Join us for a conversation with Abbe Labella (Postdoctoral Scholar in Biological Sciences at Vanderbilt University), Abin Abraham (MD/PhD Candidate at Vanderbilt University), Lou Muglia (President of the Burroughs Wellcome Fund), Antonis Rokas (Cornelius Vanderbilt Chair in Biological Sciences at Vanderbilt University), and Tony Capra (Associate Professor of Epidemiology and Biostatistics at University of California San Francisco). The events leading to birth in mammals that precisely coordinate fetal development, maternal health, and emergence into the extrauterine environment are essential components of reproduction that have remained mysterious. Understanding human birth timing, and its disruption in preterm birth, the leading cause of infant mortality, pose special challenges as human pregnancy physiology differs from species other than apes. Here we describe methods that integrate human genomics and evolutionary biology to yield new insights into this challenging and fascinating problem. We provide a brief overview of the subject (Abbot and Rokas 2017, “Mammalian pregnancy”; https://doi.org/10.1016/j.cub.2016.10.046) and our recent Nature Communications paper (LaBella et al. 2020, “Accounting for diverse evolutionary forces reveals mosaic patterns of selection on human preterm birth loci”; https://doi.org/10.1038/s41467-020-17258-6) for discussion.