UNIVERSITY OF CALIFORNIA PRESS

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      University of California Press

      Oakland, California

      © 2017 by The Regents of the University of California

      Library of Congress Cataloging-in-Publication Data

      Names: Waggoner, Miranda R., author.

      Title: The zero trimester : pre-pregnancy care and the politics of reproductive risk / Miranda R. Waggoner.

      Description: Oakland, California : University of California Press, [2017] | Includes bibliographical references and index. | Identifiers: LCCN 2017010811 (print) | LCCN 2017013124 (ebook) | ISBN 9780520963115 (ebook) | ISBN 9780520288065 (cloth : alk. paper) | ISBN 9780520288072 (pbk. : alk. paper)

      Subjects: LCSH: Reproductive health—21st century. | Women—Health and hygiene—21st century. | Pregnancy—Complications—21st century. | Women’s health services—Political aspects—21st century. | Public health. | Health risk assessment.

      Classification: LCC RG133 (ebook) | LCC RG133 .W338 2017 (print) | DDC 618.2—dc23

      LC record available at https://lccn.loc.gov/2017010811

      Manufactured in the United States of America

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       Dedicated to

       Dr. Lorraine V. Klerman (1929–2010), cherished mentor, influential scholar, and stalwart advocate for maternal and child health

      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

Acknowledgments

      The idea for this book originated years ago, while I was hiking in New Hampshire with one of my graduate-school mentors, Lorraine V. Klerman. I had just read the CDC’s guidelines for pre-conception care, and Lorraine had recently served on the CDC’s expert select panel on pre-conception care. I had many questions about the emergence of this seemingly new idea for improving birth outcomes and how it might interface with cultural assumptions about gender, risk, and responsibility. A renowned public-health scholar, Lorraine was always very patient with and intrigued by my sociological interest in the relationship between medical knowledge and social order, and she helped me turn a project idea into a reality.

      Along with her unwavering intellectual support and expansive knowledge on my subject, Lorraine’s connections to leaders in maternal and child health were key to the development of my project. Soon after our hike, in her usual collegial spirit, Lorraine invited Kay Johnson and me to her home in Waltham, Massachusetts, to discuss the history and potential implications of a pre-conception care framework in public health. Kay was lead author on the CDC’s pre-conception care guidelines, and her expertise on the subject ran deep. Kay’s encouragement was absolutely essential to the trajectory of my work, and she expedited my research in numerous ways, including supporting my attendance at the third National Summit on Preconception Health and Health Care. Additionally, Dr. Hani Atrash pleasantly welcomed me to CDC offices in Atlanta to pursue my research.

      I am truly grateful to all the experts who took time out of their busy schedules to talk with me about pre-conception care. I learned so much from them, and I admire their dedication to healthy mothers and children. I realize that all of the professionals with whom I spoke will not agree with some of my arguments in this book, but I hope that my work will engender future dialogue about that which we indubitably share: a commitment to maternal and child health. I am in awe of the everyday work they all do in this realm and am thankful to be part of the conversation.

      I am intellectually indebted to my mentors at Brandeis who were central in the development of this project. For years now, Peter Conrad has nurtured my thinking on this topic and many others, and his general equanimity kept me grounded during the uncharted journey of writing a dissertation and then a book. His knack for big conceptual thinking molded my own analytic mind in important ways. Karen V. Hansen facilitated my intellectual interest in the intersection of medicine and motherhood, and I thank her for being a model scholar and person. Sara Shostak helped me tremendously as I navigated key questions in the sociology of medicine and science. After Lorraine passed away, I was quite distressed, and Susan Parish graciously and competently stepped in as a policy expert during the latter stages of my dissertation research and provided essential assistance and support.

      It is no secret that Elizabeth Mitchell Armstrong’s work has profoundly influenced my own. After crucially helping me formulate key arguments during my dissertation work, Betsy invited me to Princeton to study as a postdoctoral fellow. To say that this was a fortunate opportunity would be a massive understatement. During my time at Princeton, I was able to work with and talk with Betsy on a weekly basis, and I learned a terrific amount about how to navigate research projects, academia, and life. Betsy is a wide-ranging intellectual, a consummate mentor, and a kind friend. Thank you, Betsy, for making all this possible.

      Susan Markens and Norah MacKendrick read countless drafts of chapters and were enduringly understanding and encouraging, uplifting me with their optimism, smart commentary, and good cheer. They were able to reveal clarity where I saw only blurred ideas, and they were quick to insert a thought-provoking comment where I most needed it. I am not sure the final manuscript would have come to fruition without them. For their camaraderie and friendship, I am immensely and continuously grateful. Rene Almeling and Kristin Barker offered extremely helpful insights in the early stages of this book project and read the penultimate manuscript in full. Their thoughtful and careful observations and suggestions vastly improved my work. Of course, any failings in this book are my own; but, for any of the book’s successes, I share them with my mentors, and Susan, Norah, Rene, and Kristin.

      Additionally, a number of colleagues—including Elizabeth Chiarello, Michaela DeSoucey, Bridget Gurtler, Joanna Kempner, Erika Milam, Jan Thomas, Ashley Rondini, Rebecca Flemming, Keith Wailoo, and anonymous reviewers at Signs and Journal of Health Politics, Policy and Law—read earlier versions of chapter