Making Sense of Pregnancy: What Experts Want you To Know About Your Body

Paulette Kamenecka

Have you been surprised by what we do and don't know about pregnancy and birth today? If you are pregnant, or have been in the past, this show helps you understand what's happening (or has happened) to our bodies--both the short term and long term effects of this transformation. We explore the boundaries of our scientific grasp on the wildly complex processes of pregnancy and birth. After my complicated pregnancies, I went looking for answers and have interviewed hundreds of experts about women's health in this transition. Every Tuesday you'll hear: Scientists at the cutting edge who are trying to uncover how pregnancy and birth work and what happens when they don't work Information you could use to better understand your own body in pregnancy .A better sense of the limits of your responsibility for what's happening inside your body Listen to hear what you won't find on a blogpost or a book off the shelf.

  1. Oct 28

    Another Way to Think about Weight Gain in Pregnancy: how your metabolism adjusts to pregnancy

    Many of us arrive at pregnancy already carrying a complicated relationship with the idea of gaining weight. At just about every prenatal appointment, your weight, or the change in your weight, is one of the first parts of your body that gets assessed. For some of us, a change in weight is what makes the big set of invisible changes of the first trimester real. For others, it can be fraught.  Regardless of the feelings you may bring to this ritual, you may wonder, why are we so closely recording weight change?  What does a change in weight mean in pregnancy?  What does it predict about how your pregnancy will progress?  How can we think about weight gain in pregnancy in a way that's different from weight gain outside of pregnancy?  Whether you feel it or not, pregnancy changes every system in your body, and that includes your metabolism, which helps determine how your body uses nutrients, builds tissue, and stores or releases fuel. The way your body's metabolism adapts to pregnancy influences both weight gain and potentially the health of your pregnancy, both for you and the baby.  So today, we will look at weight gain in pregnancy through the lens of metabolic adaptation. Metabolic change in pregnancy is an enormous topic, and there are numerous drivers of weight change, including obviously what you eat, how well you absorb food, how you move and retain fluid. But we'll focus on one important aspect; changes in insulin sensitivity as a way to highlight how complicated weight gain in pregnancy can be. This week is a solo episode focused on better understanding what that number on the scale does and does not mean.

  2. Oct 7

    How a New Cell Atlas Could Transform Our Understanding of Preeclampsia, Miscarriage and Preterm Birth: Conversation with Dr. Susan Fisher, Part II

    IWhat if we could actually watch the conversation between a fetus and its mother? Not metaphorically—the individual cells, where they are, what genes they're expressing, and how that conversation changes over the course of pregnancy. That's essentially what Dr. Fisher and her team have done in their creation of an atlas of the maternal fetal interface, that irregular boundary formed between mother and fetus key to all human life on the planet.  This week I'll continue my conversation with Dr. Fisher, focused on how new knowledge of this interface can be used to understand and potentially affect serious complications in pregnancy, and what the future may hold for intervening in a pregnancy complication while it's unfolding.

  3. Sep 30

    Pregnancy’s Hidden Frontier: The Most Detailed Atlas of the Maternal-Fetal Interface, Conversation with Dr. Susan Fisher, PhD, part I

    I don't think I can oversell today's episode.  We'll discuss the most detailed atlas of the maternal fetal interface-- that meeting and intermingling of maternal and fetal cells that sets the stage for placental creation and development. The sheer awe of the accomplishment of the research we will talk about today may be something that draws you in to this conversation.  This work represents the cutting edge of pregnancy research, and it shows how unbelievably complicated it is for a fetus to make a placenta and for that placenta to integrate itself into the mother's body.  Not only does this work give an incredibly detailed picture of the exact cells in the interface, the spatial location of those cells, accounting for which specific cell sets are near each other and what they likely communicate to each other, and the genes that make that communication possible; it also gives a sense of how the interface changes over time by looking at this interface from weeks five to 39.  It's work on this level that may hold the keys to developing a way to treat many endometrial spectrum disorders like preeclampsia, placental accreta, and even things like preterm birth. Single-cell spatiotemporal dissection of the human maternal-fetal interface; https://pubmed.ncbi.nlm.nih.gov/41951740/

  4. Sep 23

    Can your Menstrual Cycle affect your chances of Miscarriage?: Conversation with Dr. Jans Brosens, re-edited and rereleased

    Since women have been having babies, they've experienced miscarriage. For nearly as long, we have not had a useful way to address miscarriage.  Often doctors shrug at your first miscarriage and say it's a normal part of pregnancy. And if it arises because of aneuploidy, the fertilized egg is the wrong number of chromosomes--at this point, there's not much we can do about it.  But there are alternative routes to miscarriage.  Today's guest is working to better understand other mechanisms at play in miscarriage. In particular, he's focused on what happens in the endometrial lining to make the uterus into a hospitable place for pregnancy. This is a re-editing version of two episodes that I published a year ago about this research.  In the next couple weeks, I'm talking to more people who are studying the endometrial lining, so it is a good time to re-acquaint ourselves with the current cutting edge of this research.  The paper we reference is : Stalling of the endometrial decidual reaction determines the recurrence risk of miscarriage:  https://www.science.org/doi/10.1126/sciadv.adv1988

