Behind the Science Archives - Women's Health Research Cluster

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Behind the Science: Pregnancy and Multiple Sclerosis – What’s The Link?

Interviewees: Pia Campagna, Postdoctoral Fellow, Monash University, Melbourne, Australia Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: December 15th, 2023

When there are clear sex differences in disease prevalence, researchers must question the underlying factors. Women with Multiple Sclerosis (MS) outnumber men 4 to 1. What is being done to understand this statistic? How can we look into female-specific factors to disentangle these questions?

For this month’s Behind the Science, we interviewed Pia Campagna who provided some insight into these questions.

Can you tell us about your research?

Our lab studies Multiple Sclerosis (MS) and other neuro-immunological conditions. Much of my work focuses on incorporating women’s health into MS research by looking at pregnancy and menopause. MS affects 2 million people globally, roughly 75% of which are women. Previous work from our group has shown the clinical effect of pregnancy, where a pregnancy before disease onset delays the onset of MS symptoms by 3.4 years. After onset, the effect of pregnancy is more controversial, but work from our group has shown a protective effect of pregnancy on long-term disability accumulation.In my postdoc, I’m seeking to understand the biological mechanisms underpinning these clinical effects via a national multi-site prospective study.

Why did you want to get involved in women’s health?

I started research in MS due to the demographic of those affected – women. Because of this, it’s an interesting population to study in light of all of the female-specific experiences that interact with this disease. For example, it’s a disease that’s primarily diagnosed in a woman’s reproductive years (20-40 years old) so there are interactions with pregnancy, and due to the chronic nature, women are living with MS during perimenopause and menopause too.

I started my Ph.D., focused on genomics, prognostic modelling and machine learning in MS. It just so happened that other people in our group were doing this fascinating work on pregnancy. I had the opportunity to delve into the epigenetic impacts of pregnancy in women with MS, which sparked my interest in women’s health route MS. I did love the bioinformatic aspects of my Ph.D. work and hope to incorporate that down the line when we have the data available.

Is there anything interesting that you’ve learned from your research findings?

When we compared the whole blood DNA methylation profiles of women with MS who had not given birth, we identified differences in methylation patterns at genes enriched in neurogenesis and axon guidance pathways. After noticing these signals, we hypothesized that the hormonal changes from pregnancy created long-term effects that drive changes to the clinical course of MS. Now, we are collecting blood from women with and without MS before, during and after pregnancy, so eventually we’ll be able to look at DNA methylation in these different stages, as well as a range of other -omic profiles.

What impact do you hope to see with this work in the long term?

Not only is the prevalence of MS increasing worldwide but so is the female-to-male ratio. I hope that research focuses more on the female-specific aspects of the disease, which is still very understudied. Although there’s strong evidence that pregnancy is beneficial before onset, and some evidence of a beneficial long-term effect, , it’s surprising to me that we still don’t know how or why. Detangling this will not only be beneficial to women but also more individualized therapeutic targets benefit men as well. Another frontier in MS research that I would like to see more of is the impact of menopause. For example, we still don’t know if the disease gets worse after menopause, how estrogen loss interacts with disease-modifying therapies, or whether they’re as effective. Understanding the clinical aspects of menopause and subsequently, the biological aspects of menopause is an important route to take moving forward.

Where can people learn more about your work?

Twitter: @PiaCampagna
Personal website: piacampagna.com
Lab website: Jokubaitis group

Behind the Science: The Bidirectional Relationship of Behaviour and Stress

Authors: Romina Garcia de leon and Shayda Swann, Women’s Health Blog Coordinators | Interviewee: Dr. Annie Duchesne, Ph.D., University of Northern British Columbia

Published: Nov 17th, 2023

Can you give us a brief explanation of your research?

I’m particularly interested in understanding how variations in hormones influence or regulate our behaviour, but also how our behaviour may regulate our hormonal processes.

Over the years, I’ve been interested in understanding how contexts such as stressful situations might be influencing ovarian hormones (estrogens and progesterone). There’s a lot of interplay between the stress and endocrine systems. They often tend to regulate the same or similar affective and cognitive processes, but they’re often studied independently. I have a lot of interest in understanding the two systems together, and I’ve developed various approaches.

The first approach involves measuring hormone levels and exposing people to different tasks. The second approach is to use observational studies where we take advantage of already accessible databases to try to answer these questions. These studies allow us to add a bit more complexity, given the larger sample sizes.

Studying this interplay is also relevant when we’re interested in questions of sex and gender. The sociocultural constructions of sex-related traits is a central dimension of gender. These constructions inform the way in which people are expected to behave in general and with respect to sex-related traits and situations. And often, our gendered constructions transform sex-related phenomena into specific sources of stress. So I do believe there’s a lot of relevance in studying the handover between stress and the gonadal system, particularly when interested in understanding the ramifications of sex and gender.

How did you get into the field of women’s health?

My undergraduate degree was in molecular biology. From these studies, the question that remained was how do people adapt to their environments. My first foray into this question was through conducting research on materno-fetal physiology within Dr. Julie Lafond’s laboratory. Specifically, understanding the metabolic physiology of the placenta. At that time Dr. Lafond’s laboratory was interested in how maternal variation in lipidic and toxicological profiles could influence fetal development through placental physiology. This research experience allowed me to realize the central role that the endocrine system plays in communicating what’s going on in the environment and adaptively relaying this information to all other physiological systems so that the organism is best prepared for a variety of upcoming situations.

During my Master’s degree, I channelled my interest in endocrinology, development and adaptation to investigate the development of the biobehavioural stress processes. Fascinated by Michael Meaney’s research – which transformed our neurobiological understanding of the interplay between the environment, maternal behaviour and the development of the hormonal stress response, I went to work with Dr. Ron Sullivan who was one of the few researchers who looked at the sex difference in the role that maternal behaviour could have in the development of the stress responses. There, I discovered that variation in the environment can differently impact male and female rats, but also realized how we systematically excluded female animals from most behavioural neuroscience research. I continued to research the interplay between stress and sex-related variables during my PhD which I conducted in humans under the supervision of Dr. Jens Pruessner where I studied the interplay between stress and the menstrual cycle on affective processes. Finally, during my postdoctoral research, I continued to investigate neurobehavioural underpinnings of reproductive phenomena by investigating the cognitive correlates of menopause-related endocrine changes in Dr. Gillian Einstein’s lab. Findings from this project support that the type of menopause, in particular whether you have had a spontaneous or surgical menopause moderates the neurocognitive correlates related to menopause.

