Woman's Hour - Afghan government rebel over women's rights, Egg freezing, Indian Sportswoman of the Year

Episode Date: February 18, 2025

Why are members of the Afghan Cabinet speaking out against the de facto leader over his ban on girls' education and restrictions on women working? Nuala McGovern speaks to the BBC’s Chief International Correspondent, Lyse Doucet, and Fawzia Koofi, member of the Afghan Parliament and the first woman to be elected as Second Deputy Speaker.Harvest, a new documentary, shows the realities of the egg freezing process. Director and writer Sophia Seymour decided to film her journey of elective egg freezing. With the number of women choosing this form of fertility planning rising, Sophia joins Nuala to discuss why she decided to do it, and film it. They are joined by Dr Ippokratis Sarris, Consultant in Reproductive Medicine and Director of King’s Fertility.According to NHS figures more than 44,000 children in England and Wales were admitted to hospital with constipation last year - with a 60% rise overall in hospital diagnoses of constipation in primary schoolchildren in the past decade. Dr Ellie Cannon GP and author, and Sarah Timms from Education and Resources for Improving Childhood Continence (ERIC) a children’s bowel and bladder charity join Nuala.22-year-old pistol shooter Manu Bhaker is this year’s BBC Indian Sportswoman of the year. Our correspondent Divya Arya was at the event, and joins Nuala McGovern to tell us more. Presenter: Nuala McGovern Producer: Laura Northedge

BBC Sounds music radio podcasts. Hello, this is Nuala McGovern and you're listening to the Woman's Hour podcast. Hello and welcome to the program. Could reports of infighting among Taliban leadership over educating girls be a glimmer of hope for Afghan women? We're going to discuss with our chief international correspondent, Lise Dissette, in just a moment.

Also today, we'll hear why one woman conflicted about motherhood decided to freeze her eggs and also film herself every step off the way. We'll be in Delhi as pistol shooter, that's Manu Barkar, becomes BBC Indian Sportswoman of the Year. And also this hour. Data for England and Wales reveals a 60% rise in hospital diagnosis of constipation in primary school children over the past

decade. It can be a miserable condition with lasting issues and there are a myriad of reasons about why it happens and also how to resolve it but it is not talked about openly. So today on Woman's Hour we're going to change all that. If you've gone through this with your child, whether you're going through it now or have gone through it previously and you're happy to share your experience, you can text the program the number is 84844 on social media or at BBC Woman's Hour or you can email us through our website for a WhatsApp message or a voice note. That number is 03 700 100 444.

We will have a doctor with us to talk through some of the issues that all of that entails. But let me begin with Afghanistan. We know the Taliban took over nearly four years ago. The situation for women and girls there has continued to deteriorate. Rights and freedoms for women and girls there has continued to deteriorate. Rights and freedoms for women and girls have been eroded to the point that they are barred from parks, gyms, swimming pools, even raising their voices in public. There was a moment of hope in March 2022 when the Taliban government announced that secondary schools reopened for girls, but then you might remember they were closed within a matter of hours. But there are

reports now that members of the Taliban's cabinet are speaking out against their leader over his ban on girls education and also on restrictions about women working. There's a question, is this a potential crack in the draconian laws enacted against Afghan women? Let's discuss it with the BBC's Chief International Correspondent, Lise Doucet. Welcome back to Women's Hour. Good to have you with us, Lise. You have been speaking with sources close to the Afghan cabinet. Talk us through who some of the players are in this story. Hello Anula, always good to be with you and your Women's Hour listeners. Let me summarize it like this. It is a battle between the most important figure in

Taliban leadership and that is the leader in the southern province of Kandahar, Haibatullah Akunzada, he carries the title of Supreme Leader, and his word is not allowed to be, we can see now it's being challenged, but it cannot be overruled. Then you have in the capital, Kabul, the ministers in the government who, it has to be said, have been critical almost since that decision in March of 2022 where suddenly girls schools which were meant to be opened stayed shut. That criticism however has grown steadily louder until recently there was the most open

of splits where the Deputy Foreign Minister Abbas Stanikzai, who's been one of the most vocal critics of the decisions of the Supreme Leader, most of all the decision to keep girls from schools, from secondary school, to keep women out of university, and let me quote to you what he said, During the time of the Prophet Muhammad, the doors of knowledge were open for both men and women. In other words, he is now accusing the Supreme Leader, which is an extraordinary thing to do in the Taliban movement, and saying that he is taking these decisions for his own personal reasons and not according to Islam. And so the rifts, and he's not the only one, there are other powerful figures as well,

so the rifts, the disagree, let me say the disagreements are out in the open. There are cracks, but there is, this is nowhere near a collapse of the Taliban movement and their ironclad rule over Afghanistan, women and girls bearing the brunt of that. Well somebody like Stanagzai, the Deputy Foreign Minister that you mentioned there, that also quoted the Quran. For something like this, for him to question it, surely it will put him in danger? Well, I say in regular contact with him because he was the person who led the negotiations in the Gulf state of Qatar, which led of course, which fell apart and which led to the Taliban just sweeping into power in Kabul in August of 2021 with the negotiations with the Afghan government broke down. He has

left for the United Arab Emirates and many of his family live there. He has business injuries there. He goes back and forth. But this time Nula it is said he left because there's an arrest warrant for him. Suddenly it seems the supreme leader decided enough is enough. He imposed a travel ban but the Islamic State seemed to have been able to leave but he did leave before that came into force. Abbas Sanayis is saying, well, he has a kind of mild COVID infection and needed to go to recover. But there is now an arrest warrant against him. And there have been very strong reprimands to other senior leaders within the Taliban, including some of our listeners may have heard the name Haqqani Network.

