In the early twentieth century, prenatal care was promoted as the answer to infant mortality and adverse birth outcomes, including birth defects. Yet, by the end of the century, the United States consistently ranked 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 first decade of the twenty-first 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, was published 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.
This project was awarded the Rose Laub Coser Award from the Eastern Sociological Society and was supported by the National Science Foundation. More recently, The Zero Trimester was selected as one of five finalists for the 2017 C. Wright Mills Award. This award is a distinction awarded annually by the Society for the Study of Social Problems to the author of the book that "best exemplifies outstanding social science research and a great understanding of the individual and society in the tradition of the distinguished sociologist, C. Wright Mills."
“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