Academy Award-nominated actor Chiwetel Ejiofor joined me on “Salon Talks” to discuss the nearly 10-year process of directing his first feature film, “The Boy Who Harnessed the Wind,” streaming on Netflix and showing in select theaters on March 1. Ejiofor also wrote the screenplay and stars in the film, which is set in Malawi and based on a true story.

Adapted from the bestselling memoir by William Kamkwamba and Bryan Mealer, “The Boy Who Harnessed the Wind” tells the story of Kamkwamba at 13, forced to drop out of secondary school in Malawi because of his family’s financial struggles. He ends up inventing an unconventional way to save his family and village from famine by building a wind turbine that creates electricity.

Ejiofor traveled to Malawi to shoot the film, and once mixed in with the people, he absorbed the culture and learned to speak Chichewa. His film represents Malawi in an authentic, beautiful way by honing in intimately on one family’s story. It will probably make the people of Malawi proud, which was very important to Ejiofor. To me, his careful approach is the optimal way to portray and showcase cultures that are not our own.

When he sat down with me at Salon this week to about the film, Ejiofor sparked a much-needed conversation about how society is quick to box people in by the culture they belong to. There’s only one Malawi in Africa, and it’s not the same as Nigeria, or Egypt — each is equally unique and special in its own right and deserves to respected as such. Generalizations about Africa are disrespectful and do nothing but promote false and dangerous stereotypes.

My friends and I never heard anything positive about Africa growing up. I remember seeing racist cartoons of tribal men, or what looked like sharecroppers on Looney Toons, back in the day. We learned nothing about the continent in school. Meanwhile, the older beer drinking dudes who hung by the lobby in my aunt’s projects, mainly Boof, would say things like, “Dem Africans hate us and they stink just like their jungle country!” I know he’s a fool now, but as kids, we were just listening to the adults.

We didn’t have rebuttals. There weren’t any people from any part of Africa living in my neighborhood. Collectively we weren’t exposed to positive representations of Africa or any of its beautiful countries. It wasn’t until high school that I met a friend, Jol, who taught me differently.

She was Nigerian — Yoruba to be exact — and moved to Baltimore from West Virginia as a tenth grader. One day we were all hanging by the same lobby where the older drunks had boozed, and the conversation about Africa surfaced. I started with joking about 7′-7″ former NBA player Manute Bol, who’s from Sudan. We all dived into our bag of stereotypes until Jol was like, “You guys do know I’m from Nigeria.”

At first, I thought she was joking. We all did. No one believed her. She dipped off and stopped coming around us, so I knocked on her door one day and asked, “What’s up?” and she told me how she’s sick of everybody hating on Africa. So I started hanging with her without the rest of my crew and we became close. I learned about her family, their culture, history and how narrow our view of Africa was.

She introduced me to more Nigerians and I developed immense respect for them when I observed their honest work ethic. Nigerians are hustlers. The more time I spent with them, I learned that I was more African than American. I started going to Jol’s family functions and never missed the feasts her mom put on. My time with Jol forced me to quickly correct people like Boof who spread false ideas about Africa, treating the continent like it’s not the mother civilization but one monolithic place full of disease, famine and ignorance.

Stereotypes around Africa persist today, and I’m even witnessing it in the classroom.

“African Americans are lazy,” a young Nigerian student with a strong accent said during a communication class I taught a few years back at Coppin State University in Baltimore. “They have all the opportunities in the world, but they just want sell drugs and go to jail.”

All the African-American students attacked her with the same stereotypes I grew up with, while some of the students from the islands agreed.

“My family came here with nothing!” she countered. “And now my dad has two cabs, my mom is a nurse and I’m in college!”

“That’s actually not that impressive,” an African-American student replied. “My mom is a doctor, so what are you saying?”

I calmed down the group, and we moved into a more important conversation about putting people or groups of people into boxes. Ethnicity doesn’t determine destruction, failure or guaranteed success.

My Nigerian friends never boxed me in, but some of the students explained that this has been a very common experience they have had when dealing with immigrants. African Americans can be victims of the same kind of false stigmas that disrespect African and other immigrant POC cultures.

The fact is that people make these bad assumptions because they have no connection or exposures to cultures outside of their own. When you are fortunate enough to interact with another culture, the goal should be to learn all you can and absorb.