  5. Sep 16

    Inside Human Embryo Implantation: Watching for the first time, Conversation with Dr. Amelie Godeau, Part II

    Embryos speak multiple languages.  They can communicate through chemistry, which has been known for a long time, and as today's guest will describe, they can also detect physical features of their environment and alter their biology in response--which is to say they are mechanosensitive. They can generate forces that deform their surroundings, and they can respond to the force cues around them. We'll talk more today about the experiments that allowed us all to witness this ability in the viral video that captured implantation of a human embryo into a 3D matrix for the first time.  If you want to see the video,  https://ibecbarcelona.eu/human-embryo-implantation-recorded-in-real-time-for-the-first-time/ Also, in the paper, available here: https://www.science.org/doi/10.1126/sciadv.adr5199 there is a supplmentary section that has more videos that show the 3D displacement, check out adr5199!

  6. Sep 9

    How a Human Embryo Implants-- New Insights From a 3D Model: Conversation with Dr. Amelie Godeau, Part I

    If you're on the internet even a little bit, you likely saw the viral video first released last August That showed for the first time what a human embryo implanting into a 3D matrix looked like.  The video comes from work trying to explore what the embryo is actually doing during implantation. Despite how critical this process is, implantation, required for any and every pregnancy, is one of those black box topics.  Both the details of exactly how the blastocyst attaches to the uterine lining and how it embeds itself into the lining have been virtual mysteries. We do have animal models. We've seen parts of this process in a Petri dish. We've never seen it in 3D before, until now.  Today, I'll talk to the first author of the paper from which the viral video sprung. The group of scientists that studied this question examine The many things an embryo can do unprompted by an effective uterine lining, and it is mind-blowing. Traction force and mechanosensitivity mediate species-specific implantation patterns in human and mouse embryos: https://www.science.org/doi/10.1126/sciadv.adr5199

  7. Sep 2

    Your Menstrual Cycle is a Vital Sign: Conversation with Dr. Mahalingaiah, Part II

    Your menstrual cycle requires the coordination of a number of different systems in the body. We've all heard of the hypothalamic pituitary ovarian axis, AKA the HPO axis. But the system is embedded in and reactive to many other systems in the body, including the uterus, and particularly the uterine lining, the immune system, metabolic and energy sensing networks, stress axis, the thyroid adrenal axes, circadian timing systems, autonomic nervous system, liver, bone, vascular system, and the gut.  Ovarian estrogen and progesterone act as whole body signals. Using menstrual cycle characteristics like cycle length, like variability of cycle length, like the heaviness or lightness of bleeding as signals of vitality or distress, may be an opportunity to better understand both our own fertility and our own overall health.  We'll get into some of the details about what is being done now and what the future looks like for using the menstrual cycle as a vital sign.

  8. Aug 26

    What can the Menstrual Cycle Tell us about our health: Conversation with Dr. Shruthi Mahalingaiah

    The menstrual cycle plays an enormous part in the lives of half the population of the world. People tend to focus on it as a conduit to pregnancy, and it is. But through the hormonal fluctuations that drive this cycle, it affects many other aspects of health. A better understanding of what a, quote, "normal cycle" looks like and how to understand your own cycle can impact other facets of your health because most cells in a woman's body have receptors for estrogen and progesterone. Given the importance of this process, doctors and researchers, like the one I'll talk to today, are thinking about the menstrual cycle as a vital sign, like temperature or heart rate or blood pressure. It's a way to check in on many other physiological processes in your body, not only in adolescence, but through menopause. The Menstrual Cycle as a Vital Sign: A Comprehensive review: https://pmc.ncbi.nlm.nih.gov/articles/PMC11790291/

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About

Have you been surprised by what we do and don't know about pregnancy and birth today? If you are pregnant, or have been in the past, this show helps you understand what's happening (or has happened) to our bodies--both the short term and long term effects of this transformation. We explore the boundaries of our scientific grasp on the wildly complex processes of pregnancy and birth. After my complicated pregnancies, I went looking for answers and have interviewed hundreds of experts about women's health in this transition. Every Tuesday you'll hear: Scientists at the cutting edge who are trying to uncover how pregnancy and birth work and what happens when they don't work Information you could use to better understand your own body in pregnancy .A better sense of the limits of your responsibility for what's happening inside your body Listen to hear what you won't find on a blogpost or a book off the shelf.

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