For me it started with a 10g marsupial that I found had an invasive yolk sac placenta. Then David Barker showed epidemiological evidence that maternal undernutrition may restrict fetal growth and program the fetus for chronic disease in later life. But it is so much more complex than undernutrition. The mothers of the offspring Barker studied had a deprived existence in a multitude of ways. They and their in utero offspring would have been exposed to significant stress, to air pollution etc and their undernutrition was not simply calorie restriction but likely specific macro- and micro-nutrient restriction. The impact of their exposures would be strongly influenced by maternal and paternal genomes and pre-conception exposures. And, of course, the unique combination of maternal and paternal genetics that comprise the fetal/placental genome influence nutrient transport to the fetus and placental secretion of hormones and growth factors that orchestrate maternal adaptations to pregnancy. Parental genomes, diet, adiposity, cardiovascular and metabolic health conspire together with environmental factors in the first place to make conception possible or not. In turn they impact fetal growth and development, newborn and future maternal and offspring health. On top of this, the sex of the fetus has surprising impacts in many dimensions. The last decade has seen an explosion of cellular, molecular and clinical tools with which we are exploring impacts of genetic, epigenetic, nutrient, psycho-social and environmental factors on fertility, pregnancy health and beyond for mothers and children.