Ejiofor, a proud son of Nigerian immigrants who was born and raised in the UK and acts in American films, taught me that Malawi was beautiful because through “The Boy Who Harnessed the Wind,” he used his art to take me to place I have never traveled to. That one film doesn’t make me an expert on Malawi culture; however, it’s given a better understanding of that part of the world and I’m more complete for it.

Read our full “Salon Talks” conversation below, or watch it here.

Explain the title of the film for people who aren’t familiar with William’s story.

“Boy Who Harnessed the Wind” is a film that’s based on the memoir of William Kamkwamba, of the same title, and it tells his story of when he was 13 years old in Malawi in 2001 to 2002, and the circumstances of his life there in his very rural community. There was an impending famine situation based on a flooding that had happened, and then a drought — a kind of double whammy.

His community was sort of bracing for the impact of this as the prices of grain raised through the roof and they had a terrible harvest. He was taken out of secondary school, because secondary school isn’t free in Malawi, and they waited for this impending doom, essentially.

He started sneaking into the school, and started sneaking into the library, and trying to get into the library because he was very keen in science and technology and wanted to continue his studies. On one occasion, he went into the library and he found a book titled “Using Energy,” an American textbook. And on the front of it was a picture of a windmill, and so that’s what inspired him to start trying to pull together whatever scraps he could find and see if in these very challenging circumstances, he could build a wind turbine to help his community.

It’s such an inspiring story and it gives the viewer such energy: you feel like you can do anything if you put your mind to it, if you put in the actual work. Talk about Malawi. What was your experience like filming there?

I first went to Malawi in about 2009, 2010, just after the book came out. I’d written a first draft of the screenplay, and started to develop the film and I went out to do some research before continuing.

Your first trip was actually because of the book?

Yes, exactly. I was inspired to write the draft and then go out and meet William Kamkwamba. He took me around to Kasungu, which is the region that he’s from. He took me into Wimbe, which is the very specific village that he’s from. I met his family, his community, just a whole host of people. He was very generous with his time and that community was very welcoming.

Then I just started to travel the country. I wanted just to get a real sense of Malawi and so we went to the car and a couple of us—I had somebody had to help me with translation, if I needed it—and somebody else who was just helping me with logistics, and we just traveled around the country and got a feel for it really.

As an actor, you have an amazing, extremely diverse body of work. You’ve done everything from “Melinda and Melinda” to playing Frank Lucas’ little brother in “American Gangster.” How did you end up choosing this film to be your directorial debut?

Well, it was really just the book, just reading the book and understanding its layers and its complexity. On the surface of it, there’s a kind of beautiful simplicity to the story and to what William Kamkwamba did in that time, but as you sort of start to kind of peel the onion you realize just how complex this journey is and how it involves so many other, sort of, wider themes and ideas.

There are social ideas, there are geopolitical ideas, the relationship and the dynamics that we have to other countries in the world and economics and so on, and of course to the changing climate, and the environmental damage of deforestation and things like this. There just seemed to be a very wide platform to discuss a lot of different things within the context of talking about this very detailed, personal, interpersonal family dynamic centering largely on this father and son, and this sort of intergenerational discussion

You learned the language and everything too. You put some serious prep work in.

I wanted to create an environment where an audience is really invited into a kind of private space and to a very authentic world. Part of that for me was to learn Chichewa, which is one of the languages of Malawi that’s spoken in this region. Quite early in the process I knew that that’s what I wanted to do.

When I started to get the script translated, which I did with Samson Kambalu , who is a Malawian who lives in the UK and is a writer and is an artist, I was able to sort of get a groundwork in basic Chichewa and then to start to sort of learn the lines in the script.

Then when I was casting, we cast in Malawi as well as in Kenya and we cast Aïssa Maïga out of Paris, so those who didn’t speak Chichewa and those who did speak Chichewa would work together and we’d start to, sort of, work together as a little community.

As an artist you’ve had to learn how to perform within so many different cultures—the African culture in “The Boy Who Harnessed the Wind,” the culture of “American Gangster,” for example. There are so many different complexities inside the Black experience in general because if we’re keeping it all the way honest, race is a thing — people, they look at it and they talk about it. A lot of times, if you’re Black you’re put in a box. If you’re from some country in Africa, you’re just from Africa, as if Africa is just one place; as if it’s not so many different tribes and experiences. Is that something that you keep in mind for every role and every project?

 Yeah, 100 percent, 100 percent. I am engaged and I love to be engaged and work and think about things that work in terms of the African diaspora, and the specifics of that. That is always something that I have gravitated to in my work.