It's a family of senior leaders, the Haqqani brothers, and they are the main rivals now to the leadership of Aakunzadeh. They come from a different part of Afghanistan. So this rift over what seems in public to be about women's rights, because the Haqqanis, ironically, they're on the terrorism watch list, but they are the ones also pushing for the education of girls and women. This has become emblematic of a wider battle for power because women's rights is just really the torchlight, if you like. Not having, not recognizing women's rights in the way that they can go to school and can work everywhere they would like to work, stops international recognition of the Taliban, stops more resources going to the Taliban,

stops the Taliban from taking their place at the world, stop tables, and means a monopolization of power. And this is the nub of the issue, Nula. It is a battle for power, and it's being played out as it often is in the battle for women's rights. Now I should emphasize that the Taliban leadership says, and they're doubling down on this late, is that they are giving women's rights within Islam. But the critics are even within the Taliban are saying,

no, you are not you are misrepresenting Islam. This is not Islam. Islam allows for the education of girls and women. We are not giving them all of their rights even within Islam. And I wonder even if it is a battle for power, whether it's Stanak Zay or any of the others that have spoken out against the supreme leader in Afghanistan, whether it might in any way result in any concrete positives for the women and girls of Afghanistan? The only way it will change for women and girls is if the supreme leader, Haibatullah Akhundzada, the cleric at the top of the pyramid for the Taliban,

the cleric at the top of the pyramid for the Taliban goes back on his edicts and he's not someone who reacts under pressure. The others can criticize as much as they want. We have seen, I have seen myself in the provinces of Afghanistan, how local leaders actually go ahead with schools. They quietly allow girls to be educated. Hope it won't be noticed. And then it comes to the notice of the Supreme leadership and those around him. And they quickly, they quickly move against it and shut the schools down. Because initially, Nula, there was this idea of you could operate in the gray. That if nobody noticed the schools or the schools,

there's even reports now that they are moving against underground girls' schools. Online education for education, for example example in midwifery which was allowed because of course men can't give help women give birth it has to be women. There are jobs that only women can do in Afghanistan and this is the other concern that if this generation is not educated there will be no women doctors, women midwives, women teachers, all of the things they can do in a society where quite frankly the hundreds of edicts against women in more than three years is essentially erasing them from public life. There is one principle which matters more

than anything else within the Taliban movement and that is loyalty and unity. They do not want the Taliban movement to crack apart as was seen in the civil war in Afghanistan in the 90s. Not long after the Taliban came to power, a founding member of the Taliban told me that 95% of Taliban leaders do not agree with the edicts of the supreme leader. 95% NULA. And yet they felt, of course, like Afghans are criticizing, but what is happening now is you have people like Stamixai saying that we cannot, yes, we are loyal to our leadership,

but if they take decisions that we believe are fundamentally wrong, then this is something we cannot accept. So there's a little bit, it's moving an inch but the dial has to move a lot more if those cracks are to be what women and girls would want to see, what many people want to see a different Afghanistan is ever to come about. We're also going to be joined, Lais, now by Fahzia Khufi, member of Afghan, a former member of the Afghan Parliament. She was the first woman to be joined, Lais, now by Fazia Khufi, member of Afghan, as a former

member of the Afghan Parliament. She was the first woman to be elected a second deputy speaker. Good to have you also back with us, Fazia. I'm curious for your thoughts when you hear about some of the leadership defying the Taliban's supreme leader when it comes to women and girls and some of the edicts that have been against them on education and working? Yeah, I mean as Liz said one of the things, the criteria that kept Taliban together was their unity. They were very proud of the cohesive Taliban during the time that they were in power, second time during fighting. However, lately they have moved toward fragmentation. There are groups within Taliban that are fragmented

based on their powers, interests, financial resources, you know, also, you know, ethnic, tribal issues, as well as, you know, the power. The power is the main reason for them because those who are in Kabul think that the suppressive edicts of the Taliban supreme leader Haibatullah is further going to shorten their survival period and that's why they react some of them publicly react and we have seen others many of them are not happy about this because they think the more suppressive addicts, the more they will be marginalized, which will result to

their shortening of political survival. So on the other hand, I think the global pressure as well also contributed to division. For instance, recent, you know recent request for arrest warrant by ICC for the two Taliban leaders, which is the Haibatullah and also Chief Justice, created further division. When this was announced on the 28th of January, in my contact to many people in Afghanistan, especially in Kandahar and Kabul, I could see that Kandahar has become

like a military city, their leader has deployed more troops for his protection. So I think the more pressure will weaken the Taliban, international pressure will weaken the Taliban in a way that there will be further fragmentation. And I think change will only come when there is further fragmentation. It's interesting though, isn't it, when you talk about it and also as Lise does, so you have this pressure from within the Afghan leadership, these splits, a rebellion is too strong a word, I know Lise, but also what Fazia brings up there, just to reiterate for people that haven't been following this story, that the top prosecutor at the International Criminal Court, he's seeking arrest warrants against the leaders of the Taliban government saying that they bear criminal responsibility for crimes against humanity on gender grounds, so very much on women and girls and the ICC judges now have to decide whether to issue

