What would it feel like to constantly plan for something as life-changing as pregnancy, but feel ill-equipped to prepare for it? What if we told you that your health decisions pre-conception could impact not just your child, but generations to come? In today's episode, we're diving headfirst into the complexities of pregnancy planning and the repercussions of insufficient preparation. We're dissecting a recent study that found a shocking disparity between the women who plan their pregnancies and those who take active steps to prepare for them. The concept of 'Developmental Origins of Health and Disease' and its unique focus on women forms a critical part of our discussion. We particularly emphasize on the crucial yet often overlooked role of paternal health and the need for interdisciplinary collaborations to enhance overall reproductive health.
As the conversation proceeds, we shift focus to explore the unique health challenges faced by overweight women preparing for pregnancy. It's no secret that societal discourse around women's bodies is riddled with negativity, but how does this impact a woman's ability to prepare for pregnancy? How do these biases and pressures complicate weight management during pregnancy? We delve into these dilemmas, shedding light on issues often swept under the rug. This episode is an earnest attempt to delve deeper into the societal pressures, health dilemmas, and the critical need for empathic and comprehensive healthcare for all women, regardless of their body size. So, brace yourself as we navigate this complex terrain in our latest episode.
Undisciplinary - a podcast that talks across the boundaries of history, ethics, and the politics of health. Follow us on Twitter @undisciplinary_ or email questions for "mailbag episodes" undisciplinarypod@gmail.com
Speaker 1:
After we had a really interesting conversation with Shannon, I saw this article in the Sydney Morning Herald called More Than Half of Women Trying for a Baby Aren't Following Health Advice. But why? So? It says not enough of us properly prepare for what is perhaps the most significant event of our lives having a baby. So this is. This article is talking about a study published in the MJA which says that seven in 10 Australian women plan their pregnancies, but less than half do anything to prepare for becoming pregnant. So they were talking about things like stopping smoking, increasing physical activity, not using alcohol and taking supplements such as folic acid, I guess, and seeking medical advice about getting pregnant. So it was really interesting. So about half of women aren't doing that.
Speaker 1:
I will say that when I had a planned pregnancy, it had never occurred to me to do any of those things. So I'm definitely in that half of people who did not follow health advice. I didn't know that there was such health advice and that's possibly a function of having not being pregnant in 2023. Thank God. But it also made me think about what that means. I suppose to be following health advice about getting pregnant. Now we know that not everybody.
Speaker 1:
So old statistics and I can't remember where I read this or how true it is is that the average time that it takes for a planned pregnancy to become a pregnancy that sticks and turns into a baby is around nine months. Obviously, there are also pregnancies that take much, much longer to achieve, and there are unplanned pregnancies. I guess I wondered what it was to be in a constant state of planning to be pregnant over a certain period of your reproductive lifetime, and why so? Okay, there's a few things Partly, if it's taking a long time to get pregnant, that following those health advices could possibly make it more likely that you get pregnant, but it also means that your entire life anyway, is revolving around whether or not you're pregnant you know, does it seem fair to also be having to do these other things if those aren't things that are naturally appealing to you, like not drinking or taking supplements, or doing extra exercise, losing weight, whatever those things are?
Speaker 1:
Yeah, if it's not happening anyway, what sort of pressure is that putting on people? Is that a slippery slope saying that women of reproductive age shouldn't drink? Because what if they do get pregnant? And the idea is that we should be following this health advice because it makes for healthier babies. It says health behaviors of both men and women are important before conception. The fetal environment is crucial for birth outcomes but lifelong health of the child and can impact subsequent generations, and it all starts not before the baby is born but before the baby is conceived. So the idea of sort of an intergenerational justice or having a responsibility for future generations by living a certain way as a woman when you're a woman of reproductive age is really interesting and, I will say, kind of alarming to me, and so I'm just really interested to know what you think about that, chris.
Speaker 2:
Well, firstly, I think this is another one of those articles that sort of is extremely sort of, yeah, pronatal and like what Shannon's work was looking at, in the way that identity is bound to fertility for many women, or the discourse of that. So you know just that first line saying you know what is perhaps the most significant event of our lives having a baby.
Speaker 2:
So I think, though, that this is, on the one hand, I think, in relation to a lot of public health in general this idea of being in a state of constant vigilance over one's body.
Speaker 2:
So similar ideas, say in relation to obesity, that were always in a state of becoming obese. So we always need to be vigilant against becoming obese and every micro decision that you make is one that is either for is either preventative or causative of becoming obese. So there's that. Similar politics of prudence was a paper Roswell and to prose and Kane race and Catherine Mills and others wrote, I think in 2009, which was very formative on my thinking that went into my sort of work around lifestyle.
