This thesis analyzes public “nurse-ins” and breastfeeding activism of the past decade, examining public breastfeeding demonstrations as an example of collective rhetoric in which the individual is empowered in its relation to the masses. The author discusses the potential of collective rhetoric to reintroduce feminist activism at a time dominated by postfeminist discourse. Staged nurse-ins force the public to confront realities of the maternal body; however, the self-proclaimed “lactivists” seldom discuss the inseparable sexuality of the breast and the underlying narrative of “natural” and “good” motherhood. Addressing Foucauldian discursive formations, the author acknowledges that even though the resistant discourse cannot exist outside of the dominant discourses that continue to act upon it, collective demonstrations nevertheless hold the power to disrupt public perception of the maternal body.

Currently, about 1 in 3 women of reproductive age are obese (Flegal, Kruszon-Moran, Carroll, Fryar, & Ogden, 2016). Obesity in pregnancy has been associated with adverse maternal and infant outcomes (“Clinical Management Guidelines for Obstetrician–Gynecologists. Number 49, December 2003,” 2003) and maternal overweight and obesity have been implicated as increasing the risk for early childhood obesity (Ramonienė et al., 2017). Obesity is defined by the World Health Organization as having a body mass index (BMI) greater than 30 kg/m2, however, there is mounting evidence that BMI is not an accurate measure of adiposity (Kennedy, Shea, & Sun, 2009), which is one of the leading clinical concerns surrounding obesity. Understanding the associations between maternal body composition and infant body composition could begin to answer questions regarding the underpinnings of intergenerational obesity and offer a modifiable factor such as body composition as a target of opportunity to improve maternal and infant outcomes. This secondary analysis of 372 mother-infant dyads examines the associations of maternal body composition, as measured by BMI, fat mass and lean mass, with infant body composition, as measured by fat mass, lean mass, and BMI z-scores. Fat and lean masses were derived from dual-energy x-ray absorptiometry (DXA). Correlations between maternal BMI and maternal fat and lean mass were explored at one month postpartum. Associations between maternal body composition exposures at one month postpartum and infant body composition outcomes at one, four, and seven months postpartum were explored in the entire cohort and then stratified in two separate analyses by maternal BMI and infant sex to determine the potential for effect modification. Maternal BMI was strongly correlated with maternal fat mass at one month postpartum (r=0.91), and less strongly correlated with maternal lean mass (r=0.71). Maternal lean mass was positively associated with infant lean mass at four months postpartum. In obese women, maternal BMI was negatively associated with infant lean mass at seven months postpartum. In overweight women, maternal fat mass and maternal lean mass were positively associated with infant lean mass. In obese women, maternal fat mass was negatively associated with infant lean mass at four months postpartum. Maternal fat mass and lean mass were positively associated with infant lean mass at four and seven months postpartum in females but not in male infants. An increase in maternal lean mass was also found to be associated with a significant increase in female infant BMI z-scores at seven months postpartum but were not associated with male infants’ BMI z-scores. This study found that obese women with increased adiposity, as measured by BMI and fat mass, tended to have infants with less lean mass at four and seven months postpartum, while overweight women with increased lean mass tended to have infants with greater lean mass at all postpartum through seven months postpartum. It was also found that female infants born to mom’s with larger fat mass or larger lean mass tended to have increased lean mass at four and seven months postpartum, while there seemed to be no associations with maternal and infant body composition in male infants. These results confirm that the first year of life is an important time in infant development and potential programming, but they also suggest that this programming may be associated with lean mass accrual in early infancy as opposed to fat mass or adiposity. The complexity of the relationships between maternal and infant body composition in the postpartum period may involve other factors such as sex differences, genetics and nutrition, and should be further explored in future studies.

