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.
The Zero Trimester was awarded the 2019 Robert K. Merton Book Award from the American Sociological Association’s Section on Science, Knowledge, and Technology—an award given to the best recent book published in science studies—and the 2019 Adele E. Clarke Book Award from ReproNetwork, an interdisciplinary community of reproduction scholars. The Zero Trimester was also selected as one of five finalists for the 2017 C. Wright Mills Award, which 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." Additionally, this project received the Rose Laub Coser Award from the Eastern Sociological Society and was supported by a grant from the National Science Foundation.
Reviews
"Breaks new ground. The 'zero trimester' concept is an excellent addition to the sociology of reproduction’s ever-developing glossary."—American Journal of Sociology
“A sophisticated study not only of a new medical trend, but also of a contemporary result of a century-old construction of modern pregnancy, modern motherhood and women’s health care.”—Social History of Medicine
"Waggoner’s analysis is clear, compelling, and richly documented."—Medical Anthropology Quarterly
“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
"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, University of New Mexico
"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, Drexel University
“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, University of Arizona
Reviews in Scholarly Journals
Lori Freedman’s review in Contemporary Sociology
Gareth Thomas’ review in American Journal of Sociology
Gillian Love’s review in Sociology of Health & Illness