Could you highlight some of your most important findings or highlights from your research?

One central idea is that the relationship between hormones and behaviour is context-contingent. For instance, during my PhD, I demonstrated that the relationship between cortisol levels and participants’ reported levels of stress changed completely depending on which menstrual cycle they were in. These are crucial findings! Once you have recognized that how hormones can influence brain and behaviour is contingent on context, the second important question is what are the contextual dimensions that are relevant?

What has been an increasingly important field of investigation in behavioural neuroendocrinology, particularly about women’s health, is the use of feminist theory and feminist research to articulate and operationalize aspects of women’s experiences as relevant contextual dimensions, to then investigate how that particular context may moderate the interplay between hormones, brain and behaviour.

For example, the menstrual cycle is best characterized as a biosocial phenomenon. Seminal work by feminist scholars has demonstrated how sociocultural attributions about women’s bodies inform how menstruating people feel and behave when menstruating, for example, feeling pressured to conceal one’s menstruation. By understanding women’s endocrine phenomenon as biosocial, relevant, yet often overlooked, contextual dimensions can be incorporated into our understanding of the neuroendocrine underpinnings of reproductive phenomena such as the menstrual cycle.

Such an approach allows for the necessary resolution to advance bio-behavioural understandings of women’s health that avoids biological essentialist biases and prevents the belief that women are determined by their sex-related biology.

What impact do you hope to see with your work 10 years from now?

I hope I continue to complexify and nuance my understanding and investigation on behavioural neuroendocrinology, stress and reproductive phenomena. I wish that my ideas allow for a more refined and inclusive perspective. We all come to our object of study from a specific perspective or standpoint and therefore carry biases. I hope that more researchers within women’s health and behavioural neuroendocrinology (including myself here!) continue to critically engage and self-reflect on their own biases as well as the ones carried by their fields of research.

I hope that approaching reproductive phenomena as biosocially entangled becomes more of the norm than the exception in biobehavioural research particularly concerning sex and gender. More generally, I hope that culture is no longer pinpointed against nature but rather that an organism’s biology, culture and environment are embraced as constitutive, dynamic and interdependent.

Lastly, I hope for a continued diversification of the research in behavioural neuroendocrinology and women’s health. This includes but is not restricted to, who is conducting the research, the geographical locations from where the research is being conducted, the participants being included in the research, and the questions, methods and epistemologies used to advance understanding.

If you’re interested in joining the NeuroGenderings Book Club, check it out here.

Check out more of Dr. Duchense’s work here and here.

If you’re interested in more about the processes and impact of racism and whiteness within the Canadian academic context, check out this collective.

Behind the Science: Examining Inflammation and Depression Through a Bio-Sociological Lens

Interviewee: Tatiana Pakhomova, B.A., M.P.H., Ph.D. student, Simon Fraser University. Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinator).

Published: January 13th, 2023

Could you please briefly explain what your research is about?

My Ph.D. research aims to examine the socio-structural pathways between inflammation and depression. I’m particularly interested in the relationship between depression and chronic inflammation, which refers to persistent immune activation in response to various stressors. We’re interested in looking at socio-structural, biological, and behavioural factors which impact the pathways between chronic inflammation and depression, and their downstream effects. People with chronic inflammation have higher numbers of specific inflammatory markers in their blood associated with increased risk of communicable and non-communicable diseases, like HIV and cardiovascular disease. For my Ph.D. work, I’m interested in how chronic inflammation is associated with an increased risk of poor mental health outcomes. Research shows that people with depression have increased inflammation. However, many pathways are bi-directional, with complex relationships involving hormonal pathways, neurotransmitters, and socio-structural factors. Very little research looks at these relationships in young people or longitudinally. For this reason, we want to look at these long-term trends to better understand this relationship. The study I’m working on is AYAZAZI, a longitudinal cohort across two study sites in Durban and Soweto (South Africa) that was launched in 2014 and investigated intersectional, behavioural, biological, and socio-structural factors that might influence HIV risk among young people aged 16-24.

What interested you in studying how mental health affects a biological outcome like inflammation?

Part of it is personal. I’ve had episodic depression since my teenage years, but I didn’t seek help or get diagnosed until I was older. Given the barriers to accessing mental health support, my depression was left untreated for a long time. Secondly, from my academic background, my Bachelor’s was in political science and gender studies, and I have always been interested in the political aspect of health. After finishing my B.A., I worked in HIV social services with a regional staff team in Fraser Health for a few years, which led me to do my M.P.H. at Simon Fraser University, where I met Dr. Angela Kaida. I fell in love with the research process and have been fortunate to have worked in research since 2018. I also have a part-time position at the BC Centre for Excellence in HIV, looking at barriers as well as facilitators of healthcare engagement. Given this background, I was very interested in studying mental health from a holistic perspective, considering both the socio-structural and biological factors that interact to influence our health. That’s the great thing about social epidemiology – you get to bring in all of these intersecting concepts, and it’s a much more holistic way to look at health.

Why do you think it’s important to study women’s health from the social determinants of health lens?

Structural determinants of health are a huge part of my work. Many of the gaps in the literature are centred around factors in the social environment that influence biological relationships. There is evidence out there that indicates that there are both sex and gender differences in inflammation markers among youth and adults, as well as in depression or other mental health outcomes. Gender inequity significantly impacts how people experience life stressors and may influence their health at the biological level, and I am interested in how gender plays a role for both young women as well as young men. As our study participants are aged 16 to 24, we do our work with an understanding that there are numerous fluctuating biological changes in youth and young adulthood that may affect the relationship between inflammation and mental health.

