Obesity is a rising global health problem. On the one hand a clearly defined medical condition, it is at the same time a corporeal state embedded in the social and cultural perception of fatness, body shape and size. Focusing specifically on the maternal body, contributors to the volume examine how the language and notions of obesity connect with, or stand apart from, wider societal values and moralities to do with the body, fatness, reproduction and what is considered 'natural'. A focus on fatness in the context of human reproduction and motherhood offers instructive insights into the global circulation and authority of biomedical facts on fatness (as 'risky' anti-fit, for example). As with other social and cultural studies critical of health policy discourse, this volume challenges the spontaneous connection being made in scientific and popular understanding between fatness and ill health.

Obesity is a rising global health problem. On the one hand a clearly defined medical condition, it is at the same time a corporeal state embedded in the social and cultural perception of fatness, body shape and size. Focusing specifically on the maternal body, contributors to the volume examine how the language and notions of obesity connect with, or stand apart from, wider societal values and moralities to do with the body, fatness, reproduction and what is considered ‘natural’. A focus on fatness in the context of human reproduction and motherhood offers instructive insights into the global circulation and authority of biomedical facts on fatness (as ‘risky’ anti-fit, for example). As with other social and cultural studies critical of health policy discourse, this volume challenges the spontaneous connection being made in scientific and popular understanding between fatness and ill health.

The maternal body is a site of contested dynamics of power, identity, experience, autonomy, occupation, and control. Representations of the maternal body can mis/represent the childbearing and mothering form variously, often as monstrous, idealized, limited, scrutinized, or occupied, whilst dominant discourses limit motherhood through social devaluation. The maternal body has long been a hypervisible artifact: at once bracketed out in the interest of elevating the contributions of sperm-carriers or fetal status; and regarded with hostility and suspicion as out of control. Such arguments are deployed to justify surveillance mechanisms, medical scrutiny, and expectation of self-discipline.This volume helps to develop a more critical understanding of what it means to be an embodied mother. The materiality of maternity and its centrality to family and social life remains too often viewed as a ?fringe? subject, the province of feminists, activists, hysterical women. For too long, the maternal body has been subject to ?expert? advice, guidance, censure, and control. Those of us maternal bodies are at risk of being commodified and diminished, having our bodily realities reduced to mechanistic functions and our lived experience disregarded. From art to medical surveillance, from genetics to radioactivity, goddess to breastfeeding, poetry to Indigenous community, dance to body size, the critical eye of the academic and the lived experience of the mother bring into being in this work a body of understanding, of expression, of knowledge and the power and authority of the lived experience, through and about the embodied mother. This critical-creative work encompasses new insights, new research, and redeveloped perspectives which combine the personal with the pervasive and point to new meaning-making in critical motherhood studies via the medium of the maternal body.

Heavy Burdens: Stories of Motherhood and Fatness seeks to address the systemic ways in which the moral panic around “obesity” impacts fat mothers and fat children. Taking a life-course approach, the book begins with analyses of the ways in which fatphobia is enacted on pregnant (or even not-yet-pregnant) women, whose bodies immediately become viewed as objects warranting external control by not only medical professionals, but family members, and even passers-by. The story unfolds as adults recount childhood stories of growing up fat, or growing up in fear of being fat, and how their mothers’ relationships with their own bodies and attempted weight-loss experiences shaped how food, exercise, and body management were approached in their homes in sometimes harmful ways. Finally, the book concludes with stories of women who have since become mothers, examining the ways in which having their own children altered their views on their own bodies and their perceptions of their mothers’ actions, and working to find fat-friendly futures via their own parenting (or grand-parenting) techniques.

Background: The prevalence of obesity substantially increases in pregnant women. Maternal obesity is associated with adverse maternal and neonatal outcomes. The increased risk for cesarean section present in obese women has been related to potential impaired uterine contractility. The mechanism that underlies this theory is not clear. In vitro studies have shown that leptin, produced by adipose tissue and the placenta, exerts an inhibitory effect on myometrial contractility. The aim of this thesis was to evaluate the labor process in relation to maternal body mass index (BMI) and the clinical role of leptin in this process. Material and Methods: Studies I-IV are cohort studies. The first two studies analyze the association between labor duration and maternal BMI based on data from the Perinatal Revision South register and the Swedish Pregnancy Register. Study I included 63,829 nulliparous women with a spontaneous onset of labor between 1995 and 2009. Study II included 15,259 nulliparous women with induced labor between 2014 and 2017. In study III, the maternal leptin levels during and after pregnancy were analyzed in 343 obese women with respect to their obesity class (I-III) and degree of gestational weight gain (GWG). In study IV, the association between the maternal leptin levels measured in active labor and duration of the active phase of labor was analyzed in 914 women. Results: The duration of spontaneous labor significantly increased with an increasing maternal BMI; however, the duration of the pushing phase was inversely related to BMI. Time in induced labor increased with maternal BMI; however, the differences between the BMI categories were more pronounced in the latent phase than the active phase. Leptin levels were higher in women with obesity class III than women with class I during and after pregnancy. The degree of GWG in obese women was not associated with maternal leptin. No significant association between maternal leptin and the duration of the active phase of labor was identified in the adjusted analyses. Conclusions: Nulliparous obese women have a higher risk for a prolonged duration of spontaneous and induced labor. This is important to consider prior to diagnosing labor arrest that results in a cesarean delivery. As maternal leptin levels are increased with the degree of obesity during pregnancy, future research on the association of high maternal leptin levels and the duration of labor is warranted.

As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women. Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.