Pregnancy as a Teachable Moment for a Healthy Life Course: mHealth Design Paradigm Shift Abstract Pregnancy is a period of life that is most often understood in mHealth design as a medical issue. Recognizing that there is more to pregnancy than medical health, as understood by diet, exercise, sleep and fetal development, we set out to understand pregnancy from the perspective of lower-income American women. Through our qualitative study, we present our pregnancy ecology concept, which accounts for the multi-faceted experience of pregnancy as a transformational event within the life course. We use the ecology concept to call for a paradigm shift in mHealth design, away from medical information and diet and exercise tracking, and toward the use of pregnancy as a teachable moment in encouraging healthy life management practices generally. Author Keywords mHealth; pregnancy; design paradigms; life course management; health and wellness ACM Classification Keywords H.5.m. Copyright © ACM 2014. Tamara Peyton Information Sciences & Technology Pennsylvania State University University Park, PA 16802 tpeyton@psu.edu Erika Poole Information Sciences & Technology Pennsylvania State University University Park, PA 16802 epoole@ist.psu.edu Madhu Reddy Information Sciences & Technology Pennsylvania State University University Park, PA 16802 mreddy@ist.psu.edu Jennifer Kraschnewski College of Medicine Penn State Hershey Medical Center Hershey, PA 17033 USA jkraschnewski@hmc.psu.edu Cynthia Chuang College of Medicine Penn State Hershey Medical Center Hershey, PA 17033 USA cchuang@hmc.psu.edu