Woman's Hour - Botox, Covid-19 and pregnancy, Tidying and decluttering, Debora Harding

Episode Date: September 8, 2020

What do we know so far about COVID – clinically and scientifically – in women, including those who are pregnant. Jane talks to Professor Louise Kenny a clinical academic from Liverpool Women’s Hospital We’ve all heard of ‘tidy desk, tidy mind’ but is there any truth in the well-known phrase? With all of us spending more time at home during lockdown, many people used that time to have a clear out and get rid of some clutter. After so many TV shows appearing where we watch people tidy others’ houses, we ask why tidying up is so satisfying and if the amount of clutter we have in our homes can affect our mental health. Now that non-invasive cosmetic procedures are able to resume operating after lockdown, are treatments such as Botox being normalised? We take a look at the trends over time and speak to a regular Botox user about how people’s attitudes to Botox are changing. It was watching Christine Blasey Ford testify against Brett Kavanaugh that finally convinced Debora Harding that she needed to write her own memoir. The result, Dancing with the Octopus: Telling of a True Crime. The book tells the story of Debora’s kidnap and rape at the age of 14 in Omaha, USA and the aftermath while living in a dysfunctional family. Debora talks to Jane about reckoning and recovery, the long terms effects of trauma, being a survivor of violent crime and how our families shape us. Presenter: Jane Garvey Interviewed guest: Professor Louise Kenny Interviewed guest: Rachel Burditt Interviewed guest: Heather Sequeira Interviewed guest: Mel Abbott Interviewed guest: Alice Hart-Davis Interviewed guest: Debora Harding Producer: Lucinda Montefiore

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hi, this is Jane Garvey with the Woman's Hour podcast from Monday the 7th of September 2020. Big day for the programme today and let's hear the actual radio programme before you rejoin me in the podcast lounge right at the very end. My big news this morning, slightly dwarfed by other big news connected to the programme, was that I had received a new keyboard. Yes, I've got a brand new, that's my big news, I've got a functioning keyboard. Only five and a half years I've been waiting for that and it arrived this morning, of all mornings. Welcome to the programme, welcome to Woman's Hour, where of

course there's big news and we heartily congratulate Emma Barnett, who is going to be the new presenter of the programme from January. I had her on the blower a little earlier. She's full of beans. Can't wait to get started. And I wonder if actually if we can hear her on Five Live now because she is. Dozens of people have given her that. No, that's the opposite of slick, isn't it? We join Five Live and she's not actually talking. Anyway, Emma is on Five Live live at the moment or she will be in a couple of moments. And she will be taking over here at Women's Hour in the new year. So I hope you will look after her and anyone who writes off Women's Hour, by the moment, or she will be in a couple of moments. And she will be taking over here at Woman's Hour in the new year.

So I hope you will look after her. And anyone who writes off Woman's Hour, by the way, does so at their peril because we roll on and we'll be in very perky form indeed in January and indeed until January. This morning on the programme, has lockdown inspired a declutter in your house? And I'll talk to Deborah Harding,

who has written a very, very powerful memoir. It's called Dancing with the Octopus. It's about how she survived violent crime and indeed came through her own family. Deborah Harding on Woman's Hour this morning. First, though, to the University of Liverpool, which is running a study called COVID Prep. Now, this is community based and it's looking at COVID-19 in pregnancy. We're going to talk to Louise Kenny, who is the chief investigator and a professor of obstetrics, a clinical academic at the Women's Hospital in Liverpool.

Louise, good morning to you. Morning, Jane. Now, this is really, really important stuff, your research. In short, it's a plain fact that in pandemics, pregnant women don't do very well at all. And you were expecting the worst from COVID, weren't you? But what's actually happened? Yeah, that's absolutely correct, Jane. So historically, we know going back as far as the 1918 pandemic with Spanish flu that pregnant women are vastly overrepresented in mortality rates. To set that in context about 27 percent of pregnant women who

contracted Spanish flu in the 1918 pandemic died of the condition. So that tells you that they are hugely at risk and we saw something similar in the H1N1 pandemic of 2009, 2010. So when COVID first appeared in early January, quickly followed by Italy and more latterly the UK, has actually shown that pregnant women are not particularly at risk. And those that do badly in pregnancy tend to have other risk factors, such as pre-existing medical conditions, or they belong to an ethnic group that's known to be at risk. Right. And we will talk about that later because that is hugely important. But why do you think this has been the case? Well, we've got a couple of theories, but I should stress at this point in time, they are still theories. And one of my big frustrations is that