Could you tell us more about the research projects you’ve worked on before, both in Canada and abroad?

Working with Peer Researchers to co-create knowledge has been a huge highlight of my career. I’ve also been fortunate enough to have a couple of research trips to South Africa. I did my M.P.H. with the AYAZAZI study, which feels like coming back in a circle to finish what I started. My Master’s work was also mental health-focused but focused on factors that are associated with perceived stress. Now, I get to look at mental health outcomes longitudinally. It’s been wonderful to build relationships with researchers in South Africa. I’ve spent a couple of summers at the Perinatal HIV Research Unit in Soweto, which has been an incredibly wonderful experience.

What impact do you hope to see with your work years from now?

Working from the social determinants of health lens means that a lot of social and structural factors are potentially modifiable. When we’re looking at something like mental health, prevention is key because treatment options are not always accessible for some people. The purpose of this work is to give other researchers, community members, and stakeholders tangible evidence so that they can do something with it. It would be great to see some of this work be applied to policy that is youth-driven and youth-focused, that has real-world impacts, and adds something valuable to the body of research to better understand this important issue.

Behind the Science: Working in the Women’s Health Field

Interviewee: Arrthy Thayaparan, B.Sc., M.J., University of British Columbia |

Authors/Editors: Negin Nia & Romina Garcia de leon (Blog Co-coordinators).

Published: May 20th, 2022.

The Women’s Health Research Cluster (WHRC) blog started back in 2020. The blog aimed to showcase work by women and gender-diverse people wanting to make a change in the women’s health field.

We spoke to Arrthy Thayaparan, one of the first WHRC Blog Co-coordinators, about her experience working for the blog. She shares what got her initially interested in pursuing work in women’s health.

Why did you decide to pursue work as a Blog Co-coordinator?

I have an academic background in both science and journalism. Therefore, I was seeking a job that would allow me to continue to learn and share stories in the science and health realm. When I found out about the blog through the UBC Work Learn website, I knew it was the perfect fit. I ended up applying to every single option available with the WHRC, but glad I was selected as a Blog Co-coordinator as it was a much better fit to help finetune my writing skills.

As a lover of science who was starting her journalism career, the WHRC was just a great way to help me learn and expand on those essential communication skills. It also let me stay in touch with the world of academia. I got to work with a thoughtful and energetic team, while also peering behind the scenes of a research cluster taking on valuable work in the field.

Out of all the scientific fields you were exposed to, why women’s health?

I got into science journalism because I became aware of the lack of science-trained journalists who knew the field and could communicate it to a general audience. From there, I began to realize that women’s health is underrepresented, especially in the media.

For example, there were a lot of worries and myths about fertility, pregnancy, and vaccinations during the start of the COVID-19 pandemic. So, the WHRC prioritized this in our blog topics and got the conversation going. That realization and effort to engage worked out to our benefit since the pregnancy vaccination blogs are some of our most widely read blogs to this day.

What impact do you hope the blog will have in the field of women’s health going forward?

When the blog first started it was pretty small and we didn’t have too many readers or much engagement. Now, we can see how the work that we’ve done over the past two years has grown. Recently, we were voted the 9th top Women’s Health blog by FeedSpot.

Seeing that growth in just two years was motivating for everyone on the team. I think with that momentum, the blog could go on to become a staple in women’s health awareness and education. This is especially true with how diverse the WHRC members are both globally and knowledge-wise.

Do you see yourself integrating women’s health into your future roles?

Oh, absolutely! I think working here has opened my eyes to so many topics within the field of science. I’ve always associated my best journalistic work with experts or researchers I have interviewed from the WHRC. For example, Dr. Jade Boyd was a huge help for one of my biggest stories last year on understanding overdose reversals in B.C. I covered what impact that had on frontline workers of the overdose crisis. I’ll always keep coming back to the WHRC and the blog to keep myself up to date and to stay connected.

Is there anything else you would like to mention?

I’m grateful to everyone at the WHRC for having me on, the writers of the blogs for their passion, and the readers for allowing us to continue sharing this essential work. I’m especially thankful to Alex Lukey and Negin Nia, my blog co-coordinators, for bearing with me when things got stressful with school and supporting each other with the work.

Also, I don’t think enough credit is given to the support we receive from Katherine Moore, Director of Operations & Strategic Initiatives, and Liisa Galea, Cluster Lead. No matter what crazy idea we brought forward, like the Behind the Science series or creating a Medium page, they were always on board and excited. None of this would be possible without their vision or passion for knowledge translation and women’s health. I’m beyond grateful to have had the opportunity to work with them.

Other than that, I’m excited to see how the blog continues to grow, and I hope that one day I can write for the blog or about the blog.

How can people reach you?

People can follow me on Twitter (@ArrthyT) to keep up with my work. Feel free to message me to talk about potential stories or anything science-related.

Behind the Science: Helping Individuals with Eating Disorders

Interviewee: Amané Halicki-Asakawa, B.A. | Authors/Editors: Negin Nia & Arrthy Thayaparan (Blog Co-coordinators)

Published: March 25th, 2022

Editor’s Note: This blog post discusses eating disorders. If you or someone you know is struggling, call 1-866-NEDIC-20 or visit NEDIC.

In this week’s blog series, Behind the Science, we speak to Amané Halicki-Asakawa, a graduate student in clinical psychology at the University of British Columbia Okanagan (UBCO). Amané is working in the women’s health field with the aim of helping folks with eating disorders. Read more to better understand how her project is helping to create tangible change, and her advice for IBPOC in the field wishing to pursue research.

Can you please tell us about your research?

I’m primarily interested in service transformation. So, how to create a tangible change for people in the community, particularly those who live in the Okanagan.

My research is focused on eating disorders and increasing accessibility to eating disorder services, particularly using things like technology and mobile apps. My research is through the Psychopathology Lifespan and Neuropsychology (PLAN) Laboratory at UBCO. Our lab’s primary focus is on neuropsychology and clinical psychology. The research is really broad, it covers things like stroke research, hemispatial neglect, and also a lot of body image and eating disorder research.