those warrants. Do you think they will, Fazia, number one? I think there are enough evidences, especially based on room status and the investigation that conducted in Afghanistan by several missions, fact-finding missions, indicate that there are a violation of women's rights to the amounting of crimes against humanity which is regarded you know in the room status so I think the next step for the three judges in the pre-trial court is to decide based on on this and I think the possibility is that there will be arrest warrants but I hope in the meantime that there will be more people included in that more hardliners including the Minister of Higher Education the Minister of Education the Minister of Vice and Virtue the Minister of Higher Education, the Minister of Education, the Minister of Vice and Virtue, the Minister of Religious Affairs, these are the people

who are directly involved in issuing these edicts. I mean recently we heard that you know the Taliban banned women from attending medical colleges. This is going to impact directly women's health because in one or two years time our health system will be disrupted by not having enough female nurses and midwives, which already is a disrupted system. So that will affect women and children's lives. So this is, in fact, their ethics are directly impacting the lives of human beings. So this is a crime against humanity and that further creates

division among the Taliban, which is a good leverage that we can use. It's interesting because it's just two at the moment which is the supreme leader Akhundzada who we've been hearing about and the Chief Justice Abdul Hakim Hakani but you would like more. At least you have followed so many conflicts around the world. I'm wondering as you look at this that kind of push-pull of pressure could it make a difference? First of all it's very good to be joined by Fauziya Kofi. We've been discussing Abbas Stanekzai, the Deputy Foreign Minister who used to head the negotiations.

And I remember Fauziya telling me that he told her years ago that women would be able to enjoy all of their rights. They could do any job they wanted when the Taliban came back to power, except to be a prime minister. They could choose, he used the strange word, their own life partner. It has completely changed since they came to power. Nula, I remember one of the founding members of the Taliban wrote a book after the Taliban were ousted and he had this phrase, he said that about their first time they were in power, he said, we did not have the education then to make a deal with the world. In other words, people from the villages came to Kabul and didn't

understand the ways of the world. Now the leaders who are criticizing, you know, as Fauzia mentioned, they are engaging with the world. They understand the world has changed. The Taliban want to be a part of that world, but the Supreme leader lives in a world of his own making in Kandahar. And he doesn't, his edicts are not based on Islamic references. It's about a very ultra conservative reading of Afghan culture, of a time long gone by.

He has not moved ahead with the world. And it's very difficult to see how and when this will change. It will change at some point. The sad story of Afghanistan is that nothing lasts forever and we can only hope that the the wiser members of the Taliban will understand that their interests and Afghanistan's interests, in order for them to align, there has to be a place for all Afghans including its women and girls. BBC's chief international

correspondent Lise Doucet joined by Fazio Khufi, former member of the Afghan Parliament. She was the first woman to be elected as second deputy speaker. Thank you so much for that comprehensive look at what is happening in Afghanistan when it comes to women and girls. As some of you getting in touch, we're talking about constipation in school children arise in the numbers of hospitalisations for that. Let me see here's one. My four-year-old has suffered from constipation for nearly a year. I came to a head on holiday in Italy last summer and took us by surprise. She was screaming in pain

every time she felt the urge to go and refusing because she was fearful it would hurt. This withholding made it all the worse. We ended up nearly having to take her to A&E as soon as we got home. We had to disimpact her, poor thing. But now nearly a year on she is complaining of tummy aches again. I'm at a loss what to do. She eats a lot of fresh fruit and vegetables, whole grain cereals but doesn't drink enough at school. Any advice would be much appreciated. It is life-ruining. So that's the sort of story we're going to be talking about a little bit later in the program 84844 if you would like to get in touch.

But I want to turn to a new documentary. It's called Harvest. The director and writer is Sophia Seymour. She has decided to film the intimate details of her journey of elective egg freezing. It's also called social egg freezing. journey of elective egg freezing. It's also called social egg freezing. Egg freezing is not normally available on the NHS unless you're having medical treatment which could affect your fertility. Egg freezing can also be part of the IVF process for example but there is another growing group of women that are choosing it as a form of fertility planning as it has been described. Sophia's in studio with me. Good to have you with us. Hello, thank you so much for having me. We also have with us Dr. Hippocrates Saris, a consultant in reproductive medicine and director of King's Fertility. Welcome.

Thank you for having me as well. What a great name for a doctor, Hippocrates. I'm going to come to you in a moment, doctor, but Sophia, let me start with you. I'm going to come to you in a moment, Dr. Butsevier, let me start with you. The reason, what was the decision to just decide to freeze your eggs? Wow, so it was a combination of things for sure. I had, I was 35, I made the film two years ago. I was 35. I just started my dream masters at the National Film and Television School. I'm ADHD and so really

approached things in all sorts of unconventional ways. So I'd had a really exciting career but then had decided to kind of go back and study in my mid-30s which didn't sit entirely well with me when a doctor said that I should really consider getting on with it if I wanted a child and that really shocked me and sent me into a tailspin. And so I started looking at the different options around. I definitely didn't want to have a child at that point and egg freezing presented itself as a real tool or a way in which I could think about saving, saving some time and buying back some agency.

