The panic over the zika virus has certainly brought out the best in us. We’ve quickly rallied to address a threat that we speculate could harm thousands of newborns. It seems so preventable, which is why we have suddenly found the resources to pursue a cure, or at the very least, destroy the source of the problem. The news is full of images of soldiers fumigating pools of stagnant water.
 
I applaud these efforts, but I’m also saddened that we haven’t put the same number of resources into destroying the things we already know cause lasting psychological harm to children even when they’re in utero. Here’s a little of what my colleagues, like Dr. Michael Kobor at the University of British Columbia, tell me. Geneticists and neurodevelopmentalists already have proof to support the fetal origins of later psychological and physical disorders. What happens to us early in our lives, even before birth, shapes our gene expression, leading to personality and behavioral patterns that contribute to our success, or if our mothers are exposed to too much stress, future disorder.
 
It’s an easy pattern to see with alcohol consumption and the potential for fetal alcohol syndrome that affects far more children that the zika virus. The connection is much more invisible, however, but still well-known between domestic violence, or high rates of incarceration of fathers for nonviolent offences, and the stress both these preventable factors cause pregnant women. In turn, women unintentionally pass their stress to the foetus, changing a child’s neurological development and gene expression well into the child’s adult years.
 
It’s far more politically expedient, I guess, to connect a mosquito bite to microcephaly (though the connection is still not proven), while the hidden dimensions of stress evade our perception and our commitment to treatment. What’s clear, however, is that stress on mothers will do a lifetime of damage to their children. We know this for a fact because of experiments that have taken blood samples from umbilical cords and placentas and then tested for Cortisol levels (a stress hormone) as children grow up.
 
There are many interesting studies that have studied this transmission of mother’s stress to her child. Studies, for example, like CANDLE which includes 1500 moms and their newborns, led by Dr. Francis Tylavsky at the University of Tennessee. These studies show that when bad things happen to expectant mothers, their stress gets under their skin, and remarkably, changes the very genetic expression of an unborn child’s genome. From poverty to domestic violence, racism and depression, all these experiences affect the psychological development and future mental health of the child.
 
The situation doesn’t improve after the child is born. Another robust body of research called Adverse Childhood Experiences (ACE for short) has shown that a cluster of ten experiences during our early years such as physical and sexual abuse, the incarceration of a parent, and a parent’s mental illness increase one’s odds of developing a host of problems during adulthood ranging from sexual promiscuity and addictions to heart disease and obesity.
 
Together, what all this research tells us is that we know enough already to set some national priorities for children in utero and those already born and vulnerable. Except, so far, I haven’t seen the same panic in the streets to address domestic violence towards pregnant mothers as I’ve seen with regard to mosquito bites. Maybe we think things like domestic violence are just too difficult to eradicate. Or maybe we are a misogynistic society that would rather just ignore the problems that women face.
 
We do so at our peril, and at a huge social cost. First, mothers that live in poverty, have low education, and whose partners are not around are much more likely to have preterm babies. Those lower birth weight babies are more likely to suffer a great many complications. In other words, both directly and indirectly, the mother’s stress contributes to her child’s poor social skills, emotional problems, and disordered behavior. Even if the mother’s pregnancy goes full term, my colleagues tell me that babies whose mother’s experienced interpersonal violence prior to birth are likely to become toddlers that show poor cognitive skills, worse motor functioning and behavioral problems. Boys will lean towards hyperactivity; girls are more prone to conduct disorder.
 
None of this is terribly new. It’s just that the science is finally proving what we’ve intuitively known all along. Now the question is, what are we going to do about it? Will we rally around these problems and address them as public health issues as we have the zika virus? Or will we continue to let these problems fester?
 
In the United States and Canada, I’m especially concerned with the stress that so many women of color experience for so many reasons not of their own making. The high incarceration rates of African American and Indigenous men, for example, is leaving their partners and unborn children at risk. We don’t seem to factor this into our “get tough on crime” rhetoric. We ignore the fact that we are creating another generation that will likely have the very problems we are trying to fix.
 
Rather than understanding the experiences of pregnant women as part of a broader social phenomenon we treat each women's stress as an individual challenge. We have yet to mobilize all our resources to remove the preventable stressors that are ruining women’s lives. Imagine if we did the same thing with the zika virus and approached it as just one stagnant pool of water at a time in one isolated community rather than as a complex issue needing a complex, multi-level solution.  We’d get nowhere and the problem would get worse.
 
Maybe it’s time we thought about the stress on mothers as a public health crisis. We would have far healthier babies, and that is something we always seem to have money for.

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