Pre-Pregnancy Care

In the early twentieth century, prenatal care was promoted as the answer to infant mortality and adverse birth outcomes, including birth defects. The United States today consistently ranks poorly among industrialized nations on measures of infant and maternal mortality, despite widespread utilization of prenatal care. As a result of this conundrum, the boundaries of pregnancy risk shifted in the last decades of the twentieth century. In 2004, the Centers for Disease Control and Prevention (CDC) launched the Preconception Health and Health Care Initiative, promoting pre-pregnancy health and health care among women of reproductive age, with numerous implications for how we think about risk, medicine, and maternity. My book on this topic, The Zero Trimester: Pre-Pregnancy Care and the Politics of Reproductive Risk, is forthcoming with the University of California Press in 2017. The Zero Trimester details how cultural discourses around the role of women, the politics of motherhood, and the imperatives of population health and medicine have shaped the scientific and policy construction of a pre-pregnancy care agenda now pervasive in reproductive risk discussions.

I argue that the emergence of pre-pregnancy care is a watershed moment for contemporary thinking about the origins of health and disease in America. This project was awarded the Rose Laub Coser Dissertation Proposal Award from the Eastern Sociological Society in 2011 and supported by the Sociology Program at the National Science Foundation (SES-1029087).

In one paper from this project, "Motherhood Preconceived", I develop the concept of "anticipatory motherhood" to refer to the emergent public health ethic of treating all women of childbearing age as pre-pregnant. In another, published at Signs, I examine how the pre-pregnancy model has influenced public health promotion.

I have also published on this topic in Gender & Society with co-author Rene Almeling (Yale).