I think that it’s such a rich template, and so many extraordinary stories and avenues and ways of telling stories, and epic stories, big stories, emotional stories, stories that really move and stories, such as this one that, I think, not only move, but inspire. And I think you’re absolutely right, that there’s so many specific details and cultural details that are rich and rewarding.

You know when I was looking at this film, and when I was trying to make this film, it was to me a deep dive into Malawian culture and the spirit of Malawi, and then the rural communities, understanding that I, as a young man and as I grew older I traveled back and forth to Nigeria very often, and to the rural communities in Nigeria at times. I had a sense of that kind of dynamic, and realizing that obviously Malawian rural community is very different, but there are some similarities.

And as you say, there is no generic Africa. There are some similarities, but there are also these distinctions; these differences, these kind of individual traits. So it was really [about] exploring those; finding what was specific about Malawi, what you fall in love with about this country and how this country in many ways creates this solution, that it’s the whole package. It’s not what people are, but who they are.

I feel like your film is going to help some of the big social generalizations, which is a problem because when they exist it prohibits social relations. It can be disrespectful and it can be harmful. What were the challenges of being a director? Instead of just having to worry about yourself as an actor, you now have to worry about all these different moving parts on set.

It’s a very steep learning curve and really understanding how much there is to take on board was pretty interesting. And then, on top of that we had the straight forward logistics. I’d made certain decisions very early in the process that had serious implications. I wanted to shoot in Malawi.

There haven’t been a lot of films made in Malawi and there certainly not been film of this scale made in Malawi. So there was no real infrastructure to make films in the country. That meant that we had to really bring in a lot of things. And so the kind of logistical concerns of getting staff and equipment from Kenya and getting equipment from South Africa was a big part of that process.

But that was offset, of course, because the passion and the energy and the depth of feeling from the people in Malawi was so strong that it really felt kind of empowering to all of us making the film. Obviously they were aware of William’s story and they were excited for us to be there. Like it’s a crazy circus just comes to town when you’ve got a film unit that is descending on a small village in Malawi, but it was really important that they got behind this.

While you’re acting in a scene, you have to be the director too and yell cut in the middle of a scene, right?

That is also really weird. That was actually, in a strange way, the most weirdly awkward part of the whole process because I felt like I still needed to keep the cut. I didn’t need to call action because the first AD calls action. The director can call action but doesn’t need to. But calling cut is quite important for the director to do and to kind of hold the right to do that in case you want to linger a shot, whether you want roll again, whether whatever. That means kind of coming out of character slightly. I think there’s kind of an awkward b-roll that is going to be cut together of me just coming out of character to say cut.

Now that you’ve directed a film, do you ever think about any of your films from the past and think I wish I would have directed that film or made it differently?

I actually didn’t think of it like that. I mean I definitely felt when I was going into the process that there were films that I had felt had really worked in certain ways because of decisions that had been made. Just understanding that is very useful going into the process of directing. Also, and equally useful, if not more useful, is the times when there are decisions that you didn’t think were great. And trying to sort of avoid making those kind of choices. Having had a lot of experience in film, that kind of vocational quality to approaching directing was really useful.

Education was an important theme in the film. I think that a lot of people are going to see it and feel the power—the power of reading, the power of thinking, the power of just being able to imagine a reality that you don’t live in. Was that one of your main goals?

Absolutely, 100 percent. The critical power of education can’t be underestimated. It is the difference between here and there if somebody wants it to be. I feel that it is a question of empowering young people to sort of, as William Kamkwamba did, identify the problems that he faces and identify the solutions to those problems and to live in the solution to the problems.

That’s one of the things that I thought was just so incredibly remarkable about him doing that and feeling that and working within that at the age of 13. I think it’s inspiring not only to people who of that similar sort of age group. I think it’s inspiring to everybody, to everybody that faces challenges, to nations that face challenges.

You have some people who will always say they like the book more than the movie or vice versa. How do you approach that as an artist? Because the book itself is amazing and did really well, but the film is special in a different way.

I think you need to take a bit of time to sort of analyze and really find what it exactly is that you like about the book. Of course you might like the story and that is great and broadly speaking you can relay the story in the film, but I think you’ve gotta kind of break it down thematically.

You’ve got to find out sort of very honestly for yourself, what is it about the book, what is it that it represents for you, and how do you then go about structuring that into a screenplay that is personal to you. You got to sort of take the book apart in a way and rebuild it as a sort of combination of you and it, as honestly as you can.