What are you currently working on?

My master’s thesis is focused on adapting a self-help mobile phone app for use within an eating disorder context. The goal is to provide people with eating disorders who are waitlisted for treatment an interim service while they’re waiting. The pandemic has increased waitlist lengths dramatically, which were already really long prior to COVID, and so eating disorder treatments are very, very inaccessible for a lot of people right now. The aim of that project is to try to make sure that people have some sort of support, so that they aren’t being forgotten in the system.

What got you interested in this research?

As a woman and being subjected to a lot of cultural issues surrounding thin idealization, I was drawn naturally to eating disorders. They appear a lot in popular culture, and once you dig under the surface a little bit, you realize that there’s so much more going on that drives these disorders. There is a lot of really serious underlying stuff related to emotion, regulation, identity, all sorts of stuff. So, I think learning about the severity, complexity, and the existing treatment gaps made me realize how important they are to study.

What impact do you hope your research will have in the women’s health field and beyond?

I really want my research to have a tangible outcome. I think that when participants are involved in your research, you’re asking them for something. They are providing their time and sharing upsetting, really intense things that they’re going through – especially in mental health research. I just want to make sure that the participants in my studies are able to get something back. Also, we’re in a transforming world, and technology is becoming so much more accessible and mainstream. My hope with projects like this is to show that there can be ways to access and deliver services that aren’t being used right now. I want people to know that these things can actually fill in the gaps and create a bridge so that people can access the treatments that they need.

As a IBPOC in the science field, what advice do you have for future IBPOC academics wanting to pursue a similar path?

It’s really important to find mentorship in people who look like you and who’ve shared your experiences. I think it can be really helpful to seek out mentors, even colleagues and peers. They don’t have to be the highest members of academia, they can even be grad students who are a little bit older than you are, or research assistants at labs doing research that you are interested in. Being a racialized person in academia can be very isolating, especially as most institutions lack diversity. Finding those supports and people who can empathize with your experiences and your specific struggles is incredibly helpful. I’ve sought out many mentors in the past who have helped me and continue to help me, and without their support it would have been a lot harder than it needed to be.

What is the best way for people to learn more about your work?

Feel free to connect with me through Twitter (@amanekha), and check out our lab website to keep up to date with our research.

Behind the Science: Understanding Nanomedicine

Interviewee: Dr. Hagar Labouta, PhD | Authors/Editors: Arrthy Thayaparan & Negin Nia

Published: February 25th, 2022

With our blog series Behind the Science, we strive to share the stories and amazing work of a diverse range of scientists and academics in the Women’s Health field. The latest feature in our series is Dr. Hagar Labouta, assistant professor at the University of Manitoba’s College of Pharmacy and a renowned nanomedicine researcher. In this blog we speak with her to better understand exactly what nanomedicine is and to learn of her journey through academia as a Hijabi woman of colour.

Can you please explain what your research is?

My research is in nanomedicine. So, we work with small things called nanoparticles, or small particles. Those tiny particles are very powerful, you can use them to target specific sites in the body that you are not able to do with conventional therapies. You can also decorate nanoparticles with some chemical groups or ligands on top. For instance, those attached ligands could target specific cancer cells. Therefore, there would be higher accumulation at the tumour side and lower accumulations elsewhere, and as a result the patient suffers less side effects from chemotherapies.

Most of the applications of nanomedicine have been in cancer therapies, but there are lots of other applications that require nanotechnology-based solutions. The focus of my lab is using those technologies to develop safe and effective therapies for the treatment of maternal and fetal disease during pregnancy. More specifically, we design new nanoparticles to carry drugs that are essential for the mother or the baby and we carefully characterize them in the lab as well as evaluate them under conditions that simulate human pregnancy.

How did you get interested in pursuing this work?

My dad, Dr. Ibrahim Labouta, was a professor of pharmaceutical chemistry. I lost him recently to COVID-19 but he was my mentor throughout my entire life, who got me into science. Since I was a child, I wanted to be like him. He was my number one supporter to leave my home country after my master’s degree to pursue a career in Germany, where I got supported by my mentor during my PhD. I was really lucky to be mentored by great mentors, Drs. Labiba El-Khordagui, Marc Schneider, Claus-Michael Lehr and David Cramb, who pushed me into the direction of this research and significantly impacted my career.

In the beginning I was inspired by doing science, and drug delivery was a big thing. When I started my PhD in Germany, I was fascinated by nanomedicine and how powerful this field is. I think we’re now witnessing the glory of this field, millions and billions of people are now receiving the COVID-19 vaccines by Pfizer and Moderna that are based on mRNA lipid nanoparticles.

In 2019, I started at the University of Manitoba with lots and lots of ideas. I got in contact with the Children’s Hospital Research Institute of Manitoba (CHRIM), and I started collaborating with Dr. Richard Keijzer and his team to develop a delivery system for a specific microRNA to babies diagnosed with congenital diaphragmatic hernia before they are born. That was the first project I did related to fetal health. Now, the main focus of my lab is maternal and fetal health.

What got you into women’s health?

My father got me into science, and he was also very interested in women’s health. When I was working at the University of Alexandria in Egypt, he was working in the Women’s Health Centre and was responsible for several women’s health projects in Africa and the Middle East. So he invited me one day to give a talk there, and so it’s always been in the back of my mind that I wanted to do something related to women’s health.

The motivation has always been there, especially when I started to go deeper into women’s and fetal health. I started to realise that most applications of nanomedicine are geared towards cancer, which is a really big thing and we have seen several products already in the market. But if you’re talking about helping or using those technologies for women’s health, it’s really an area that is understudied and there are lots of questions that haven’t been answered yet – which is why I want to use my expertise in this area to answer these pending questions.

As a Muslim Hijabi woman, how has it been for you going through the ranks of the scientific community?