Okay, the film is beautiful. I love the way it was filmed and watching it and it, I should say, every intimate detail is there. We go with you through this process day by day. What I took from it is that it is as much about being conflicted about motherhood as actually wanting a baby. The reason that you go to freeze your eggs, would that be fair? Yeah, absolutely. I think when people talk about freezing their eggs, it seems like it would be something you're doing because you really want children. But actually for me, it was kind of the opposite. I'd never really, I'd always erred on not wanting children and I'd felt very unsure about what that would look like for me. And so kind of

before even deciding to do the egg freezing process, I felt like I had to make a decision about whether I was, if I even wanted them at all. And so the film became a way to carve out time, make space for that and interview those closest to me. So I interviewed my mum and my best friend. With my mum, I'm kind of being sort of almost asking permission from her to kind of not have kids potentially. And with my best friend, I'm kind of reaching out and saying, hey, you know, we've done everything together since we were 20. What do you feel about this? I don't want to be going on a different route to you. That feels really scary. And then lots of the films set

in a swimming pool where I kind of set out these really intimate conversations with lots of different women and you hear their voices throughout the film. And from them, I was kind of just reaching out and saying, hey, you've had a child. What do you think? You haven't had a child. What do you think? And I was gathering together all these opinions and trying to make a decision because it's scary, you know, not knowing whether you're going to end up in the right place or not. But I suppose the question is, can anybody ever really tell you because it's such a personal decision. What did you think about the actual day to day of egg freezing? We see the realities of you injecting yourself again and again, for example? Yeah, so in the film, the opening sequence, or one of the opening sequences is me trying to inject myself for the first time, which felt like a monumental thing to do. I mean, who the hell knows how to stab themselves in the stomach

with a needle? That was pretty grim. And there's a lot of hesitation around it, as you would expect. But then actually, as you get used to it, it doesn't really hurt. And then as you get used to it, doesn't really hurt and then as you get used to it you can you sort of have to do it twice a day so you just get used to just stabbing yourself and it doesn't really feel too bad. I was struck by something you said that that you felt it was tragic in some ways because it was so far away from what traditionally would have been having sex basically to make a baby. Yeah, absolutely. I mean, I think when you're confronted with having to potentially think

about freezing your eggs, it does feel very lonely and isolating. And then you're kind of in your room with this box of injections, trying to kind of fill your body with hormones, to try and produce some eggs, to eventually try and potentially have a baby in about five or ten years time. It's not the best process to do and quite grueling and emotionally it takes its toll. And so it makes you reflect a lot on where you are. And I couldn't help but feel in some way a sense of failure or a sense of shame that I was having to go through it. So then making the film was almost like a taking back of that and saying, OK, I

refuse to feel these feelings. I'm going to make a film about it, put it on show so that we don't have to hide away from having to do it. I want to know how you felt when you saw the film off yourself, because it is an invasive procedure. And at one point early in the film, actually, you are being given a general anaesthetic, so you are unconscious, and once you are gone under, they put you in medical stirrups as they retrieve the eggs.

And, you know, the vulnerability of you there, I found it very affecting. And I can't imagine looking at yourself going through that. Yeah, it was definitely really tough to go through. I had an amazing crew, I have to say, who supported me through it. My editor especially sifted through hours of me talking on the video diary and footage of me at the clinic, speaking to the nurse, being injected, getting tests,

and eventually the big operation. But something happens in filmmaking, I think, where you can somewhat detach. I think we had a sort of code name for me, I think I was referred to as Caroline or something quite like that, so that I could sort of say, oh, she's really going on a bit in this take, should we just cut it? And so I was able to detach a bit and see my body more as a vehicle to tell the story rather than it being about me per se. With that, it cuts from you in stirrups to being spread-eagled in a swimming pool, which

is a similar position physically, but so comforting in comparison. Yeah, so the swimming pool is the total antidote to the clinic. The swimming pool was a sort of metaphor for the womb. It was a kind of safe space where I went to reflect, hear what the doctors had said, go over what they were saying, speak to women who could give me advice and feel cocooned in the water away from the kind of the world that was pressing in on me at that time. So yeah, it was a really amazing thing to have in the film. And I want to bring in Dr. Saras here for a moment.

Are you seeing an increase in women like Sofia who are not sure about motherhood going through this process? I think, first of all, I want to say it's a fantastic piece of work, because it's very important to demystify this and to make it more open to people to understand what we do because it is by the end of the day a medical procedure. And actually we have some data about it and we do see a year-on-year increase. So if you just look at the UK, the HFAA which is a regulatory body, the last data had from 2022 showed that compared to 2019, there's been an 81% increase in the

number of people come forward to freeze their eggs. And we've been seeing that trend increasing ever since. And actually, approximately 5% of all treatment cycles in the fertility sort of sector, so IVF and the rest, is for egg freezing for this exact sort of discussion we're having right now. But there are, as with all pregnancies, no guarantees and in the film, there was one doctor who said they don't have as much research on egg freezing in this manner as they do on the IVF process for example but they talked about one potential baby perhaps that's a big caveat from 20 eggs

I mean do we have any idea how successful it can be just not there yet with the figures? We have quite a bit of data unfortunately I do not like using the total words either guarantees or insurance policy. They're not success rates for egg freezing very dramatically based on multiple factors including Primarily the age at the time that the eggs are collected and the number of eggs being frozen That's more than when you actually come to use them But if you want some very very basic numbers to see how dramatically it changes over time for somebody who's more than when you actually come to use them. But if you want some very, very basic numbers to see how dramatically it changes over time, for somebody who's less than 35,

who let's say wants a 50-50 chance of having a child from those eggs, they only need about six to eight eggs frozen. And if they want a 90% chance, they need about 20 eggs. But let's go to 38. And I specifically chose 38 because that's the average more common age that women in the UK freeze eggs,

