BackgroundGrowing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines.MethodsThis cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight.ResultsFifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known.ConclusionsThese results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child.
The rapidly shifting field of epigenetics has expanded scientific understanding of how environmental conditions affect gene expression and development. This article focuses on two ongoing clinical trials-one in the United States and one in the United Kingdom-that have used epigenetics as the conceptual basis for testing the relationship between nutrition and obesity during pregnancy. Drawing on ethnographic research, I highlight the different ways that clinical scientists interpret epigenetics to target particular domains of the environment for prenatal intervention. Here I examine three environmental domains: the pregnant body, the home, and everyday experiences. In so doing, I show how different scientific approaches to epigenetics multiply concepts of "the environment," while also individualizing responsibility onto pregnant bodies. Ultimately, I argue that how the environment is conceptualized in epigenetics is both a scientific and a political project that opens up questions of reproductive responsibility.
The Lancet Commissions are widely known as aspirational pieces, providing the mechanisms for consortia and networks of researchers to organize, collate, interrogate and publish around a range of subjects. Although the Commissions are predominantly led by biomedical scientists and cognate public health professionals, many address social science questions and involve social science expertise. Medical anthropologist David Napier was lead author of the Lancet Commission on Culture and Health (2014), for example, and all commissions on global health (https://www.thelancet.com/global-health/commissions) address questions of social structure, everyday life, the social determinants of health, and global inequalities.
This article introduces the feminist praxis of duoethnography as a way to examine the COVID era. As a group of diverse, junior, midcareer, and senior feminist scholars, we developed a methodology to critically reflect on our positions in our institutions and social worlds. As a method, duoethnography emphasizes the dialogical intimacy that can form through anthropological work. While autoethnography draws on individual daily lives to make sense of sociopolitical dynamics, duoethnography emphasizes the relational character of research across people and practices. Taking the relational aspects of knowledge production seriously, we conceptualized this praxis as a transformative method for facilitating radical empathy, mobilizing our collective voice, and merging together our partial truths. As collective authors, interviewers, and interlocutors of this article, the anonymity of duoethnography allows us to vocalize details of the experience of living through COVID‐19 that we could not have safely spoken about publicly or on our own.
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