From here to maternity: suddenly fruit matters

In a first of a series of intensely personal blogs, NHS England’s Maternity Transformation Programme Manager and mum-to-be throws the spotlight on her work as she records key stages of her own pregnancy:

It’s a curious thing when your work life and your personal life collide.

While I have worked in Health Policy for 12 years, never have I worked directly on a policy or programme which I’m simultaneously experiencing first-hand. But at this moment in time, I am both the maternity transformation programme manager for NHS England and I am four months pregnant – or to put it another way, I have the equivalent to a 100g avocado growing in my uterus.

I have been in my professional role for two years, and I have spent much of that time, thinking through national strategies, considering policy problems, and ensuring the ‘user voice’ is at the heart of everything we do. But now I am finding my own ‘user voice’ and I wanted to take some time to reflect on my experience.

What I probably hadn’t really appreciated is that once you are on booked in on your maternity pathway, some decisions may have already been made for you.

For example, a high BMI may have already restricted your choices for a water birth. We also know in policy land that BMI impacts on safety outcomes too. Obese women are more likely to develop gestational diabetes, hypertension, preeclampsia, need labour induction, cesarean delivery for fetal distress, postpartum haemorrhage, need neonatal resuscitation and deliver hypoglycemic infants.

The one thing that has struck me is how little we seem to talk about preparing for pregnancy, ensuring that we are keeping all our birth choices open to us, and finding ways to actively contribute to safer outcomes by entering this phase of our lives as healthy as possible.

I’m not sure women truly realise the impact prevention can have on their and their babies’ outcomes. Talking to my friends many of them, when considering having children, took a relatively fatalistic approach, with the attitude ‘if it happens it happens’ without changing any lifestyle behaviours.

The truth is we are probably never truly ready, and we all modify our ways upon the news we have conceived, but as we slim down in preparation for holidays, maybe we should take – including men, yes guys, evidence shows that your health status also impacts on the future health of the baby, and the support you can give your partner whilst she carries the fruit cargo – a few more steps in preparing for the huge physical shifts which take place during pregnancy.

Tommys recently launched a fantastic #areyouready campaign and preconception toolkit, which I think highlights some of the things we should be thinking about.

As many don’t have our first contact with health services until we are eight weeks (or a 1 gram raspberry) pregnant, proactive preconceptors look to the internet, apps and other sources for advice which can be an overwhelming minefield.

I think we should be talking to girls about this as part of their sex education at school. Of all the things we learnt at sex education class, preparing for pregnancy, and taking preconception care seriously was never mentioned. All classes were geared towards safe sex and not getting pregnant, and not at all about embedding early on that sometimes getting pregnant can be tricky and having a safe and personal pregnancy with all choices open to us, take a bit of work on our part too.

I took a sigh of relief when I was told at booking that I’m a ‘low risk woman’ but I can’t quite imagine the feeling of being told otherwise in an already apprehensive period.

For more information visit these sites:

Katie Ratcliffe

Katie Ratcliffe is a health policy and programme manager, with 12 years’ experience in central government roles in the UK, South East Asia, and the Middle East.

Completing her Masters in Health Policy from Imperial College in 2012, she has brought to the Maternity and Women’s’ Health team in NHS England a combination of programme management skills and broad policy knowledge which is supporting the transformation of maternity services across England.

In her spare time, Katie is a keen traveller, follows politics and social affairs and enjoys swimming and Pilates.

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  1. Anonymous says:

    I work in policy in mental where I have been asked to remain silent about my person mental health experience. I was told that this is because I am employed to ne an NHS England professional. Why are you permitted to speak about your personal experience in pregnancy?

  2. Nicola Arrow says:

    Well Katie, as a mother of one your article was very interesting and many points expressed rang true. Well written and interesting.

    I do know someone of the same name as you, such a coincidence though she does go by another name by her friends.

    Look forward to the next blog!