to reach that same 50% chance you need 12 to 14 eggs and to reach that 90% chance you're actually now talking about 35 eggs. So the numbers really changed quite a lot. I think it's important to make that very clear when people think about having egg freezing. And we're talking about thousands of pounds to do it because it's rarely available on the NHS unless you have some medical treatment that would be affecting your fertility. Absolutely, so unless somebody's going through medical treatment, maybe chemotherapy or surgery to the ovaries or other sort of conditions like that, it's not available in the NHS and although a cycle of IVF might be advertised to be around let's say three, three and a half thousand pounds, by the time you add the medication that can go anywhere from 500 to 2,000 pounds and then by the time you

add the yearly storage fee which can be around 200 to 350 pounds and then using the eggs we're talking really about seven to eight thousand pounds per cycle of IVF so it's definitely not cheap. And the process, I mean I kind of delve straight into it with Sophia, that you take hormones, follicles grow, eggs are retrieved, which is an operation under general anaesthetic. What else is involved? Doctor? I have a feeling I might... Yes, so...

Sorry, go ahead. The process of egg freezing is effectively like... So the process of egg freezing... Can you hear me? I can. You know, the line is breaking up a little bit. Let's try it one more time and we'll see how it works. Sorry, so can you hear me now? Yes I can.

So thank you. So the process of egg freezing is effectively similar to doing a cycle of IVF except that the 80% of it happens now which is the collecting the eggs and then 20% happens later. And as was explained there are these daily injections that continue for a couple of weeks. And this is known as the stimulation phase. And during this phase, scans or ultrasound scans are performed every a couple of days to look at the ovaries in order to monitor the progress of these growing follicles, which is basically where the eggs are inside, and occasionally blood tests are taken to check hormone levels. So once these follicles have

grown enough in sufficient size where we expect to collect mature eggs to retrieve them, you get this final maturation injection and you collect the eggs two days later. So this entire process takes approximately two weeks during which one has to visit the clinic for scans every two to three days followed by this egg collection procedure,

which is exactly as you mentioned done under anesthetic, where where with ultrasound guidance a little needle through the back of the vagina goes inside the ovaries to collect the eggs and then there's a take-in to the lab, the check for maturity and if they're mature they're frozen with a technique called vitrification and then you can actually keep the eggs for whenever you need them. In the UK surprisingly you can keep them up to 55 years. I read that this morning that you can actually keep the eggs for whenever you need them. In the UK, surprisingly, you can keep them up to 55 years. I read that this morning, that you can keep them for 55 years, which that's another conversation at another time.

But I do want to come back to another figure, Sophia. You might have seen figures like this as well. This is a study at Guy's Hospital that found just 16% of women who froze their eggs returned to use them. Yeah, I think that's what I was thinking about when listening to the doctor. I think the stats are still really opaque. I think it's hard to really make head or head or tail of it. And what I've seen, especially amongst my peers and my friends who are thinking about doing it, is it's it's really actually at the stage of doing it, it's about, and having the eggs eventually on ice, it's more like a psychological weight that's lifted. It's a way of kind of making

sense or taking back some kind of control over the decision and buying time. So then, I suppose then when you're thinking about whether people are going to use them in the future, who knows whether in four or five years time you're even going to be in a position to use them. It's just that sense of having the time to think about it away from the baby fever and the noise that can sometimes feel incredibly oppressive and trapping. Even though there is no guarantee obviously. Yeah absolutely. Like you've kind of got what you've got, in a sense, if you wait a number of years past prime fertility.

Yeah, I think there being no guarantee is obviously something to consider and I wouldn't advocate for anybody to kind of put their bodies through something like that. So grueling and it's so expensive, which then leads to the question of do I even want children? Do I even want this? It kind of each stage begets another question. But from my own experience I really felt that my whole perspective on whether I wanted children or not shifted after I raised my eggs for sure. Well where did it shift to? Well if I'm being completely honest, this is the place where I felt like maybe I didn't want children

actually after having that security. The Lister Clinic were incredibly supportive in getting me through the process. I didn't feel pushed into it by them at all. They were down the road from the film school so I was able to talk to the nurse every single day about it and my worries and actually by carving out that time I really felt by the end oh wow okay I've done this but actually I don't think I'm gonna go through with it in the end. So instead of fertility insurance policy and everybody hates that term because it's not really because there are no guarantees of a payout I don't know what what what you would call it it's something else right it's a focusing perhaps of the mind for you.

100%, I think you read a lot about this kind of inactive decision to have children. It's almost like letting time just play out without having to really address it. And I could feel myself doing that, just compartmentalizing, getting on with my career ambitions and putting it to one side.

So the egg freezing and definitely making the film was this real privilege to be able to carve out the time to really think about it and make a decision and so now when I'm asked by the inevitable people who say when you gonna have kids, why are you having kids? I can say do you know what, I spent some time thinking about it, I made a film I've frozen my eggs and right now I'm fine. I don't think I'm going to have them but I can maybe change my mind. But even though that's obviously

as we said not an insurance policy. What age are you now? I'm 37. 37. Thank you both for speaking to us so much. That is Sophia. You can find also her film online. It is Sophia Seymour and it's called Harvest. Good name. Dr. Hippocrates, Saris is consultant in reproductive medicine and director of King's Fertility. Thanks to both of you. I've been reading some messages that have been coming in this morning.

