More about Molly...
for those who like a good origin story, here is mine.
In an attempt to summarize the long version below: I’m a stress physiologist with a convoluted career path: over a decade of academic research → founding team member at a maternal health startup → co-founder and founding executive director of a non-profit focused on gender equity and working motherhood. Through these experiences (and the incredible people I have learned from along the way), I've become interested in (dare I say obsessed with?) the intersection of perinatal physiology, motherhood, women’s health, gender equity, and stress.
But, if I really had to sum up what led me to this project, it’s this: I’m a “how?” kid.
While most kids gravitate towards “why?” and revel in trapping adults in the endless cycle that inevitably leads to a “just because!”, I always preferred a different flavor of adult question torture – “but, how?”
“Why?” asks for a reason. “How?” asks for the way.
Pursuit of “how?” questions likely explains why I gravitate towards science and definitely drives my interest in physiology – the study of how the body works.
Pursuit of“how?” has also revealed crucial data gaps that exist in areas that I am most passionate about and fascinated by. How did we get to a point where more gaps exist in the research around pregnancy and women’s health than many other fields of biological research? How do these gaps affect the current state of our world, our health, our care system, our support structures? How do we close the gaps? And if we’re too far off from closing them (because, well, we are), how can we at least shrink the gaps within a framework that still draws from research-backed information?
In many ways, the professional path I’ve traveled up to this point explains my thought process and everything to come for The Maternal Stress Project. So, for those actually interested in long-winded biographies, here you go…
The science hook → STRESS
I dissected a squid in the 5th grade. That’s pretty much all it took for science to hook me.
In college, I specialized. Endocrinology was my jam, transfixed by the world of hormones. How tiny molecules set loose in the body could relay such specific signals. Directing daily rhythms, reactive behaviors, coordinating a delicate dance of responding to internal and external stimuli. So cool, right?
The laboratory was fun but the outdoor opportunities of life as a field biologist called to me. I mixed classic benchwork research in a reproductive endocrinology lab during the school year with classic field research during a summer spent recording and deciphering parrot calls in Costa Rica and then a semester abroad in Kenya studying wildlife management. With physiology as my drumbeat, though, I sought research opportunities that merged lab and field, and landed at the National Zoo’s Research Center as a Reproductive Sciences research intern. I spent the summer pulverizing wolf poop into dust fine enough to extract hormone bits from for analysis. Not exactly the fieldwork experience I had imagined. But in those hours of poop pulverization, for the sake of improving reproduction strategies in the captive animals, I kept coming back to a “how?” question. Despite seeming like a key question for conservation, no one seemed to be able to answer it: how does stress, at a physiological level, affect reproduction? This question set off the next stage of my research journey.
I needed to know more about stress physiology.
For my doctorate, I joined a lab at Tufts University that checked all boxes – fieldwork, lab work, deep dives into physiology, and, the most important part, a way to study the “how?”s of stress. The approach of the Romero lab is to start at the most basic level – recognize and understand how the stress response system works at an adaptive level. Put simply, how does the stress response, the brain and body’s response to a perceived threat, help an animal cope and survive?
Studying the adaptive response requires studying an ‘intact’ system, working with study animals that have not been selectively bred by humans. Lab rats and mice are important to research, of course, but to get the heart of the adaptive stress response, you need an animal that has not been artificially selected for generations. Most of our research used non-native wild birds, living and surviving and reproducing based on what allows them to live and survive and reproduce in the natural environment. Luckily, when studying stress, the way that our brain and body react to stressors is well-conserved across species, which means that the basic pathways, signals, targets, neurochemistry, etc all show up in similar ways whether you study a frog, a bird, a rodent, or a human.
Understanding the adaptive stress response then allows for an important view of what goes wrong when the system is pushed beyond its adaptive capacity – when it becomes maladaptive, as in the case of ‘chronic stress’, and results in stress-related illness.
By the time, I was a card-carrying PhD, I had a range of stress research under my belt: I studied the cardiovascular fight-or-flight response in starlings, I spent summers in the Mojave Desert quantifying the effects of chronic stress in wild chukar, I went to the Galapagos to work with a team studying physiological changes in marine iguanas between El Nino starvation years, I examined brain tissue to analyze changes in stress-related hormone signals upstream. Put succinctly, I dove deep into the world of stress physiology, which is why ‘stress physiologist’ is the best way I can describe myself post-PhD.
I circled back to reproduction as a postdoctoral fellow. Focusing on neurobiology and dabbling in behavior, I tried to root out specific signals that could shut down female fertility following stress exposure. I became slightly obsessed with seeking a measurable link between the perception of external stress and the internal stress cascade.
After over a decade and a half of research, a PhD, and two postdocs, I left academic science.