at the moment, the quality of our data is quite poor. So we know that we're not seeing the number of women that we perhaps might have expected to see in the maternity units and on the ICUs with COVID. But what we don't really have a feel for is the actual denominator, the number of pregnant women in the community who are contracting COVID. So right now, I can't tell you whether pregnant women are getting the disease and they're just not getting sick or whether they're not actually picking up the infection in the first place. And that's a fundamental question that we need to address. And hopefully COVID PrEP, the study that we're running at Liverpool, will shed some light on that. So how are you doing it? So in the UK, when pregnant women book for antenatal care, we take a sample of blood to look at their exposure to viruses of interest, particularly things like rubella. It's really important that we know whether a woman is rubella immune in pregnancy.

That sample gets stored on average for about two years. And we've got permission to actually take those samples out of storage for 16,000 women who've booked for antenatal care at the Liverpool Women's both before and during the pandemic, and actually performed serology or antibody testing on those samples to look at the passage of COVID through that pregnant community. It's a very large community, all booked through one hospital, so it's a very feasible study. And this will tell you then, because you'll be tracking these women over how many years?

So we're doing this study over two years. We're looking at the year before the pandemic hit and this current year, 2020. And we'll be able to look at, we'll get a good feel for the denominator. We'll know because we're sampling every pregnant woman what the actual baseline in terms of the infection in that community was.

And then we'll also know because we'll have hospital level data, what the complication rate was. And the antibody testing, that is, I mean, that's good enough, is it? Well, interestingly, when we first designed the study, there was a variety of different antibody tests under development. And we didn't actually specify which one we were going to use, because it's a very quick, very fast moving field. But we are getting close. In fact, we do now have an antibody test that has the required sensitivity and specificity for us to do this study. Right. And let's talk then about one of those vulnerabilities you mentioned, because we do know that a much higher percentage of women who

really suffer when they're pregnant from COVID are women of colour. Now, why do you think that might be a massive issue? Well, frustratingly, and incredibly importantly, women of colour are overly represented in mortality statistics from all causes of mortality and pregnancy in all high income countries. And in fact, maternal mortality, which has fallen year on year in countries like the UK and other high-income nations over the last century, is now actually going up in the States. And that's largely been driven by mortality

in black and other ethnic minorities. So, and it's a complex, there is undoubtedly a set of complex reasons. But institutional racism is absolutely one of them. In addition to... Can I just interrupt you there? You say institutional racism, and I want to know how practically that manifests itself in antenatal care. Well, lots of studies have shown that black women and women of colour often present late with diseases that, had they presented early,

interventions would have been very effective. Which, forgive me, but slightly puts the blame on them, or appears to. No, far from it. Normally, not at all. They frequently present late because they are marginalized through other sort of factors of society. There is a lack of outreach. There is a lack of understanding in the community that they might be particularly at risk. One particular condition that I have spent a long time researching is a condition called preeclampsia. Now, we've known for quite a long time that black and Afro-Caribbean

women are much more at risk of preeclampsia for a variety of different reasons. They are genetically probably more predisposed to this condition. But we've not made many attempts to educate the very communities that are affected that they are at particular risk and to educate them as to the early warning signs and the necessary steps to take. Right. Can we talk too then about your study? Because your study, based in the northwest of England, around Liverpool, I know Liverpool Women's Hospital is phenomenal and much admired, but will you really, will your results really be able to help women of colour who may well be at high, well, we are, we know they are at a higher risk of COVID-19,

bearing in mind that you will not be looking at the most ethnically diverse population in the UK. No, you're right, Jane. And you'll know from having grown up there that our city of Liverpool is not particularly ethnically diverse. And in fact, the BAME rate within our pregnant community is about the national average. So it's very different to cities like Bradford and Manchester.

We are, however, studying 16,000 women. And with a 10% BAME rate, average so it's it's very different to come to cities like Bradford and Manchester and we are however studying 16,000 women and with a 10% BAME rate there will be a significant number of BAME women within that cohort but our hope is that by publishing this by doing this study and publishing it we can share the data nationally and perhaps inspire others who work in hospitals where they or areas of the country where there are more ethnically diverse to follow suit and do similar work. It has been a key factor and much discussed, not least on this programme, that men are actually at significantly higher risk of dying from COVID-19. Oestrogen is generally pointed to as being a possible explanation.