Being Hijabi and a woman from a minority, it definitely has been a journey, and I’m proud to be Hijabi. In general, people tend to respect you when they see how you respect your background and culture. I feel very fortunate to be a Muslim Woman from Egypt. I was also really lucky to work in labs where many were inclusive. But there were definitely some people who were discriminating. Nevertheless I just kept going, and currently I’m a faculty member and a Hijabi. I hope this inspires other people who are Hijabi, non-Hijabi, minorities, or females, who are looking to build their career in academia. I hope I can send them a message that this is possible, I hope their route is now easier than mine. Just to add to that, I want to also emphasise that having a family doesn’t mean you can’t be a professor. I have a loving husband and two kids who made me better in many different ways. Everything is possible; academia is not really limited to a specific population or stereotype of a scientist.

Behind the Science: The Intersection of Social and Health Psychology

Authors: Negin Nia and Arrthy Thayaparan (Blog Coordinators) || Interviewing: Frances Chen, Associate Professor of Psychology, University of British Columbia

Published: November 26th, 2021

COVID-19 has made our social interactions even more isolated and reliant on technology. This month on Behind the Science, we speak to Frances Chen, Associate Professor of Psychology at University of British Columbia, exploring the intersection of social and health psychology linking our social lives (especially online), mental health and physical health.

Could you describe what you are pursuing in your research?

I’m interested in how we develop and manage our social relationships and how our social lives influence our health. This includes both good effects and bad effects. Good effects include when we’re able to receive social support from our loved ones, or when we feel a sense of belonging in our communities. Bad effects could include when we have a conflict with somebody that we care about, or when we feel lonely, socially isolated, or experience social rejection. In my lab, we try to advance scientific understanding of these phenomena.

It is also important to mention that women and men can experience different kinds of challenges when navigating social relationships. Sociocultural norms can play into those different challenges that women and men face, but also biological factors such as how our hormones influence our social behaviour or emotional reactions.

What got you interested in pursuing this research?

There’s a saying, “all research is ME-search.” I would say that’s true of me. For as long as I can remember, I’ve always cared deeply about social connection. I believe it’s a very powerful part of what it means to be a human being. When you have experiences and relationships where you feel seen, accepted, loved, and appreciated, those are incredibly powerful experiences. On the other hand, if you are going through a relationship conflict or a breakup with a romantic partner, if you’re feeling socially isolated, or you don’t have social support and a strong social network to lean on, it can feel emotionally devastating. I’ve personally observed how strongly social connections influence my own health and well-being, and I’ve also observed that in so many other people’s lives.

What sparked your interest in women’s health?

The more I look at these questions that I’m pursuing, the more I see that there are both social and cultural factors, and also potentially biological factors, that play into some differences in how women and men experience social relationships. I think it’s important to consider those potential differences because if our ultimate goal is to improve the mental health and physical health of people of different sexes and genders, then we need to be aware of these kinds of nuances.

In one line of work in my lab, we are investigating why depression and anxiety tend to be more common experiences for women than men. To investigate this, we are currently running a large-scale prospective study where we’re tracking the emotions and social functioning of young women during their teenage years. We’re collecting a bunch of different metrics, including data on their changing hormones and social experiences, to help us understand some of these questions around women’s mental health better.

What impact do you hope your research will have on today’s world and also in the future?

I think that loneliness and social isolation are increasingly common experiences. This may be in part a side effect of globalization. People move around a lot more than they did in the past, which might cause them to uproot themselves from a social community and have to make new connections.

Another factor might be how we increasingly seem to be replacing our in-person face-to-face interactions with interactions on our smartphones and computers. Although technological advances have created opportunities for connections that didn’t exist for past generations, they are also a double-edged sword. The COVID-19 pandemic has made many of us realize that these computer-mediated ways of connecting aren’t a perfect replacement for our in-person interactions. In today’s world and into the future, it’ll be increasingly important to ask and seek answers to these questions around how we can kind of manage to stay socially connected, despite these new challenges that we’re facing.

Behind the Science: How Women are Fighting the Opioid Crisis

Authors: Arrthy Thayaparan and Negin Nia, Women’s Health Blog Coordinators | Interviewee: Dr. Jade Boyd, Ph.D., University of British Columbia

Published: October 29th, 2021

News of the opioid epidemic is constant in Canada. But what’s discussed in the media rarely goes beyond the scope of updated death rates and the repeated calls for life-saving policy change. That’s why advocates and researchers, like Dr. Jade Boyd, are essential to change the mainstream discourse and view of the opioid crisis.

As a research scientist at the British Columbia Centre on Substance Use, Dr. Boyd has worked in Vancouver’s Downtown Eastside and across Canada at the heart of the opioid crisis. She has been observing, speaking to and learning from the very individuals affected by this crisis — trying to come up with a solution.

This month on Behind the Science, Dr. Boyd highlights the challenges faced by women and marginalized individuals in the opioid crisis, and what it’s like to work in the midst of an epidemic.

How did you get into this field?

Originally I was interested in dance, visual arts and media-based work, but was always interested in social justice issues and had a hard time kind of combining my art interest with social justice issues.

From an arts background, I moved into gender studies and knew that I had a strong interest in looking at the differences that women might experience in the world in relation to men. Also, the inequities that were coming up were always important to me, particularly for marginalized women, Black, Indigenous, women of colour, poor women, and gender diverse, transgender, and non-binary people.

During my postdoctoral studies, I was doing arts-based research with women who use drugs. There I was looking and trying to do work about resiliency, and some of the amazing things that [women] were managing to do despite all the structural barriers that they’re facing in their everyday lives. And from there, I really enjoyed working with women who use drugs, and I was really lucky to work with community groups that were led by their members.

Now I’ve moved a bit away from the arts and more into health and medicine, and that’s just because of the focus on substance use, which has become a passion of mine. It was always a topic in my family growing up and remains important to me throughout my work.

Could you highlight some of your most important findings or highlights from your research?

