Weighing the Future: An Ethnographic Examination of Epigenetics and Prenatal Interventions
The ethnography examines the different roles of epigenetics in both new scientific thinking and within clinical trials that test nutritional interventions on pregnant women deemed obese. Contrary to commonly held assumptions that underlie genetic determinism, epigenetics represents a paradigmatic shift through the study of how environmental conditions affect gene regulation. Research and prevention efforts around the growing public concern for childhood and adult obesity have recently shifted focus to a new population: pregnant women. Epigenetic science claims that women who are obese during pregnancy have a higher chance of having children who develop obesity and diabetes in adulthood. In the case of obesity during pregnancy, epigenetic researchers worry that a pregnant woman’s diet and overall health may affect not only the health of her unborn child, but also the genetic development of future generations. My ethnography follows scientists as they navigate through the new epigenetic paradigm and investigate the effects of dietary interventions on obese pregnant women.
This project involved sixteen months of multi-sited ethnographic fieldwork, carried out between 2012 and 2014. I completed participant observation and interviews at two randomized clinical trials: the SmartStart trial in the United States and the StandUp trial in the United Kingdom. Both trials use epigenetic theories to test the efficacy of prenatal interventions. However, each trial uses different diet and exercise interventions on pregnant women. While the US trial implements a behavioral intervention that focuses on weight gain and calorie control, the UK trial emphasizes the need to control sugar consumption during pregnancy. Both trials also follow up with the participants’ children to evaluate the effects of the prenatal interventions on the children’s early development. I actively participated in the SmartStart trial in the US as a nutritional counselor and volunteer staff member. I was responsible for delivering the dietary intervention, recruitment, and data collection practices. At the StandUp trial in the UK, I observed twenty-four intervention visits and over twenty different data collection visits, as well as monthly staff meetings and weekly conference calls.
The ethnography juxtaposes the justification and design of the clinical trials on behalf of the staff and scientists, with the experiences of the pregnant participants. By examining the application of dietary prenatal interventions in contemporary science ethnographically, I aim to interrupt a pattern of thinking in which women’s bodies are the inevitable targets of intervention to address future epidemics. Throughout the ethnography I examine themes related to how epigenetic science has influenced notions of the environment, “good mothering,” “healthy eating,” and the future risk of disease. In the ethnography I argue that individualizing dietary responsibility solely on the mothers obscures the social, gendered, and environmental factors that also influence their behavior and health. My findings show that epigenetic science is not a homogenous or monolithic paradigm. Rather, different scientists are applying particular aspects of epigenetics, which contribute to what I call the proliferation of epigenetic adaptations.