This is about constipation in children. Let me read this one. My seven year old daughter suffers with constipation regularly. It is awful. Obviously it's horrible for her but it's so stressful for us as parents too. Seeing her in discomfort is distressing. We have to give her laxatives hidden in hot chocolate and she's afraid of going to the toilet. Poor thing. Here's Helen, a retired GP says an apple a day really does keep the doctor away, unpeeled, and a glass of water at each meal. Meals eaten at the table. Wheat Apex is a great breakfast, fiber calcium in the mix, in the milk, excuse me, no sugar needed, there are other brands too. This is a massively

misunderstood condition, says another, it's very difficult to manage as a parent, so obviously many of you going through it, 84844 if you would like to get in touch. And the reason we're talking about it is because there are NHS figures that are in the papers today. It says more than 44,000 children in England and Wales were admitted to hospital with constipation last year. So that is a 60% rise overall in hospital diagnoses of constipation in primary school children in the past decade and increases also seen in preschool and secondary age groups. Experts say greater awareness is needed of the physical harm and misery, we're hearing about that from our listeners, that can be caused by the

condition, sometimes it's trivialized, there's definitely a stigma about it and people don't talk out about it so we're changing that here. I'm joined by Dr. Ellie Cannon, she's a GP and author, also Sarah Thames from Education and Resources for Improving Childhood Continence, which is a children's bowel and bladder charity. You're both very welcome to Woman's Hour. Let me begin with you, Ellie. Constipation is common in childhood, particularly when children are being potty trained, so it's around two or three years of age. Is there any specifics for how regularly a child should go to the toilet to poo? No, not really. I mean, it's the same as adults. People misunderstand constipation, as you alluded

to in what you've already said. Constipation means you have a difficulty or problem pooing. It's either painful when you go, it's hard when you go, it's difficult, you don't go often enough so it means you're uncomfortable. But there is no set time that anybody including a child has to poo. So some children will poo a couple of times a day and that's normal for them and some children or adults will poo sort of once every three days and as long as you're comfortable, as long as your life is carrying on, it's not affected and then that's absolutely fine. How is it possible for a parent to know there's a problem? Well I very much believe in parental instinct so I reckon parents

will know when there's a problem. Any toilet avoidance can be a sign of constipation. Any sign of course that your child is telling you that it's uncomfortable to go or not wanting to go. Feeling lethargic, having tummy pain, issues if you notice if you're still involved in your sort of child's toileting habits and you notice anything for example like of course blood in the toilet of course is very serious but also if you sort of notice that the poo is very pebbly or it's very hard or there's a teeny tiny amount and one of the other issues that we don't talk about, it's very stigmatizing, is children having accidents.

So children who actually have sort of soiling in their pants and that sort of thing, that can often be a sign that a child is holding on too long because they don't want to go because it's sore. And then they end up sort of having accidents or soiling. So that can also be a sign. Let me bring in Sarah Thames here. How do you understand the reasons for the increase? I was mentioning some of the figures at the top there. I think as Ellie says really, you know, there can

be a lack of awareness of the signs and symptoms of constipation. We also are concerned about less access to healthcare professionals and we know that GPs are under so much pressure now. But I think also there's a lack of access to health visitors. In the past, young children were seen regularly by health visitors but now again the health services is so stretched. So it's a combination of both really but we are really, you know, calling for a greater awareness of bowel and bladder health. And how do you want to do that? We really want to destigmatize toileting, We want to get more people talking about poo.

As you know, young children love talking about poo. As you get older, it becomes something that people are ashamed of and why we all do it. So I think that if we can just get more people talking about it, more people talking about what's normal and then raising awareness well what to expect you know and when things look different. Okay well let's talk about it and what are the common causes Ellie of constipation? Well lots of different things sometimes we don't know why children are constipated and there are obviously dietary reasons why children can be constipated, so for example not eating enough fruit. I get sort of quite concerned about the current sort of middle class commentating on sugar because actually we know that sort of sugar in fruit and fruit juice and particularly

in dried fruit is actually very good for children to help them poo and I've had patients who say to me but we don't want to give them sugar even in sort of fruit and actually we know that the sorbitol, the very specific sugar in fruit, it helps children to poo so definitely diet, being sedentary because if you're exercising your whole body that also exercises your bowels and gets you moving. Absolutely sort of Sarah completely rightly sort of mentioned sort of a lack of health care in terms of sort of getting the health of constipation but also we have a massive lack of toilets in this country which really doesn't help people so we really

have an issue with public toilets. Children often don't like pooing sort of in uncomfortable places and we need to feel comfortable where we poo so there's no public toilets. People don't like sort of going to the toilet in schools as well that can sort of be quite embarrassing. I mean is there a way to change that? If it's schools, for example, and many of these were talking about primary school children, I know there is increases in other parts of childhood as well. I mean, any thoughts, whether that's Sarah or Ellie? I think access to toilets in schools is an issue that we feel very strongly about.

We think that the voices of children and young people really need to be heard around this. And I think, as you mentioned, school toilets are not always very pleasant. There's a lack of privacy. So for primary school children, usually the doors, they're very small doors, you can see under them, you can see over them. And so, you know, children avoid pooing. So I think, yeah, we need to really listen. And we would love to open up conversations with these organisations, you know, and be working together to solve these problems. Let me read some of the messages that are coming in and the Romani. Here's one. When my son was a toddler, he started to get constipation.

