Providing the healthiest and safest environment in the first 1,000 days of life is the greatest gift which parents can give to their children. We return to the theme of control over our lives to ask who is in control of this gift, and whether today’s medicine and public health hold the answers. We explore the dilemmas facing today’s governments and the decisions that individuals make in terms of personal responsibility when maternal and child health are not prioritised by health policy-makers. We discuss sexual and reproductive rights, why women’s health has not been prioritised – especially during the pandemic – and reasons for high maternal mortality in some countries. We offer an optimistic close to the book; a call to action. We explain that, while planning for parenthood is important, the actions needed do not have to be sustained over a long period. We emphasise the many opportunities which adolescents and young people can seize as the parents of the future. This hope can generate the resolve to make the first 1,000 days of life as good as possible for the next generation. Knowing the secrets of our first 1,000 days is a vital part of this.