Editorial

You know by now that the InnovAiT Editorial is firmly rooted in the past, but only because it is written several months before publication. This matters little for much of what concerns us and this journal; we can easily keep up with new guidance and slowly emerging health trends. However, the pandemic that now rages will have inflicted far more harm by the time this July issue lands on your door mat. Did we believe the predictions? What have we learnt from the experience?

This special issue on maternal health reflects the care that we take when considering the future and the care, shaped by experience, needed to ensure that another generation arrives safe, free from harm and ready to build a good life, a good future. Pregnancy focuses our thoughts on the future and for obvious reasons.

Kirsten Lafferty et al. help us to understand the investigation and treatment of infertility, a problem that can cause great distress for couples planning a future and trying to start a family. Priyanka Krishnaswamy and Rohit Arora tackle the difficult problem of recurrent pregnancy loss that can bring sadness and despair before expert help comes to the rescue.

Pregnancy can bring symptoms that require us to give reassurance, explanations and effective suggestions. Rebecca Cox and Ingrid Granne provide information to help us in this task in their article on the symptoms of pregnancy. Prescribing in pregnancy causes anxiety for doctors and patients, but guidance from Kirtsen Lafferty et al. helps inform safe prescribing decisions. What advice should we give to our pregnant patients about diet and exercise? How much exercise is safe and when should it be curtailed? Chee Kuan Chuah and Ebrahim Mulla review the advice we can give to patients to keep them healthy in pregnancy.

We know that blood results can look different in pregnant patients, but what is normal and what may signal disease? Musarat Tufail and Stephen Lindow help to distinguish between the physiological and the pathological when considering haematological results and conditions.

When the new baby arrives and tiredness is compounded by breastfeeding difficulties and questions, how can we assess the problem and provide helpful answers? Alexander Field et al. make suggestions and describe the different problems, often easily solved, that can beset breastfeeding mothers and their babies.

Last month Anthony James, your new AiT Chair, described important issues facing the world that have prompted his call for ‘The Big Conversation’. I share his concerns and commend his advocacy of action, change and political commitment:

Both as organisations (the NHS is the world’s fifth largest employer and the RCGP is the largest medical royal college) and as individuals, I believe those working in health and social care have a vital part to play in driving forward change on climate crisis and other issues that impact on the health of the population. From communicating risk to ensuring that policies promote public health, we need to be at the forefront of helping to create a healthier future.

And, by the way, when we think about our healthier future, what lessons will we learn from the pandemic? Many anticipate that the experience gained by all of us during recent months will bring about permanent change, not least in the way we practice. Some change will be practical and routine, but some may relate more profoundly to our concern for future generations, how we give medical care and how much health care matters to all of us.

At the risk of blatant opportunism, in considering maternal health, please reflect on how else we might keep the newly arrived safe and free from disease. We have knowledge, empathy and often an emotional engagement to care about the future and learn from the past. We have the instincts and insights to advocate effective change without too much emotion, whether anxiety about the future or melancholia about the past. We are a profession that can help shape a better, healthier future by being part of conversations, both big and small. What do you think? Have a conversation and a bigger say by sending your article, short or feature length, to the usual address.