From around 1970, critics of the medicalisation of women’s bodies drew attention to the centring of the foetus and neonate in ‘maternal’ and child health, as medical researchers and public programs sought to drive down foetal and infant mortality rates. This stimulated both scholarship and advocacy around women’s agency in reproduction. In recent years, there has been renewed interest in pregnancy and foetal outcomes, now on the risks that overweight and obese women pose to their children once adult, and through them, to later generations. In association with this concern with epigenetics and maternal risk factors, there has been growing emphasis on the need for interventions pre-conception and in early pregnancy to prevent cardiometabolic disease. In this article, I draw particularly on examples from South Africa. I describe first how the continued idea of a ‘normal’ birth ignores the ways in which race, class and poverty shape reproductive possibilities. I then analyse the logic that positions women as ‘foetal containers’ and so as vehicles of poor intergenerational health. Such approaches to women, and their pregnant bodies, ignore the structural factors that influence body size, diet and health.