I think it would be great if schools gave the book to kids so they that could read it and be inspired by the story, but then actually be rewarded by seeing the film, so it’s like it’s two whole different things.

Yeah and they’d see what was similar and what were the differences. And it’d actually open up a little bit more of the conversation of how you go about structuring a screenplay as well.

Are you directing again? Is there something in your future?

Yeah, I certainly hope so. It’s been a very exciting process for me. And I was incredibly fortunate to find something that I was so excited by, that I stuck with for 10 years more or less you know, through the kind of peaks and troughs of that experience. And I think that’s what it needs really. I don’t need to spend that long, but it needs something that you really feel as passionate about.

Something in Nigeria, or something in the UK, what do you think?

Maybe. We’ll see. I think there is a lot of opportunities, basically. And I’m excited about pursuing them.

I was reading an interview that you did a while back, and you were talking about playing Othello as a young person and then revisiting the role as an adult. Do you feel like you’re able to convey certain emotions in a reverse way? Like, of course when you are young you don’t really understand jealousy and things like that the way you do when you get older. Are there certain things that you played as a young person that you feel like you couldn’t really do or redo, or certain energy that you couldn’t visit, or do all those life lessons add up and you get better with age?

That’s a great question. You know there’s a Bob Dylan line, I was much older then and I’m younger than that now. And I feel like sometimes that’s true for me as well that there are certain things that I did and I can look at and I can see that I did when I was younger that I don’t know what would be.

There would be something interrupting me now. There would be a neurosis that’s built in. There would be something a bit more kind of mannered or slightly harder to find. I would get in my way a little bit more. And I do see that with certain things.

I think, gosh, back then I was fearless and now, not so much. Other things you kind of grow with, you understand life more in a sort of more linear way and so you can get better.

Certainly, with Othello that was true that I felt that when I didn’t understand any of those emotions I couldn’t really be inside of the project. But then years later, I understood all those things.

You’ve accomplished so much. Do you care about awards and stuff like that or do they become just like whatever, afterthoughts?

I mean it’s never been comparable to the doing of it, to the actual engaging in the work and trying to push myself to just as far as I can go with the work, and how much I can get out of the work. I have found, and it might be a slightly a cliché, but I do find that it’s true nonetheless that the work is its own reward if it really sings, if it clicks with you, if you feel that it’s been accomplished well.

Don’t get me wrong, it’s fantastic to get awards as well but it’s not the kind of primary purpose.

Spike Lee got his first competitive Oscar this year, and a lot of us were extremely happy because we feel like he’s been snubbed for a very long time. But sometimes when I look at someone as accomplished as you, or as accomplished as Spike, I wonder does it really matter, do awards matter? You’re already recognized by your peers at such a high level and people are always flocking to the work. Then when you see Spike run on stage and jump on Samuel Jackson, it’s like yeah, it’s the thing!

Yeah, I mean I loved that. I loved that he was so happy. And it did make me reflect. I was like, I hope that if that ever happened to me I would be as happy as Spike because it made me happy that it meant so much to him. And I think that’s great. I think that’s positive that he cared.

You also have “The Lion King” coming out this year. Are you excited about that part?

Very excited. I mean, it’s amazing. As soon as I was asked, I was just kind of thrilled. It was an amazing original, and I think this is going to be incredible. I’m sort of first in line. I’m waiting like everybody else. I’m just really excited by it.

Fifteen million babies are born pre­maturely each year. Stephen Quake’s daughter, Zoe, was one of them: she arrived via emergency C-section after Quake and his wife, Athina, made a middle-of-the-night dash to the emergency room, a month before Zoe was due. She spent her first night in an incubator, and her father, a bioengineer then at Caltech, wondered why birth couldn’t be more predictable. 

That question lingered in Quake’s mind. Months before Zoe began her junior year of high school, her dad announced he had developed a maternal blood test that may be able to alert women that they are going to deliver prematurely—before 37 completed weeks of gestation. He has since launched a startup to commercialize the technology and create a cheap, easy test that women could take around the sixth month of pregnancy.

The prematurity test isn’t Quake’s first foray into prenatal health. When Athina was pregnant with Zoe, she had undergone amniocentesis, an invasive needle biopsy used to detect Down syndrome and other conditions. When it’s executed by doctors with lots of experience, the risk of miscarriage is low, but it exists—and that’s nerve-racking for expectant parents. “I thought, Oh my God, this is awful—that you have to risk losing the baby to ask a diagnostic question,” he says.