The primary objective of the work presented in this thesis was to identify trends in maternal body mass index (BMI) over time, the demographic predictors of those women most at risk of being obese in pregnancy, health inequalities, and the impact of maternal obesity on maternity services. A mixed methodology utilised quantitative and qualitative research to address these objectives. Data were collated from 34 maternity units across England, including 619,323 deliveries between 1989 and 2007 inclusive. Analysis identified an increasing incidence of maternal obesity over time, regional differences in incidence, and significant inequalities with women residing in the highest levels of deprivation, and Black ethnic group. A systematic review was carried out including 49 studies investigating obesity and pregnancy outcomes with acute maternity resource implications. The meta-analysis found significantly increased odds of a number of outcomes, and concluded that maternal obesity had a considerable impact on maternity resources, and contributed towards a poorer prognosis for the mother and the baby during delivery and in the immediate post-partum period. Qualitative interviews and focus groups with 30 HCPs across eight NHS Trusts in the North East of England were carried out to identify barriers in implementing maternal obesity services, and to gain HCPs perspectives on what they felt was required in order to address maternal obesity effectively. The study identified the themes of ‘Service Development’, ‘Psychosocial Issues and Maternal Obesity Services’, ‘Information, Evidence, and Training’, and ‘Where to go From Here?’. Overall this programme of research has identified that maternal obesity is increasing over time and is significantly associated with health inequalities. The increase in maternal obesity has an impact on acute services, and HCPs feel that a holistic approach is required through partnership work in order to address maternal obesity effectively. This programme of research has primarily contributed to the knowledge of maternal obesity with the provision of the first national level statistics for trends in maternal obesity. The research has also provided a holistic view of the impact of obesity in pregnancy on maternity services, including the impact on resources and the issues relating to addressing the maternal obesity in clinical practice. The research has also identified aspects of service that need to be improved, and knowledge gaps in how to move services forward to effective address maternal obesity. The contribution of this research to the knowledge base is emphasised in the journal pre-publications, dissemination through UK and European, and international conference presentations, being an invited speaker at a number of conferences in the UK, and I received the 2007 Association for the Study of Obesity (ASO) Student Researcher Award for producing exemplary work in the study of obesity.

Background: Numerous maternal factors, such as body mass index (BMI), gestational weight gain (GWG), diet and physical activity (PA) have been shown to impact infant birth weight. In the UK, antenatal care tends to be based on pre-pregnancy BMI and women are not weighed routinely during pregnancy nor are there guidelines for GWG. However, it is widely acknowledged that maternal obesity and GWG in excess of the American Institute of Medicine guidelines are associated with increased risk of foetal macrosomia and recent studies have suggested a role of the timing and composition of GWG beyond that of BMI. The purpose of this study is to examine the effects of timing and composition of GWG on neonatal anthropometric outcomes in a prospective cohort study amongst women with a BMI≥30 kg/m2 in Plymouth, UK. Methods: Women (n=75) were recruited at 12 weeks gestation. Maternal height, weight and body composition assessed using skinfolds at biceps, triceps and subscapular were collected at baseline and repeated at 28 and 36 weeks gestation. Four-day food diaries and four days of accelerometry were collected in the days following each of the three study visits. Following delivery, infant weight and gestational age were obtained, and neonatal anthropometric measurements were recorded within 72 hours of delivery. Results: Maternal energy intake was positively associated with GWG and rate of fat mass (FM) accrual, in the second (r = 0.435 and r = 0.395, respectively, p < 0.05) and third trimesters (r = 0.333 and r = 0.317, respectively, p < 0.05), with no associations observed between maternal energy intake and rate of fat free mass (FFM) accrual in either trimester. Maternal rate of FFM accrual (in both trimester 2 and over total pregnancy), not FM nor rate of GWG, was positively associated with infant birth weight z scores (r = 0.360 and r = 468, respectively, p < 0.05) and upper arm area muscle estimate (UME) (r = 0.291 and r = 0.357, respectively, p < 0.05). Second trimester intake of sugar was positively associated with infant UME (r = 0.419, p < 0.05), while third trimester intake of sugar was positively associated with both infant UME and infant birth weight z score (r = 0.376 and r = 0.308, respectively, p < 0.05). Conclusion: The present study suggests that maternal accrual of FFM and intake of sugar during pregnancy may be associated with increased infant birth weight and lean mass. Further research is required to determine whether interventions should focus on changes in maternal body composition alongside diet and lifestyle during pregnancy, or if they should continue to focus on limiting total GWG.

Excerpt: In their recent study [ 1 ], Lavesson et al. concluded, “In febrile parturients, neither maternal nor fetal temperatures dropped after paracetamol, but paracetamol halted an increasing trend and stabilized the fetal temperature. The effect of paracetamol on maternal temperature was inconclusive”. This conclusion, however, is not supported by the data in the study, in that the calculation of case and control temperature differences demonstrates clear fetal and maternal temperature decreases after paracetamol.