Speaker 2:
But here as well, this, this idea of pre pregnancy, that, yeah, you're a constant state of being pregnant, of becoming pregnant, and this is reinforced by the working epigenetics around the early. What's the thing that? Not the social determinants of health, but the sort of developmental origins of the health and disease is an area, and epigenetics which tries to say that you know, in some ways it's what your grandmother did, that is, has a determining effect on your health.
Speaker 2:
And so, yeah, brings up these questions of intergenerational justice and supposed causes and harms. You know, should I blame my maternal grandmother for my, you know, or should I blame, you know? Is there some causative aspect? And so it's women often.
Speaker 1:
So yeah, yeah, yeah exactly.
Speaker 2:
I was part of a paper. Actually, I think I ended up leading a paper, which was awkward, but what would we call it? Yeah, it was sort of responding to this. So yeah, the developmental origins of health and disease is this sort of epigenetics movement where a lot of this research about you know what you eat before getting pregnant has a effect on the development of the fetus. But there is a group of people who are saying, well, we need to look beyond maternal influences.
Speaker 2:
So some people say that the developmental origins of health and disease really has become the maternal origins of health and disease, and so there is this disproportionate focus on women, and so there's a group of people who are trying to talk about the paternal origins of health and disease and develop that as an epigenetic paradigm, which I wasn't expecting to talk about this, but yeah, which some colleagues Maritzi Amaloni and Elshar Lawson Boyd and myself wrote an article situating the father strengthening interdisciplinary collaborations between sociology, history and the emerging paternal origins of health and disease paradigm, where we basically say that if we're talking about food and diet in particular, that is, family practices or domestic practices around food have historically and contemporarily are often orient around the male partner or male children in terms of what's eaten, and that also there are dangers of going too far down that path because then it can in a sense reinforce certain heteronormative, patriarchal ideas of diets and eating.
Speaker 2:
So, for instance, there are recent people research the importance of the family meal. Isn't the family meal such an important thing for family cohesion and wellbeing? And often it'll accompany a picture of the happy white family all sitting around the table with the male head at the table. But family meals are also a site of violence and anxiety and deletion and reinforcing of very unhelpful ideals and norms.
Speaker 1:
Yeah.
Speaker 2:
So I think that this article is. Obviously they would be saying that they're not doing that, but I think back to this idea of the pre-pregnancy, or being in a constant state of becoming pregnant. Yeah, it's clearly picking up and probably part of these epigenetic discourses, but then, also, I think, this longer and more pervasive discourse of that, this sort of been constantly prepared, constantly vigilant over micro decisions and choices.
Speaker 1:
Yeah, yeah, interesting. Thank you very much. You would say something useful.
Speaker 2:
Well, I mean, I think it's also interesting coming back to the conversation we were having with Shannon about sex education and the lack of it, but then I, yeah, to what extent would we want this kind of stuff included?
Speaker 1:
Well, exactly, I'm just. I'm just looking at another, another. I mean, it's a lot going on in this article where it says, for example, around half of women are overweight or obese entering pregnancy. If you have maternal obesity at the time of conception, you're more likely to produce a baby that's overweight and more likely that child will be obese, which goes to what you were saying before.
Speaker 2:
But man, but then they also say that then losing weight during pregnancy is not as a good thing to do, so it's another one of these beautiful dilemmas that they bind women in Don't be fat, don't lose weight now, and it's already. You've already damaged your child Exactly.
Speaker 1:
So I'm wondering then if you're fat and you get pregnant by accident, what do you do, because you know you're not going to have a good baby? I don't know.
Speaker 2:
Yeah. Anyway, oh yeah, ok, I think it comes down to as well just the complexities of human health and lives, and that these are not. Yeah, obviously these are. You know, I'm not questioning the scientific rigor of some of these studies, but they are done in looking at very specific questions and with very specific biomarkers in mind that don't fully account for, say, the social, historical and cultural practices of things like eating and the diversity of them and they can't account for those.
Speaker 2:
And I think, going back to the Chekhov quote that I used at the start of that talk, I think because there is so much information about this area and it's this sort of what for COVID say, a discursive explosion of advice around what to do before pregnancy suggests in and of itself, the plurality of that advice suggests that there is no one true answer.
Speaker 1:
So yes, and let's end there.
Speaker 2:
OK.
Speaker 1:
Yes, yeah, yeah, no. I just had one final comment. That was basically all of these are the things that presented as if they're sort of pre-pregnancy, as if they're somehow like neutral, as if women who are overweight or obese, who are of child-bearing age, are like, oh, oh, it's going to affect my baby, oh, in that case I'll lose some weight. As if they haven't been bombarded with all sorts of negative, just discourse around their bodies anyway, as if it's somehow sort of easy and manageable. And yeah, it's difficult, and with that I really will stop, ok.