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Social inequalities in birthweight are an important population health concern as low birthweight is one mechanism through which inequalities are reproduced across generations. Yet, we do not understand what causes these social inequalities. This study draws together theoretic and empiric findings from disparate disciplines—sociology, economics, public health, and behavior genetics—to develop a new integrative intra- and intergenerational model of preconception processes influencing birthweight. This model is empirically tested using structural equation modeling and population-level data containing linked mother-daughter pairs from the National Longitudinal Survey of Youth (NLSY79) and the Children of the NLSY79 (N = 1,580 mother-daughter pairs). Results reveal that birthweight is shaped by preconception factors dating back to women’s early life environment as well as conditions dating back three generations, via integrative intra- and intergenerational processes. These processes reveal specific pathways through which social inequality can transmit from mothers to children via birthweight.