Objective: This study presumed that a high or low bodymass index (BMI)might increase the risk of infant mortality. Therefore, a meta-analysis was performed to systematically assess the association between maternal BMI and the risk of infant mortality. Methods: The electronic databases, including Pubmed, Embase database, and Cochrane Library, were systemically searched by two investigators from inception to November 26th, 2020, with no language restriction. In parallel, a dose-response was assessed. Results: Finally, 22 cohort studies involving 13,532,293 participants were included into this paper, which showed that compared with normal BMI, maternal overweight significantly increased the risks of infant mortality [risk ratio (RR), 1.16; 95% confidence interval (CI), 1.13–1.19], neonatal mortality (RR, 1.23; 95% CI, 1.08–1.39), early neonatal mortality (RR, 1.55; 95% CI, 1.26–1.92) and post-neonatal mortality (RR, 1.18; 95% CI, 1.07–1.29). Similarly, maternal obesity significantly increased the risk of infant mortality (RR, 1.55; 95% CI, 1.41–1.70), neonatal mortality (RR, 1.55; 95% CI, 1.28–1.67), early neonatal mortality (RR, 1.37; 95% CI, 1.13–1.67), and post-neonatal mortality (RR, 1.30; 95% CI, 1.03–1.65), whereas maternal underweight potentially decreased the risk of infant mortality (RR, 0.93; 95% CI, 0.88–0.98). In the dose-response analysis, the risk of infant mortality significantly increased when the maternal BMI was >25 kg/m2. Conclusions: Maternal overweight or obesity significantly increases the risks of infant mortality, neonatal mortality, early neonatal mortality, and post-neonatal mortality compared with normal BMI in a dose-dependentmanner. Besides,maternal underweight will not increase the risk of infant mortality, neonatal mortality, early neonatal mortality, or postneonatal mortality; instead, it tends to decrease the risk of infant mortality. Early weight management may provide potential benefits to infants, and more large-scale prospective studies are needed to verify this finding in the future.

9 Abstract Aim of the study. In mammals, including humans, the dominance of maternal influence on fetal size is manifesting. The main known limits from non-genetic components causing the physiological variation of the birth weight are maternal skeletal dimensions (body height and weight) and parity. The main aim of our study is to analyze the relationships between maternal height, maternal weight at the beginning and at the end of gravidity, and anthropometric parameters of a newborn. Data and Methods. Our study is based on transversal anthropometric data of 201 newborns (92 boys, 109 girls) born in Regional Hospital Kladno during one year (from September 2010 till August 2011), and their mothers. In one set of newborns (n = 156) 24 different body sizes were measured in detail. In the second group (n = 45) only birth weight, birth length and head circumference of the newborn were registered. Somatic characteristic of mothers were gathered by questionnaire. Results. The average value of the birth weight of newborns (boys: x = 3 318 g, girls: x = 3 232 g), maternal height ( x = 167,3 cm) and maternal pregravid weight ( x = 64,7 kg) correspond to the reference values. The maternal average age is 29,9 years. Statistically significant dependence can be seen between the birth weight and birth length of a newborn...

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Cette étude traque le corps maternel dans l’histoire de la métaphysique. Chez Platon, il oscille entre chôra, nourrice du vivant, et matrice animale qui gouverne le corps féminin Mais la chôra, n’est pas
« Triton Genos » mais premier environnement de l’être qui est exproprié dès son origine. S’en suit l’errance du corps maternel fondatrice de la métaphysique. La volonté d’effacer le corps maternel est au cœur de la métaphysique définie comme haine et jalousie à l’égard de ce corps. Aristote théorise l’engendrement en soi mais inaugure la tradition de l’infériorisation des femmes due à leur matrice que la médecine gréco-­‐latine entérine. Le christianisme comme « métaphysique des sexes » invente une figure du corps maternel purifié avec la Vierge Marie. Aux XVIIe et XVIIIème siècles, le sujet possède son corps et ses enfants et assombrit la dignité de la personne. Le corps maternel agonise et ce matricide dit la nouvelle économie libidinale qui perpétue l’enfouissement renouvelé de la mère. Le corps qui arrive est machine, sans organes et sans utérus. Un corps fabriqué, instrument de soi, qui célèbre la naissance sans mère. Le corps auto-­‐engendré dit le phantasme masculin d’en passer sans le corps maternel. Son analyse dans la cartographie des philosophes femmes du XXème siècle, universaliste, différentialiste, queer, cyborg, est incontournable. Le point culminant de notre étude mesure les enjeux actuels des biotechnologies, phase finale de l’effacement du corps maternel puisqu’elles tendent à l’externaliser et à l’assujettir. Devant le commencement radical qu’ouvre la naissance qui se fait grâce à la chair matricielle pensante des femmes, ne faudrait-­‐il pas bâtir la nouvelle métaphysique sur une ontologie de la vie basée sur l'ordre symbolique de la mère, seule issue possible pour sortir du désordre de la pensée ? / This study seeks to uncover the maternal body in the history of Metaphysics. In Plato, it varies between the chora, nurse of the living and the animal matrix which rules the feminine body. However, the chora is not « triton genos » but the first environment of the being who is expropriated from its origins. The maternal body can begin to wander and Metaphysics lays on that wandering. The Will of erasing it is at the heart of Metaphysics defined as hatred and jealousy. Aristotle thinks through the Begetting in itself but also ushers in the tradition of devaluing Women’s bodies in particular their womb, which is exactly what the Greek Latine Medicine confirms. The Christianity as “Metaphysics of the Sexes” invents a purified figure of the maternal body with the Virgin Mary. With the XVII and XVIIIe centuries, the subject owns his body and his children and this darkens the Dignity of the Person. The maternal body is dying and this matricide illustrates the upcoming libidinal Economy that perpetuates the burial of the Mother. The new body is a machine, without organs and without a womb. This manufactured body, tool of the Self, celebrates the Birth without the Mother. The self-begotten body represents the male fantasy to procreate without the female body. Analysis of it in the cartography of Women Philosophers, alternately universalist, differentialist, queer, cyborg is highly needed. The climax of this study measures the actual stakes of Biotechnologies, considering them as the final step of a large and global Erasing of the maternal body in an attempt to externalise and enslave it. In front of the radical beginning that opens Birth, made possible by the female thinking matrix flesh, why not build a new metaphysics upon the Symbolic Order of the Mother, this is the only way to leave forever the original Disorder of philosophical Thinking?