Onto pregnancy + maternal health
At the tail end of my second postdoc, a new obsession took hold of me – pregnancy physiology and maternal health. Partly because I had just grown and birthed my first child. Partly because a friend started a maternal health company and the academic job market was hell for a PhD who graduated in the aftermath of the 2008 recession.
I will not get into it much (and you will probably be able to tell from Maternal Stress Project posts) but I am OBSESSED with pregnancy physiology. If everyone understood how incredible and amazing the pregnant body is and how it does what it does, birthing bodies would rule the world AND abortion would be legal everywhere. But I digress…
A key eye-opener at this stage of my professional journey was exposure to the data gaps that exist in pregnancy research and maternal health and the consequences of those gaps when it comes to innovation, investment, healthcare pathways, etc. When a friend and colleague, Dr. Jodi Pawluski, a maternal mental health researcher, asked me to co-author a review paper on the hormonal stress axis and postpartum depression, I could not resist. In the middle of a literature review for the paper, I had a depressing epiphany – the data gaps are huge. The cavalry is not coming. We cannot apply what we don’t know. And there is A LOT that is unknown in the space of stress + pregnancy physiology + maternal mental health. We wrote a follow-up Letter to the Editor in Archives of Women’s Mental Health that called out the need for supporting research in this field.
Overall, I found the flimsy use of the phrase “evidence-based” in the understudied world of pregnancy and the entire peripartum period a little frustrating. The intention is pure but often lacks the acknowledgment that the acquisition of critical evidence is still decades in the future1. In order to bridge the knowns and unknowns in the space of stress + pregnancy physiology + maternal health, I worked with Dr. Pawluski and Dr. Romero to create a theoretical model we called the Maternal Reactive Scope Model. The goal of the model was to create the scaffold to allow action now while ongoing work of researchers continue to fill in the gaps. (I’ll post more about this model for those science-y folks feeling especially curious and bold about learning.)
Cap off with gender equity, motherhood-related barriers, and caregiver support
Co-founding &Mother brought me full circle. When my co-founder first approached me with the idea of starting an organization to address motherhood-related barriers in sports, my first thought was – “this applies to science too: the mothers are missing! and we’re all living with the consequences of that.” How many research programs died on the vine when the person behind it dropped out of science due to lack of support as a caregiver? And how many of those research programs might have focused on women’s health issues or pregnancy or caregivers, etc? Are the data gaps that I am so obsessed with related to these missing, unsupported mother scientists?
Another aha moment was reading Dr.
’s article “It’s Not Burnout. It’s Betrayal.” in the dark days of COVID. The piece explained how pandemic-era women (mostly mothers) experienced an unprecedented pressure cooker and, with so little structural support to buffer that stress, got pushed over the edge. As more and more data came out from the natural experiment of forced, unsupported caregiving, one thing became clear – the pandemic didn’t create completely new stressors for these parents, it only put more people in a more intense pressure cooker, enabling an observable shift and statistically significant data points. Also, that shift affected white, middle to upper class women, which (unfortunately) made the stressors more visible.It’s all connected
And so here we are. We cannot improve women’s health or solve the maternal health crisis without recognizing how the stress related to modern American motherhood impacts health via the stress pathways. Stress pathways affect any system in the body, from the brain to the cardiovascular system, immune system, metabolic system....
At our most basic level, we are animals responding to our surroundings and circumstances. As humans, we process the input in more complicated ways – not exactly about survival in the wild – but the physiological response we trigger is all the same. As are the health consequences.
We have all felt the effects of chronic stress.
Reframing stress in the context of American motherhood allows for new opportunities to improve health. We can identify low hanging fruit. We can chip away. We can affect health at an individual and population level by eliminating, mitigating, and buffering stress exposure. But, in order to do that, we have to see and embrace how it all connects.
When I see the issues through the lens of stress (both risk and opportunities for solutions), I see that:
Lack of paid leave is a health issue.
Childcare access and disruption are health issues.
Gun control is a health issue (adding onto the fact that guns kill and injure people daily, the idea of guns killing and injuring people = stress)
Workplace discrimination is a health issue.
Racism, sexism, and ableism are health issues.
Abortion access is a health issue (adding to the fact that people die from limited access to this important medical procedure, the pressure of not having access = stress).
The motherhood penalty is a health issue.
The gendered mental labor load is a health issue.
And on…
Now my brain craves “how?”
And that’s where The Maternal Stress Project comes in.
Join the fun!
Lots of reasons to point to here. Historical and present-day bias in research design focusing on male subjects, animals, and humans. Active avoidance of studying pregnancy from basic science to clinical level (difficulty, ethical issues, assumed ethical issues). Lack of funding (pregnancy and maternal health weren’t even NIH funding categories until 2016). Lack of women, especially mothers, in science (in a very unscientific survey of ‘just asking people’ when researchers in the pregnancy/maternal health space point to inspiration for their work, they often say “when I had my first baby…”. This includes myself). And I could go on…