• Einband: Gebundene Ausgabe
• Anzahl der Seiten: 274
• Kontakt zum Hersteller: Nicht verfügbar
• Verantwortliche Person: Nicht verfügbar