Miranda R. Waggoner

Motherhood Preconceived: The Emergence of the Preconception Health and Health Care Initiative

Since the 1980s, maternal and child health experts have sought to redefine maternity care to include the period prior to pregnancy, essentially by expanding the concept of prenatal care to encompass the time before conception. In 2004, the Centers for Disease Control and Prevention endorsed and promoted this new definition when it launched the Preconception Health and Health Care Initiative. In arguing that prenatal care was often too little too late, a group of maternal and child health experts in the United States attempted to spur improvements in population health and address systemic problems in health care access and health disparities. By changing the terms of pregnancy risk and by using maternalism as a social policy strategy, the preconception health and health care paradigm promoted an ethic of anticipatory motherhood and conflated womens health with maternal health, sparking public debate about the potential social and clinical consequences of preconception care. This article tracks the construction of this policy idea and its ultimate potential utility in health and health policy discussions.

Epigenetic determinism in science and society

The epigenetic “revolution” in science cuts across many disciplines, and it is now one of the fastest-growing research areas in biology. Increasingly, claims are made that epigenetics research represents a move away from the genetic determinism that has been prominent both in biological research and in understandings of the impact of biology on society. We discuss to what extent an epigenetic framework actually supports these claims. We show that, in contrast to the received view, epigenetics research is often couched in language as deterministic as genetics research in both science and the popular press. We engage the rapidly emerging conversation about the impact of epigenetics on public discourse and scientific practice, and we contend that the notion of epigenetic determinism – or the belief that epigenetic mechanisms determine the expression of human traits and behaviors – matters for understandings of the influence of biology and society on population health.

More and Less than Equal: How Men Factor in the Reproductive Equation

In both social science and medicine, research on reproduction generally focuses on women. In this article, we examine how men’s reproductive contributions are understood. We develop an analytic framework that brings together Cynthia Daniels’ conceptualization of reproductive masculinity (2006) with a staged view of reproduction, where the stages include the period before conception, conception, gestation, and birth. Drawing on data from two medical sites that are oriented to the period before pregnancy (preconception health care and sperm banks), we examine how gendered knowledge about reproduction produces different reproductive equations in different stages of the reproductive process. We conclude with a new research agenda that emerges from rethinking the role of men and masculinity in reproduction.

Pregnancy Intentions, Long-Acting Contraceptive Use, and Rapid Subsequent Pregnancies Among Adolescent and Adult First-Time Mothers

PROBLEM Greater understanding is needed related to qualitatively assess pregnancy intentions and rapid subsequent pregnancies among adolescent and adult mothers. METHODS Four-site prospective study of 227 adolescent and adult mothers. Data were analyzed to understand the relationship between pregnancy intentions, adolescent status, and use of long-acting contraceptives and rapid subsequent pregnancy. FINDINGS The findings from this study provide evidence of the importance of goal-oriented pregnancy intentions, long-acting contraceptive use, and older age in delaying a second pregnancy. CONCLUSION Findings reveal the need for clinician awareness of the qualitative pregnancy intentions of young women and potential desired use of long-acting contraceptives.

Narration and Neuroscience: Encountering the Social on the “Last Frontier of Medicine”

As the neurosciences endeavor to explain increasingly complex aspects of human biology and behavior, domains of human life that can only be assessed in social interaction become ever more important, if formally unacknowledged, dimensions of scientific research. Drawing on semi-structured interviews with 14 researchers who study epilepsy genetics, this chapter examines how neuroscientists encounter ‘the social.’ We find that at the beginning of their careers, researchers are intrigued by epilepsy as a disease of the brain and a means of exploring “the last frontier in medicine.” However, as they begin their investigations, the importance of building social relationships, gleaning the subtleties of seizure experience available only in patient narratives, and engaging with families in the field quickly emerge as important parts of epilepsy genetics research. Some researchers hope for and work toward a day when new techniques or models will allow them to forgo the time consuming, painstaking, and often invisible work of gathering detailed histories, combing through patient narratives, and traveling to field sites to meet with families. However, these accounts make clear that, at the current moment, much of “the molecular work” of epilepsy genetics research is built upon social interactions, relationships, and experiences.

Biology After the Sociobiology Debate: What Introductory Textbooks Say About the Nature of Science and Organisms

that preoccupation might arguably be more symptom than cause, but the celebritycauses-pathologies argument is rarely subjected to such challenges. The paucity of evidence is most glaring, at least to me, in two areas. First, given the goal of clarifying what is distinctive about contemporary celebrity, there is surprisingly little attention to how new media have reshaped celebrity culture, about which there is a growing body of research and thinking: both the ‘‘PR-Media hub,’’ for instance, about which Rojek writes convincingly, and the circulation of celebrity talk are in the midst of reformulations that are mostly set aside in Fame Attack. Second, the book’s claims about ‘‘stargazers’’ are puzzlingly detached from research on celebrity audiences, aside from the psychological research on pathologies. Some people no doubt become ‘‘addicted to stars’’ and ‘‘imitate the bad behavior of stars’’ (p. 47), but existing research on celebrity audiences and fandom—very little of which is considered in the book—does not indicate that these are the primary forms of engagement with celebrity culture. Indeed, a more serious consideration of existing research on celebrity audiences would complicate some of the book’s central claims—including, for example, the assertion that ‘‘celebrity culture is ubiquitous because it affords access to the deep human need for transcendence and meaning’’ (p. 178). That last claim, however, hints that Rojek is actually up to much more than his title and central argument suggest. Despite its commitment to demonstrating the pathologies of celebrity, the book ranges much more widely and idiosyncratically through celebrity culture, synthesizing an impressive array of ideas, including the seminal ones he put forward in his important Celebrity (2001). In fact, Fame Attack feels like several books packed into one: even if one is not persuaded by the argument that fame attacks, there is much worth considering outside of that central strand. Rojek covers older territory—the ‘‘factory system’’ of celebrity production, parasocial relationships between stargazers and stars, celebrities as charismatic figures, celebrity philanthropy—and mines it for new insights. Perhaps more valuable than Fame Attack’s extravagant warnings about celebrity’s dangers is its wide-ranging theory about the ‘‘supply’’ and ‘‘demand’’ factors that have pushed celebrity culture across national and institutional lines and deeper into everyday life. Read this way, as a bumpy tour through celebrity culture and its problems by one of its most accomplished observers, Fame Attack remains a worthwhile trip.