Convinced there had to be a better way, Quake got to work developing noninvasive blood tests to assess much of the same information as amniocentesis but with less risk to the pregnancy. He used bits of free-floating fetal DNA found in maternal blood to get a peek at the genetic makeup of the fetus. More than a decade later, multiple biotech companies offer a version of similar tests for Down syndrome and other conditions to pregnant women in clinics worldwide.

Likewise, blood tests, often called “liquid biopsies,” are in development for a number of applications, including detecting early-stage cancer and revealing whether a replacement heart is failing in the body of a transplant recipient. In 2014, Quake identified evidence of dying neurons in the blood circulation of Alzheimer’s patients, a step that is being used to develop tests for neurodegenerative and autoimmune diseases.

Predicting preterm birth would be another important breakthrough. Globally, more than one in 10 babies is born preterm, a public health problem that cuts across socioeconomic and geographic boundaries. Babies in poor nations like Malawi are born too soon—the country has an 18% rate of preterm birth, the highest in the world—but so are babies in the US, like Quake’s daughter in prosperous Southern California.

Complications from preterm birth are the leading cause of death worldwide in children under the age of five. Preterm babies can struggle with infection, learning disabilities, and problems with vision and hearing. In poor countries, babies born significantly preterm often don’t survive. In wealthy countries they usually do, but sometimes with long-term consequences including behavioral problems and neurological disorders such as cerebral palsy. There’s an economic factor, too: babies born preterm cost, on average, 10 times as much over the first year of life as those whose birth had no complications.

Just ask Jen Sinconis, whose twins arrived with no warning at 24 weeks’ gestation in 2006. Twin pregnancies are considered high risk, but Sinconis’s pregnancy had been uneventful until she started having what she assumed were Braxton Hicks contractions, which can occur weeks in advance of delivery as the uterus primes itself for labor. She was wrong, and her twin boys arrived within six hours.

Aidan weighed 1 pound, 14 ounces (850 grams) and had to spend three months in the hospital; Ethan weighed 1 pound, 6 ounces, and was worse off. He was on oxygen for most of his first year of life and barely escaped needing a tracheotomy. Sinconis received a shot of surfactant to help develop her sons’ lungs as soon as she reached the hospital, but if a test had been able to alert her doctor that she was at risk for early labor, she could have been given the medicine sooner, when it could possibly have made a difference. “If I had known they would have been born prematurely, our entire life would be different,” says Sinconis, a creative producer at Starbucks corporate headquarters in Seattle.

The boys’ medical care cost more than $2 million and didn’t end when they left the hospital. They remained in isolation at home for the first three and a half years of their lives; Sinconis can barely keep track of the number of doctors and therapists they’ve seen through the years. She and her husband were forced to sell their home, liquidate their retirement and savings accounts, and eventually declare bankruptcy to deal with the nearly $450,000 that insurance wouldn’t cover. Now 12, the boys have mostly caught up developmentally to other children their age. But their parents are just starting to emerge from their financial struggles. “We’re way overdue for a way to predict preterm birth,” Sinconis says.

A new test

Zoe, now 17, “is all grown up and totally healthy,” says Quake, a professor at Stanford University for the past 14 years, but figuring out how to predict preterm birth had been in the back of his mind since she was born. It “felt like the next big mountain to climb,” he says. “We had gained confidence from noninvasive prenatal testing. Preterm birth was like Mt. Everest.”

Quake knew there were no meaningful diagnostics that could identify which pregnant women would give birth too soon. The biggest tip-off is having given birth to a preterm baby before, something of little use for a first-time mom. Additionally, preterm delivery can be caused by multiple factors: infection, twins, or even maternal stress. “We don’t have any understanding about what is triggering preterm birth,” says Ronald Wapner, director of reproductive genetics at Columbia University Irving Medical Center. “We have been shotgunning it.”

Quake also knew that direct DNA measurements wouldn’t help. Analyzing a baby’s DNA, inherited from his or her parents, is fundamental to testing for Down syndrome because it can reveal the presence of an extra chromosome. “It’s a genetic question,” says Quake. But research has shown that the baby’s genetic profile makes a minimal contribution to prematurity. So instead, Quake focused on DNA’s molecular cousin, RNA. These molecules are harder to spot in blood (they’re short-lived) but would provide a more relevant readout, Quake believed, because their levels go up and down according to what’s going on in a person’s body. Could it be that a pregnancy headed for trouble was sounding early alarm signals?