Are we getting close to a situation where we might be giving men oestrogen supplements? Well it's a really interesting question and I heard the interview with Louise Newsom my colleague and collaborator a few weeks ago on this programme. So you're right women in general do better in Covid than men but some of that protective effect appears to be lost at the menopause which has led us and others to look at the role of female hormones such as oestrogen in terms of their protective effect. And that may well account. It's one of the hypotheses that we're working on in pregnancy, because in pregnancy, oestrogen levels go up by about 300 fold. So that may be one of the reasons why pregnant women seem to be doing better. And in fact, it has inspired some clinical researchers in the

States to start a trial of estrogen, transdermal estrogen. So basically, estrogen patches that listeners may be familiar with as a form of HRT. There's a trial of this treatment modality in male patients that have been admitted to the ICU with severe COVID in the United States. The trial hasn't published yet, but I think it has completed. So that's one theory. The other theory is that in pregnancy, particularly, the maternal immune system is ever so slightly altered. And that's really to allow the mum to grow a baby,

which is at least half foreign, antigenically foreign to her, without any complications. And that's probably why women have done so badly in previous pandemics, because that change in immunity makes them very susceptible to viral infection. It's why every year we concentrate all our efforts on having women vaccinated against flu. And we know that if women get things like chickenpox in pregnancy, they can be very sick. um covid seems to be a very different disease and you might have heard or the listeners might have heard about a phenotype of the disease a type of the disease whereby patients get what's known as like a cytokine storm they

have a particularly inflamed multi-system disorder and these are normally the very severe end of the spectrum the patients that end up on the icu And one theory that we're working on is that in pregnancy, that subtle alteration in the immune system actually prevents pregnant women from manifesting the most severe phenotype of the disease. So, you know, they may well pick up COVID, but they don't get that very severe cytokine storm inflammatory picture because their immune system is altered in some way. It's absolutely such a fascinating area of research. Best of luck with everything you're doing. Thank you very much indeed. Thanks Jane. That is Louise Kenny, a clinical academic now from Liverpool Women's Hospital but also a professor of obstetrics. Now if you've been stuck at home as so many of us have perhaps for a slightly longer period of time than you might have expected, has it inspired a bit of an old declutter?

Have you just looked around you and thought, I've got to do something about this? Rachel Burditt runs a business helping people declutter and Heather Sikira is a psychologist. And we'll talk to Heather first because I gather we've just lost Rachel. So let's talk to Heather. Heather, what actually, what's the definition of clutter?

Hi, Jane. It's lots of stuff all out of the place, what's the definition of clutter? Hi, Jane. It's lots of stuff all out of the place, all over the place. It's a kind of visual noise that distracts our brain and essentially drains its resources. Drains its resources? I haven't thought of it quite. But that ornament you picked up in, I don't know, in Blackpool 25 years ago, that's draining my resources, is it? If there's a lot of stuff around in your environment, yes, potentially. So from a neurological standpoint,

this kind of visual noise is continually draining our attention at a micro level. And if you imagine there's lots of stuff continually vying for our attention, our brain is trying to work harder to filter out what's important in that moment and what's not important. And as we have a finite level of resources, our brain has to decide what to attend to and what not to attend to. Yes. It's distracted. Can you tell me the difference between mess and clutter or is there no difference? I don't know that there's any difference there. There isn't. Okay. But untidiness then? Well, I think it's all on a continuum.

Perhaps untidiness is at one end and at the other end there's clutter. And then maybe at the far end there's hoarding, a clinical condition where people just accumulate more and more belongings and stuff until they can't have their lives as they want them anymore. Stay with us, Heather. Rachel's with us now. Rachel, good morning to you. Hello. Morning. You're a professional home organiser. What does that mean? That means I will come into whoever's home would like me to and declutter and organise whatever area of their home they want me to, whether that's a kitchen cupboard, a wardrobe, a toy room, you name it, I'll organise it.

What kind of people get you involved, Rachel, and what stage of clutter are they at when they call you in? I have a complete variety of clients. So I have your retired couples that are downsizing. I have busy parents that are time poor and are needing someone to come in and overhaul the toy room or the boot room. And then I have a couple of footballers wives who just want beautiful Instagrammable wardrobes. Yes, carry on. And the level of clutter, it depends on the type of client. So I have come across people at the end of the hoarder scale all the way through to, as I said, someone that's got beautiful designer shoes that just wants them colour coded and matched up and looking gorgeous.