He became very scared and held on to his poo, which went on for a long time. After numerous trips to the GP hospital, he eventually grew out of it. Only now as a 15-year-old, he told me that he hated the feeling of going for a poo. What about that, Ellie? I mean, gosh, that poor kid that went through so much. Yeah and that's quite a common story that I would hear and I'm sure Eric they've heard that a lot as well and actually you have to be able to sort of feel satisfied and comfortable doing a poo. That's why the environment as Sarah just said is so important because

you know you sort of might have to sit there for a little bit and you do have to feel so the feeling can feel a bit strange and I'm sure that is something that children really don't like and actually I do want to give a shout out to Eric because as a GP I do actually signpost patients and parents to Eric because they have all of these resources for children of all different ages to actually encourage children to feel comfortable about pooing and get used to it. It can be something that you don't need laxatives, you don't need a change in diet, you actually need a sort of emotional shift in feeling comfortable going to the toilets. change in diet, you actually need a sort of emotional shift in feeling comfortable

going to the toilets. And I will just say, Eric, is Sarah Timm's organisation, Education and Resources for Improving Childhood Continence. You mentioned fruit there. Two separate people have got in touch to say dried apricots are helpful as a snack or chopped up with cereal. Another, this is Jen Homecook's, Jude Plums Will Cure Constipation. I started eating them a few years ago. Haven't suffered since. Also delicious cold. Another, this is Jen Homecook's, hidden problem and one that parents find difficult to discuss, we provide advice and glad you're airing this and having a more widespread discussion.

But for a parent then Ellie, I mean what point do you think, okay I need to go to the doctor? I would say you'll know when you need to go to the doctor but basically if your child's daily activities whatever they may be are being affected by pooing then you need to go to the doctor so whether that is playing, play dates, going to school, sleeping, meal times, anything once anything is affected by constipation then you need to be going to the doctor and you can't go too soon so absolutely get help and referrals we have things called bladder

and bowel services for children and it can take time for referrals to sort of come to fruition so go sooner rather than later. That probably goes for advice for going for a poo as well. On woman's tower, there's somebody else got in touch saying, my son at four didn't want to go to the loo, I wallpapered the loo with comics and it worked. People go in, so there's a little tip, why not? That's fantastic. It's great, isn't it? Lots more tips if you want to send them in, 84844. I do want to turn to another aspect though as well. A recent survey suggested that one in four children starting school in England and Wales are not toilet trained.

I wonder what you are hearing about that Sarah. I mean some are asking you know how involved should teachers be for example. Well again this is something we'd really like to sort of, you know, to work with schools on. So the reason really why this number has increased and it's increased in the last sort of 10, 20 years is that nappies are so very good now. You know, they're very, very absorbent. Gone are the days where you would see your toddler with a saggy nappy walking around. So children aren't feeling that discomfort where they would want to come out of their nappies because they're perfectly happy and they've basically got a portable toilet.

They can carry on playing, they can carry on doing what they want without interruption. We've also again got the lack of access to healthcare professionals throughout those key years. And so, you know, and also more of the child led parenting where, you know, parents may well be waiting for their children to say, I want to use the potty or I want to use the toilet. But because they have got such amazing nappies, are they going to say that? So we have to kind of get in a bit earlier really with this. I had not heard that previously. Ellie, any thoughts on this? Yeah I think sort of you know that's absolutely right and I really see

amongst the families that I look after a lack of support whether that is community support, generational support and absolutely the concept of the health visitor and the funding for the health visitors. And we seem to spend a lot of time within the world of parenting, talking about things that are incredibly unimportant, like what snazzy buggy you're going to have

or that type of thing, as opposed to this type of thing, which obviously doesn't make for a great Instagram post but is probably much more important. I want to thank both of you for speaking to us, raising awareness as we talk about something that is often a little bit covered up or stigma. 84844 if you'd still like to comment on it. Dr. Ellie Cannon is GP and author. Sarah Thames is from Education and Resources for Improving Childhood Constance, also known as ERIC, which is a children's bowel and bladder charity. Now I want to turn to India where the country sporting greats have been walking the red carpet for this year's BBC Indian Sportswoman of the Year award. Taking the top prize was 22 year old pistol shooter,

that is Manu Barker, whose impressive Olympic performance and drive to succeed while both the expert jury and also the general public. Joining me to tell us more from Delhi is the BBC senior correspondent Divya Arya, who was at the awards last night. Welcome Divya. Tell us a little bit how this all went down last night. You should have been there Nula. It was a very, very impressive ceremony. We had the who's who from the political arena, sports greats, former players, but also the vice president of BCCI, the likes of media personalities, which you would want to come and encourage you uh... the achievers in such an honor

and uh... as you know the bbc organizes this indian sportswoman of the year every year to spotlight the achievement of women in sports which is not talked about so much in india and uh... the whole process as you mentioned first the jury calling out five nominees and then opening it to an audience vote is kind of a nice marriage, I feel, between a very professional assessment of how they've performed in the last year and really how the people are receiving

their achievements. And Manu Bharkar was the favorite. She was there to receive her award. And she was very gracious and very transparent in talking about her journey uh... she had almost quit the sport of shooting after she qualified for the tokyo olympics but wasn't able to win a medal though she had done very well at the commonwealth nation games

and then her pistol malfunctioned as well and uh... she said that she almost went into a depression. So yesterday when she got that honor she said she hopes it highlights the resilience that she has shown and makes other people inspired in many ways not just in sports. Let us hear a little clip of her Divya accepting the award. of Afrodivia accepting the award. I hope that this inspire not just so many women in our country, but also all the athletes and all the people who have big dreams, who want to do something big with their lives.

