Authors: Matthew Tersigni, MPH, MD (c) , Leonor Separi, HBSc, MD (c)
For many of us, Mother's Day is an important time of year. It is the day we get to thank our moms for everything they have done and sacrificed for us. We recognize the time they had put into raising us, caring for us and being there when we needed them most. There are about 9.8 million mothers in Canada, and on average, they spend over 7 hours caring for their families per day! Many of our moms are also working or studying even when they are not with us [1]. Moms are superheroes and how they manage to do so much in a day is nothing short of magic.
Nevertheless, despite everything we know moms do, we are learning about even more ways that our moms can influence our health. New research shows that women's health can impact their children's health even before they are pregnant. By understanding that a healthy mom makes a healthy baby, we can begin to understand the significant implications for population health.
Ensuring moms are healthy before and during pregnancy is not easy, considering that approximately 50% of pregnancies are unplanned [2]. If we were trying to improve mom's health before pregnancy, connecting with women trying to get pregnant will only impact prenatal health factors for half of pregnancies. Instead, the more inclusive approach to take is prioritizing [all] women's health. If we can support all women to be healthy before and while they are pregnant, we increase the health of everyone that is born.
The question you might be asking is, 'how exactly does a mom's health influence the health of her baby'? One of the new ways researchers are thinking about this is through the concept of epigenetics. All of the information that makes who we are is written in our genes. Our genes are then arranged in a way that makes it easy for our cells to retrieve that information. Try thinking of our genes as the words on a page and epigenetics as the book containing all the pages. Now imagine trying to read a book normally versus trying to read the same book with its pages glued together. The information within the books is the same, but it is much harder to retrieve from the glued book! Epigenetics is our bodies' tool to determine which genes we want to be read depending on our environment. Animal and human studies suggest that maternal stress experiences before and during pregnancy have epigenetic effects on children and that these epigenetic changes may impact physical and mental health [4–8]. Stress experiences ranged from depression, intimate partner violence, and food insecurity to stress from natural disasters and state violence [3,5–7,8]. Epigenetic impacts of maternal conditions such as diabetes are also being explored [9].
Understanding how our mom’s health impacts us at a cellular level compliments the general effects of poor maternal health for children. For example, mom's who experience depression around pregnancy may have higher rates of preterm birth, low fetal birth weight, delayed child cognitive development, and higher stress hormone levels in children [10]. If moms have diabetes during pregnancy, children have an increased risk of heart disease from childhood to early adulthood [11].
Mom's experiencing obesity also have a higher risk of pregnancy loss, giving birth early, having babies that are too big, and difficult labour [12].
Knowing that maternal health can significantly impact their child's health, we have to ask how we can make moms healthier? Well, as one might expect, the answer is not so clear. A recent study in Korea found that the availability of healthcare alone did not predict a healthy mom. Instead, population health factors, such as socioeconomic status (SES) and transportation access, were more predictive of mom's health [13]. Women from low SES are less likely to access resources once they are pregnant. This can include access to smoking cessation resources, access to blood tests and ultrasounds and nutrition counselling [14]. Without access to nutrition programs, there is a risk that essential nutrients like folate, which assist our nervous system in developing, are missed. It was also found that moms who had to continue to work long hours during their pregnancy were more likely to have negative consequences like preterm birth [15]. Enabling women to take more paid time off during their pregnancy will avoid negative consequences. Therefore, if we want to make mothers more healthy and consequently their children more healthy, we have to address the root cause of poverty and its effects.
Making our moms and future moms healthy is essential. Looking at the research, we see that a significant amount of the impacts of mom's health on baby's health, come from the social systems and institutions that mom's need to interact with. Initiatives like living wages over minimum wages, paid sick days, prevention of food deserts, transparent, anti-oppressive democratic practices, and accessible mental health supports may be the ways that we have the most positive impact on the health of moms, and therefore kids, at a population level.
On May 9th, say thank you to your mom for all the fantastic things she has done for you. Also, take the time to think about how we can keep future moms healthy and safe so that their kids can grow up and thank them one day. Happy Mother's Day!
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