Ce mémoire porte sur le dualisme sujet/objet visible dans les représentations sociales du corps maternel véhiculées par les discours portant sur la gestation pour autrui. À travers une analyse des discours juridiques, gouvernementaux et de presse, nous montrerons de quelle manière une vision objectivante du corps maternel côtoie une vision subjectivante de celui-ci et comment ce double regard constitue une condition d’émergence de la pratique étudiée. Pour ceux qui s’opposent à la pratique, la subjectivité maternelle prend place dans le corps enceint et pour les tenants, elle se situe prioritairement dans l’intention, dans le projet parental. Le corps maternel ne peut être désigné comme tel seulement s’il accompagne l’intention, sinon, il n’est qu’enceint. La littérature en science sociale est abondante quant à la manière dont les acteurs directement concernés, comme les mères porteuses, les parents d’intention et les tiers reproducteurs et reproductrices conçoivent la pratique, mais peu de recherches s’intéressent aux représentations du corps maternel, et encore moins, à la place du dualisme sujet/objet en leur sein. Ainsi, suivant la conception du corps humain et du sujet moderne, le corps reproducteur féminin est appréhendé comme une entité séparée du sujet et de nature mécanique et pathologique que l’obstétrique moderne doit contrôlée afin de soigner plus facilement le nouveau patient, le fœtus. Toutefois, en parallèle se construit un discours psychologique concevant le corps maternel comme un lieu où la subjectivité de la future mère et du futur enfant se construisent. Le corps maternel pose problème à la figure hégémonique moderne d’un sujet masculin séparé du monde, de par ses potentialités reproductives et sa position face à l’altérité qui est vécue de manière interne et corporelle. Il est donc l’objet d’un recadrage technique et discursif vers cette hégémonie. Les techniques de reproduction assistée et la gestation pour autrui sont des exemples de ce recadrage et du double processus de subjectivation et d’objectivation. Ce mémoire démontrera comment les discours sociaux sur la pratique suggérant une vision de la subjectivité maternelle fluide (priorité à l’intention) se heurtent à une vision rigide (inscrite dans le corps maternel) de celle-ci. / This thesis focuses on the subject/object dualism visible in the social representations of the maternal body conveyed by the different speeches on surrogacy. Through an analysis of governmental, legal and media discourses, we will demonstrate how an objectivating conception of the maternal body stand alongside a subjectivating conception of it and how this double glance constitutes one of the emergence condition of the studied practice. For whom who disagree with surrogacy, the maternal subjectivity take place inside the pregnant body while for the upholder, it is located in priority in the intention, the parental project. The maternal body cannot be designated as such if it doesn’t come with the intention, if not, it is only pregnant. The social literature is abundant about the way the different actors, like surrogate mothers, intentional parents, and third parties perceive the practice but limited researches take a direct interest in the social representations of the maternal body, less again in the place of the subject/object dualism in them. In this way, following the modern conception of the human body and of the subject, the female reproductive body is seen as a entity separated of the subject and with a mechanical and pathological nature that the modern obstetrics should control so it can treat the real patient, the fetus. However, in parallel, a psychological discourse is being constructed in which the maternal body is seen like a place where subjectivity of the future mother and the future child are developing. The maternal body is problematic for the hegemonic modern figure of the masculine subject separated from the world, because of its reproductive potentialities and its position in front of the alterity whom is experience in an internal and a corporal way. It is then the object of a technical and a discursive reframing towards hegemony. The assisted reproduction technologies and surrogacy are examples of this reframing and of the double process of subjectification and objectification. This paper will show how the social discourses on surrogacy that suggest a vision of a flowing maternal subjectivity (intention is priority) collide with a inflexible vision of it, that is inscribed in the body.