I think one of the basic things that’s important or defines my research is that we want to have equitable, accessible health care and harm reduction that actually meets the needs of people. That’s always what I’m looking to help define. Communities already know what works for them, and what doesn’t. So amplifying their voices to change those policies to better meet their needs drives my research and anything that I’ve done.

And of course, the other biggest thing is the fact that women, men and gender diverse people experience substance use and health policies quite differently and are impacted differently. Women have to deal with criminalization and stigma, and fears around child apprehension, and racialized and gendered violence in ways that are different from cis men. Even though we already know that it seems like it continues to be siloed or under-recognized.

My work helps to maintain the importance of seeing what the needs are of those who are underserved because our health policies around harm reduction don’t always take women and gender diverse peoples’ needs into account in a fulsome way. So the work that I did look at women and gender-diverse peoples’ access to overdose prevention sites and other new overdose prevention interventions, I think are some of the highlights.

What impact do you hope to see with your work 10 years from now? And what do you hope to see from policy changes regarding the opioid crisis in the future?

I want to see the end of preventable deaths, so I would hope that 10 years from now we would not be in an overdose crisis. That people have access to the supports that they need in order to live well, and experience not top-down, but community-led efforts.

I think that part of that is expanding more holistic approaches that are looking at poverty, systemic racism, and criminalization. Indigenous women have very high rates of overdose compared to non-Indigenous women — that are almost equal to men. They’re also over-policed and over-surveilled. So if we don’t address our prohibitionist policies and how they intersect with colonialism and misogyny, the stigma that stems from that, housing and wage inequities, or the extra surveillance of women, then we’re not going to see a lower overdose death rate.

Ending the criminalization of drug use is key, as it has severe repercussions on the health of women who use drugs. While access to safe, non-toxic pharmaceutical-grade drugs is a step forward, it simply is not enough.

Why is it important to have research looking at both women’s health and substance use?

Substance use and the way we deal with it, and the policies around substance use, impact women’s health. Women are more likely to hide their substance use because they experience a double stigma.

Both men and women experience stigma related to substances. But women and gender diverse people experience greater stigma because they’re not conforming to gender norms. So poor women who have children are going to experience heightened surveillance by social services, especially if they are Indigenous or a woman of colour. They’re going to experience it by law enforcement and also if they’re experiencing poverty, through housing. So that affects their health in a multitude of ways, and they may be more likely to be criminalized.

If women are more likely to hide their substance use, then they’re also at heightened overdose risk, because they might be using alone without the support of someone to help them reverse an overdose. And if they’re more likely to be second on the needle, because of gendered power dynamics that already exist in our society, that means that they’re more at risk for transmissible diseases. All of those things negatively impact women’s health.

I personally don’t think using substances is a health risk, it’s the policies around it that increase risk. The way our social and structural environment impacts women who use drugs in creating negative outcomes.

Is there anything else you want to mention? Any inspirations for your work?

Our medical norms and research tend to stem from the male perspective — that’s the kind of society that we live in. As I mentioned, we want to ensure equitable and accessible access to all forms of health care. That’s why it’s important to me to look at diverse women’s needs. Because poor women’s needs are different from middle-class women, and racialized women’s needs are different from women who benefit from white privilege and what is going on there. What are those dynamics? And if we don’t have that kind of equitable access to health care, it doesn’t work if it’s only serving one population.

I’m very influenced by the communities and women that I work with who use drugs. Many of them are engaged in activism if they’re able to, and not everybody is, as it falls on them due to government inaction. Their expertise and knowledge, their hard work, resilience, and perseverance in the context of ongoing and constant systemic, and structural barriers that they experience — it’s very inspiring.

Early on when I was doing a project with some women who use drugs, they documented what they do in their everyday lives, and all that they were doing. Many had to travel daily to obtain their drugs, on top of all the activist work they were doing while caring for people in their community, while also navigating poisoned drug supplies and income generation. They had this added work to deal with. Doing that work on resilience has been really important to me, but at the same time, many women that I’ve worked with over the years have passed away — it’s heartbreaking. Many of these deaths were preventable because they are the result of our flawed drug policy and ongoing structural violence. And in the midst of all that, people are persevering and doing this hard work to save lives.

Experience with COVID-19 Vaccine While Pregnant

Authors: Negin Nia and Arrthy Thayaparan (Blog Coordinators) | Interviewing: Dr. Cindy Barha, PhD, Department of Physical Therapy; Dr. Chelsea Elwood, PhD, Department of Obstetrics and Gynecology

Published: October 9th, 2021

To go along with our latest blog looking at research and effects of the COVID-19 vaccine on pregnant women, the Women’s Health Blog spoke to Dr. Cindy Barha to hear her personal experience with receiving the vaccine during pregnancy.

While the information mentioned in this Q&A is the personal anecdote of Dr. Barha, everything mentioned has been verified and additional reading has been listed along with this blog.

When did you decide to get your vaccine?

I got pregnant in September of last year, a few months after COVID had hit, and the first wave was just ending. I had already decided that I was going to get it as soon as I was eligible to get the vaccine.

Why did you get vaccinated while pregnant? What was your thought process going into that?

I kept a close eye on data coming out of the United States and the UK. They were the only countries at the time that I could find that were actually keeping track of COVID infections in pregnant women. Everything I’d seen was pointing towards COVID symptoms being much more serious in pregnant women, compared to non-pregnant women of the same age.

So if you were pregnant and got COVID, you’d be at higher risk for being hospitalized and being put on a ventilator, compared to a woman that was not pregnant and the same age as you. So that just kept coming up every time I looked to see if any new data had been published.

As soon as I became eligible, and I had the opportunity in my second trimester, I jumped on it. I had no reservations about getting the vaccine. Nothing had come out in any of the studies I had seen to suggest that the vaccine was unsafe during pregnancy. I was always going to get the vaccine and I was actually really happy to receive it during my second trimester, because I was really hopeful that Baby would receive some protection. And this is exactly what is being seen in more recent studies, COVID antibodies are found in umbilical cord blood!

Other than your research, who did you go to for advice on informing your decision?