Quake and his team, including Mira Moufarrej, a grad student in his lab, scrutinized blood samples from 38 African-American women considered at risk for preterm birth, in some cases because they’d previously had a premature baby. Overall, black children in the US are born prematurely about 50% more often than whites. Thirteen of the women ended up delivering early. By analyzing RNA molecules in their blood, the researchers found seven genes whose changing activity signals, taken together, seemed to predict which babies had arrived prematurely.

Quake told me he was surprised by the result. “Holy shit, might we have figured out a way to determine preterm birth?” he recalls thinking. “We’re still trying to understand the biology behind these seven genes,” he adds; it’s not yet clear whether the signals are emanating from the mother, the placenta, or the baby. Quake suspects they are “reflecting the mom’s response to the pregnancy going off track.” In other words, he says, “the whole thing is derailing and the mom is responding to that.”

“The beauty of this approach is that it allows us to see a conversation going on between the mother, the fetus, and the placenta,” says David Stevenson, co-director of Stanford’s Maternal and Child Health Research Institute and principal investigator at its prematurity research center. “It’s like eavesdropping. Now we can access this as it’s being communicated, which helps us understand what’s going on throughout pregnancy.”

Treatment Hope

Five hundred years ago, fascinated by his anatomical dissection of the womb of a pregnant women who had died, Leonardo da Vinci wrote about his intention to unravel the secrets behind conception and preterm birth. He never did, and even today, there are relatively few answers. Perhaps because so little is known, pharmaceutical companies haven’t seen preterm birth as a promising area for investment. Indeed, it is “one of the most neglected issues,” says Sindura Ganapathi, co-leader of the Maternal, Newborn & Child Health Discovery & Tools portfolio at the Gates Foundation, which along with the March of Dimes and the CZ Biohub, a medical initiative funded by Mark Zuckerberg and his wife Priscilla Chan, has funded Quake’s work.

“We need many more interventions,” says Ganapathi. “We are pretty limited in our armamentarium.”

A test could be a first step toward new drugs or treatments. Knowing who is at risk would let women prepare—say, by picking a hospital with a neonatal intensive care unit or working with an obstetrician who could prescribe progesterone, a drug sometimes given to try to extend pregnancy. “It goes back to personalized treatment,” says Wapner. “We still haven’t been able to identify how progesterone works and who it works for better. RNA could help us better understand who should get these medications.”

The new window on pregnancy could lead to applications beyond preterm birth. “From the standpoint of where this could go, you could look at placental development, fetal development, and fetal-maternal interaction,” says Wapner. “RNA has been the stepsister of DNA until very recently. It’s a damn good clue about how to differentiate who’s at risk of preterm birth, and it could give us a better way of evaluating what’s going on during pregnancy.”

In line with that, Quake has formed a startup, called Akna Dx, with lofty goals. It’s raised more than $10 million from investors including Khosla Ventures of Menlo Park, California. “Our idea is to do blood-based tests to give key insights,” says CEO and cofounder Maneesh Jain. “What is a fetus’s gestational age? Are you at risk for preterm birth, or severe postpartum depression? Pregnancy tends to still be a big black box. We want to give you insights into what is happening internally so you can take action.”

Other experts say more evidence is needed that RNA can provide those insights. That’s because so many different factors can contribute to prematurity, and it’s not clear how well Quake’s biomarkers will do in a broader population. “The difficulty is that preterm delivery is not caused by one thing,” says Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and an expert in noninvasive prenatal testing. Infection, a compromised placenta, maternal stress, a twin pregnancy—all of these and more can trigger preterm birth. “In really small numbers, Steve was accurately able to distinguish women at risk of delivering preterm,” says Bianchi. “But the numbers were really small.”

Quake readily agrees that his initial findings need to be validated through a large clinical trial before any test would be ready for commercial use. Quake’s team is working to confirm that the results from the African-American women hold up in other groups as well. Collaborators, including some of Akna’s cofounders, are now collecting blood samples from 1,000 pregnant women.

“We hope this is going to save a lot of lives,” says Quake. “That’s really what we’re aiming for. But this is just the beginning of the story … It’s a very fertile area, no pun intended.”

Bonnie Rochman is a health and science writer based in Seattle and the author of The Gene Machine.