Weighing the Future: Clinical Decisions and Pregnancy

• In Event: Examining the Exceptional: Case Studies of Knowledge Production in Biomedicine and Science

Abstract

Weight measurements are a standard and expected procedure in all facets of clinical practice. Although this practice is routine and ubiquitous, weight as a clinical metric carries a long and divergent history, particularly in regards to pregnant women. Pregnant women are often at the center of a two-pronged debate: should weight be monitored during pregnancy? If so, what is the appropriate amount of weight a pregnant woman should gain? These concerns, I argue, are directly related to growing public concern over the obesity epidemic, and emerging epigenetic paradigms of fetal programming, which claim that women’s weight and diets during pregnancy can have permanent consequences for future progeny. In this paper, I provide a comparative analysis of weight gain in the United States versus the United Kingdom using clinical trials in each respective country from 2012 to 2014. The two randomized clinical trials test interventions of diet and exercise on pregnant women who are classified as overweight and obese. The US-based trial focused on weight control. However, in contrast, the British trial prioritized glycemic control; specifically, a diet that asked pregnant participants to lower sugar, saturated fat, and carbohydrate intake. The trial in the UK does not monitor weight during pregnancy and did not provide any weight gain recommendations for the participants. Understanding the choices and decisions that went into the clinical trial construction and the divergent recommendations regarding the monitoring of pregnant women reflects the cultural understandings and uses of weight as a routine form of reproductive technology and control.

Author

• Natali Valdez, University of California Irvine