I had two excellent OBs (obstetricians) at BC Women’s hospital, Dr. Chelsea Elwood is one of them and she is an infectious disease expert. I had a couple of conversations with her, I was curious what experts thought [about getting the vaccine, while pregnant].

Around the same time, I had a family member and a friend who were also pregnant, and were both skeptical about getting the vaccine. So, I shared my experiences and the knowledge that I’ve been able to gather from the data with them. But I also asked Dr. Elwood if she had anything to share that I could pass on to them and she pretty much echoed everything I’d seen in studies looking at vaccine safety and efficacy.

Did you have any side effects after the vaccine?

I had very few side effects. In fact, I think I only had a sore arm for maybe 12 hours, and I think that was because I slept on that side. But I didn’t get a fever, or any aches or pains. It was basically like getting the flu shot at that point for me, and I don’t normally get any side effects from that either.

I mentioned this to Dr. Elwood and she told me about some data suggesting that women that are pregnant are suffering from less side effects from the COVID vaccine. My personal experience echoed what she was seeing in the data, that side effects seemed to be blunted in women that were getting their shots during pregnancy. I had the same experience from my second shot when I was breastfeeding. I had almost no side effects whatsoever.

How did you feel about any effects to your baby?

When I got my first shot during my second trimester, researchers had just started to see that the antibodies that were being produced from mRNA vaccines were crossing the placenta.

So Baby got some protection from my first shot. I got my second shot when i was about 3 months postpartum so Baby got antibodies from my second shot, as well through breastmilk.

In a way this was a good sort of vaccine schedule for me, because the baby got antibodies through the placenta and through breastmilk.

On a more cheerful note, how’s your baby now?

He’s great. He’s protected from COVID as far as I know. He’s four months old now and just living his life.

Is there anything you would like to share to people who are or looking to get pregnant and trying to decide whether they should get the vaccine?

I think what I would say is, don’t think only about yourself, but also think about your baby. The vaccine has been given to over 6 billion people, and a portion of those people were pregnant. There’s been no negative outcomes in terms of pregnancy or fertility in any of these cases.

So think about yourself, think about your baby. The vaccine is our best chance of getting through this pandemic. Without it, pregnant people are at a higher risk for being hospitalized, and that will potentially be harmful for your baby.

The Women’s Health blog also reached out to Dr. Chelsea Elwood, a clinical assistant professor at the University of British Columbia in the department of Obstetrics and Gynecology, to hear her recommendations.

What is the recommendation right now?

So we recommend, in line with the Society of Obstetricians and Gynecologists of Canada, and a large number of other international bodies, that persons who are pregnant, persons who are breastfeeding, and anyone planning a pregnancy get the COVID-19 vaccine.

Is there a certain time period when women should receive the vaccine?

As soon as it’s available. So we recommend that at any time in pregnancy, first trimester, second trimester, third trimester, they should get the vaccine, including postpartum.

When it comes to the different vaccines, is one better than the others? Is mixing vaccines an issue?

We recommend any of the COVID-19 vaccines in pregnancy. There is currently more published data, generally on Pfizer and Moderna, although we are expecting much more data from the United Kingdom on AstraZeneca. There’s no safety signals related to pregnancy with any of those vaccines. So we actually recommend any of them.

The data around vaccine mixing is continuing to be studied and emerging. To be honest, at this point in time, we recommend any of them as long as patients are fully vaccinated and can’t make a preferential recommendation of vaccine mixing versus not in pregnancy.

With the talk about boosters, do you think pregnant women should be getting a booster shot?

At this point in time, there’s no data to suggest that pregnant women respond any differently than their non-pregnant counterparts. So a woman who is pregnant and has, for example, an autoimmune disorder and would normally qualify for a booster, then they should get their booster. Pregnancy, in and of itself, is not a reason at this point in time to get a booster.

What do you have to say to folks worried about their babies and the vaccine?

Maternal vaccination for infant protection is a very well established modality to get babies protected from infectious diseases. We have traditionally seen that in the influenza vaccine, where moms are protected, babies are provided antibodies through placental transfer, as well as through breast milk afterwards.

We actually use maternal immunization for infant protection as a very good strategy to protect babies from whooping cough in the first couple of months after they’re born. And we recommend routinely the whooping cough vaccine in pregnancy for that reason. The COVID-19 vaccine is recommended primarily for maternal benefit. Meaning the outcomes that are being prevented by our mums getting COVID-19 vaccine, are ending up in the ICU hospitalized or having preterm birth by being vaccinated.

Being vaccinated in pregnancy, and the degree of which that is going to protect the baby from COVID-19 has yet to be seen, because we simply don’t have enough data at that point in time. But we would expect it to be protective in the same way that any other vaccine in pregnancy does, in that it would confer some protection for babies after they are delivered and through breast milk.

What would you like to say to the folks deciding whether they should get vaccinated?

I’d encourage them to reach out to their maternity care provider and have that conversation. The Society of Obstetricians and Gynecologists of Canada and most of the provinces have great resources available to help patients and practitioners have the conversation.

But again, we’re very clear about the recommendation because of the potential harm of COVID-19, the clear harm of COVID-19 if you get it in pregnancy, and the safety data we have now around vaccination in pregnancy.

I would also discourage people around the social media that’s going around about the risk of infertility. There’s no data that the COVID-19 vaccine causes infertility. In fact, the studies actually oppose this. There’s no theoretical reason why the COVID-19 vaccines would cause infertility. And so we do recommend that people who are trying to get pregnant get fully vaccinated before they get pregnant, so that they’re protected during their pregnancy.

So we recommend again that persons who are pregnant, persons who are breastfeeding, and anyone planning a pregnancy get the COVID-19 vaccine.

Behind the Science: Postpartum Care in China and Canada

Authors: Alex Lukey, Arrthy Thayaparan and Negin Nia (blog coordinators) | Interviewing: Kejia Wang, BSc, University of Pennsylvania, MA, University of British Columbia

Published: September 24th, 2021

For the next post in our Behind the Science series, we speak to Kejia Wang on her masters work at the University of British Columbia and career journey. In our discussion, Wang takes us through her work in women’s health research, and defines what postpartum confinement care is in China and how that differs from western systems of care.