You write your story, so your story will continue till the time you leave it too. So I left my story not at Tokyo, but it continued. And I'm so grateful that I made it to Paris. You can hear the emotion in her voice there, Divya, can't you? Tell us a little bit about her. How did she begin shooting? Well, the good thing about Manu is she comes from a family that was very supportive and

had an interest in sports and her father encouraged her to join sport. But she comes from a state which doesn't encourage women in many ways. It's actually the state which has the worst child sex ratio. So it has a much lesser number of girls as compared to boys and is, you know, it's sad, but despite the law banning it, there's a selection of the fetus of the child through ultrasounds and then even the elimination by illegal abortions in that state. So people like her who have risen from that state and brought such laurels are making a lot of difference, as she said, an inspiration

not just for women in sports, but for women in general. Yes, and also I suppose that resilience that she had when she was kind of almost pushed to the side, because she got a lot of criticism and abuse after failing in Tokyo, but managed to come back from that is quite something. Indeed, and she also had a fallout. It was a bit dramatic with her long time coach when she was training for, you know, for Paris. And then she got together with him when she was training for Paris.

And that she credits him a lot for her success. And it has been, you know, something that everybody has been very curious about, you know, how that relationship develops. But it is so key and it spot been you know something that everybody has been very curious about you know how that relationship Develops but it is so key and it spotlights another issue that women in sports in India face Which is the lack of good coaches so because the contribution of sports women has been If I may say neglected or not paid much attention to they haven't got the best coaching potential backing them There aren't many paid much attention to. They haven't got the best coaching potential backing them. There aren't many female coaches and in fact we had somebody from the sports ministry at the event yesterday who promised that that's a problem they hope to correct in the policies

that they're going to be bringing in the future. Let us run through quickly Divya some of the others that we heard. Emerging player of the year? Oh yeah, she is such, she was such a favorite, such a darling, everybody wanted pictures with her. She is a very young girl, just turned 18 in January. She's an archer, one of the few archers in the world who play without arms. So she has a rare congenital deformity called focumelia and she uses her legs to you. And she won at the Paris Paralympics. So she was named the emerging player of the year. We also have a category which was introduced in the last edition called the Para Sportswoman of the Year.

Though in the five nominees for the main award, we did have a Para Sportswoman, but there was a feeling, and that's what we heard from the community, that they felt that these women need to be honored as a separate category as well. And Avani Lekera, interestingly, another shooter, got that award and she won a golden bronze in Tokyo and then returned to get that gold again in Paris, you know, setting a record for Indian female athletes at Paralympics, the first one to win three

medals and she was honored as the Paras Sportswoman. And the third award was the lifetime achievement. So just like we want to spotlight players who are just emerging, we also want to recognize the contribution of women who actually started out when women were not being talked about. So this time it was Mitali Raj. She's just retired a couple of years back. She's a cricketer, if you don don't know and she's been the longest running captain from 2004 to 2020 to 18 non-stop years of captaining the Indian women's cricket team. And some say that her journey mirrors the journey of women's cricket in India, where initially there was no money, women paid for their own travel, practiced on pitches with

riddled with pebbles, to now having come under the umbrella of the richest board in the world, the BCCI that runs the men's cricket, now runs them, kind of shows the change that is coming and the attention that is being paid to women. This is so interesting because we have covered cricket many times here on Women's Hour and it is Indians, women cricketers' salaries that are really at the forefront and leading the way globally. It's interesting isn't it that there's that dichotomy among for example some of the issues that women and girls

are facing that you mentioned and then them leading in other parts globally. Interestingly, Mithali Raj is one of the loudest voices who campaigned for pay parity for women in cricket in India and that's something the BCCI, which is the board for cricket control in India, one of the richest boards, agreed to very recently and which is why I say that her journey as a lifetime achiever also mirrors the journey of women's cricket in India and that is a hard won win. Yes.

So, good to hear about all those women. I hope you had a great night as well as Manu Barker did. I am sure Divya Arya. It was her birthday, you know. What is it? We got her to cut a cake. Oh, how great is that? She's having her best day and best year. Divya Arya, thanks for joining us. The BBC senior correspondent in Delhi. Your messages continue to come in about children and constipation. Here's one.

Children need to be helped to recognise when their bodies are signalling, signalling, to let the poo out and then given time to sit in the toilet in a relaxing manner with a book if needed. Children need their feet supported. You can't poo easily if your feet are hanging from the toilet. Another. My daughter based her A-level film final on her brother's constipation. Dried apricots, what a name. It got her an A, good woman. She is studying film at university now. Her poor

brother had to be bribed to be in the film but he did and it was a sterling job. Use a squatty pot or squat position, that helps, another tip. And on that I will leave it for today. Do join me tomorrow when we will be looking under the hood of Formula One and what it is like for women within that world. I'm going to be joined by female Formula One driver Jamie Chadwick, I'm looking forward to that, and also a live performance in the studio of the punk band the Labrini Girls. We're going to be able to hear them loud and proud in the Woman's Hour studio tomorrow. I do hope you'll join me 10 a.m. right here.

That's all for today's Woman's Hour. Join us again next time. I'm Nicola Cochlin and for BBC Radio 4, this is history's youngest heroes. Rebellion, risk and the radical power of youth. She thought, right, I'll just do it. She thought about others rather than herself. 12 stories of extraordinary young people from across history. There's a real sense of urgency in them. That resistance has to be mounted, it has to be mounted now. Subscribe to history's youngest heroes on BBC Sounds.