How did you become interested in women’s health research?

I earned my undergraduate degree in the United States, where I was a bioengineering major. After that, I came to UBC to do a master’s in English, specifically rhetoric. My focus at UBC were rhetoric and Science and Technology Studies. Combining the two topics allowed me to make use of my existing knowledge from STEM while learning more about how scientific ideas are debated and disseminated in the public sphere.

After coming to UBC, I met Professor Judy Segal, who became my supervisor and mentor. She is an expert on the rhetoric of health and medicine. In Judy’s classes, we talked a lot about women’s health research. As a woman myself, I am interested in how women’s health is talked about and understood, and wanted to study women’s health from an intercultural and multidisciplinary lens.

How did you decide to make the leap from bioengineering to english?

It was very interesting! I was always interested in both science and english as a child. I went into science thinking that was what I wanted to do. But after a few years of working in science, I realized that I preferred talking about science rather than actually doing science. I want to be that person who can take an engineer’s work and explain to the lay public what it actually means. I am interested in the perception of scientific (or pseudoscientific and science-adjacent) ideas by the public and how different communities use these ideas to improve their lives.

How did that journey lead you to where you currently are in your career?

The engineering degree gave me a solid STEM foundation. The rhetoric at UBC gave me the foundation to understand how STEM and STEM-adjacent ideas are talked about in a public sphere. Now I’m doing work at the Resident Doctors of BC, where I am able to combine my abilities.

So now I’m looking at both in considering policy. How do we take the data and concerns that people have and use that to draft policies that make sense from the scientific perspective, but also benefit the patient and the provider?

Regarding your thesis work, could you explain what you did in simple terms?

When I started my master’s at UBC, I decided to do a thesis. We settled on postpartum care in China, because it ticked a lot of boxes in terms of what I was interested in.

I was interested in confinement because it’s sort of a peripheral health practice. As a practice and framework for postpartum care, it has not been validated by a randomized clinical trial (RCT), generally considered to be the gold standard of health research in the West. But since it’s still ubiquitous in Asia, it’s very much in the public consciousness. So I wanted to look at what it does, why it may be important to Chinese women as well as the Chinese nation. Which, from my research, has a vested interest in supporting this practice to support a particular conceptualization of motherhood. The “ideal Chinese woman,” so to speak. I was also interested in how this Chinese practice might inform a more global and holistic perspective on what is good for our health and wellness.

For those that don’t know, could you describe what postpartum confinement is?

The Chinese practice of postpartum confinement is an umbrella term for several different practices that Chinese women do right in the period after they give birth, usually for about one month.

There is a whole spectrum of possible practices, some more and some less popular, that women choose from. Usually, a woman will pick about three or four different practices with the advice and suggestions of her family and health care providers.

Some of these practices include consuming specialized meals intended to restore her vitality or avoiding certain environmental triggers. This can include anything, such as washing your hair to the overuse of electronic gadgets. In some cases, there are movement restrictions, such as not leaving the house for the first few days or longer. There is also the sense that the woman is supposed to be taken care of by others, either by the family and partner or by peripheral health professionals, such as a doula, postpartum nanny, or workers at postpartum centers.

What are some common misconceptions of postpartum confinement?

A big one is that since the English term calls it ‘confinement,’ there is a sense that women are locked up in their houses. This obviously sounds oppressive and knowing Chinese practices, like the one-child policy, you may think that is true.

In some cases, there is an element of coercion to it if the family members or centre has too much power dictating what the women should or shouldn’t do. Generally speaking though, the woman has a lot of power in choosing what she wants to do. All these things are still woman-centred and these practices are supposed to help the woman recover.

What do you think is the most important impact of your research?

I think one finding that I wasn’t expecting was the Chinese state’s investment in these practices and women’s health. In a way, that seems to run counter to how people might usually conceptualize the Chinese government. You hear about things like the one-child policy or the forced IUDs. That is considered to be quite invasive.

The state, in supporting this practice, positions itself more benevolently. This practice is framed as something that helps the woman recover, and even become a better woman. You are expected to not only recover the vitality and health that you had before, but there are these messages that encourage you to become an even more successful worker in your field, mother, and contributing female citizen.

Another thing was that I came to understand the practice of postpartum care in China as filling a niche for what the western medicine model is not providing to women who are going through childbirth and the postpartum. Western medicine provides many guarantees around health outcomes measured by quantitative parameters. But there are other measures of wellness and health, such as bonding with the infant and bonding with the family, and a return to the “normal” that is also very valued. So that’s why I think the practice has the reach and support that it has.

The other thing to add to what’s interesting is the western model seems to be more infant-centred in the postpartum. While the Chinese model is very much mother-centred, which really shifts the whole paradigm around which practices are prioritized.

Based on your work, what would you like to see adopted in the healthcare system?

So from a different culture’s, and dare I say EDI (equity, diversity and inclusion) point of view, especially in a city as ethnically diverse as Vancouver, it would be very helpful if a Chinese Canadian mother giving birth would have these kinds of support from her home culture.

Obviously, this is not unique to Chinese people. If it’s possible to have that kind of support, not in the sense that you would be offered the full Chinese postpartum experience in Canada, but if there is more familiarity with these ways of thinking and providing care.

The other thing, which is much more difficult, is for the health system to start considering other parameters in the outcomes when we talk about improving patient outcomes. This would mean incorporating other indicators, such as the time required for the mother’s general fitness level to return to her pre-childbirth baseline.

Why do you think we need to focus on women’s health in research?

If we have a very child-focused postpartum system, that means that the mother’s health is likely being overlooked. This is unfortunate, because the postpartum is a very important moment in a woman’s life – she is adjusting to her new role as a mother physically and mentally, both at home and in broader society. I think it’s important and good for there to be more attention brought to the mother during this developmental period in her life.