So it is a complete scale I'm looking at. I don't doubt your expertise, but couldn't you do that yourself up to a point if you felt that passionately about it? Absolutely. I say to people, it's not rocket science at all. It's just whether you have the time and inclination to want to do it yourself or actually, you know what? I'm going to spend my time doing something else and get somebody to come in and do it professionally for me so that when I come back from work or I pop to the shops and I can open my wardrobe and I've got this beautiful organised wardrobe and clothes. When you go into the house then do they they have to hand over control to you do you give them something and say look why are you hanging on for example I've got my children's school reports and their you know their little busy books from reception and things like that I don't know why I've got them I don't know who else is going to want to look at them.

But I can't bear to throw them out. What do you say in situations like that? I always say to my clients, I am never going to throw anything away personally. It is their choice. But I'm there to talk them through it and to understand. For example, your children's school books, take photos of them, download them onto your computer

so you've still got the memory if you don't want to be keeping them. So there's always ways around of keeping a memory rather than actually having the physical side of it. Have you, you mentioned hoarding. I mean, that is a very, very serious condition, I know, and it's in no way amusing. But have you ever come across somebody who is genuinely really struggling with that condition, Rachel? Absolutely. I have had quite a few clients who, if they've had a loss in their life, a family member or a child, they found it very, very difficult to let go of something. And again, that's not my full expertise. I am there to kind of help them as much as I can. But as I said, it's down to people to make that decision so it can be quite tough for people to let go of items

Yes, I mean there's obviously a spectrum here Heather but this is a very real problem for some people isn't it, hoarding? Absolutely, yes It can be really disabling for some people And do you link it? They don't have people in their house anymore and it can be really shameful Yeah, well Rachel linked it to loss of a person.

Is that the start or can that be the starting point? That can be the start of it, yes. There's often a lot, a whole host of losses in people's lives who go on to hoard, absolutely, or other aversive life events such as traumas or stresses. They kind of build up and they just decrease a person's capacity to organise their stuff and to declutter. And it just gets on top of people. People get into a real vicious circle, feeling super overwhelmed in life and then just unable to sort themselves

out without help sometimes. Is there any logic to what they hoard? Sometimes there is. So Rachel's already talked about sentimental items that might have belonged to somebody that they cared about and have lost. So yes, there can be. But often there isn't. It might just be a toilet roll, or it could be building up cans of beans in the cupboard, or it could be newspapers. So literally, it can be anything. And when you talk to people who are in that situation, what's your starting point? To start small, to start small and build it up bit by bit. Because these people are naturally feeling very overwhelmed, super overwhelmed in life. So we have to make it doable for them. So to start off building up from

just maybe clearing out one small area, maybe opening some posts that has been building up by their front door for several weeks. Maybe it's just starting off with one letter if a person is really overwhelmed. But then we build up to bigger and bigger things. And to somebody listening now who is perhaps concerned about a relative or a good friend, when or how do you intervene? That's tricky because it's about not shaming the person, but to go in really supportive to them so that they know that you're absolutely on their side, that you're not going to shame them anymore, that you're going to just help them get through this bit by bit. Yes. It's not tremendously easy to do, is it, to put it mildly? No, not at all. Sometimes you need external help, maybe clinical help from the NHS or maybe

somebody such as Rachel. Yes. But of course, there is also a very important health and safety impact here. If somebody is living in an overcrowded property, then there must be a fire risk. I mean, this can't be ignored, Heather, can it? No, no, no, no. And there have been cases where fires have been caused by newspapers stacking up or other hygiene problems from all the clutter that's there that hasn't been sorted. Yeah, I think we do need to make clear there is obviously a genuine mental health situation here.

And there are other situations in which people like Rachel can go in and just help people sort out their stuff. It's a totally different thing in lots of ways. Heather, what about your, sorry, Rachel,achel rather what is your own home like it is well i have two small children so it's it is organized but um i'm not very specific about everything has to be organized all the time as long as everything's put away at the end of the day everywhere has a home my children know that there's a system of where things go um but i am pretty relaxed when it comes to having toys out and things everywhere. But I do know where my car keys are in the morning. So I am organised when it comes to that level, definitely.

Yeah, but are you somebody who will quite vigorously and rigorously clear away everything at the end of the children's day? Absolutely. I have to. I like a clean, clear space. I'm not quite a minimalist, but I'm getting there. And my children are the same. Well, one of them is very similar to me that they will organise and tidy and put things away and like a nice clear bedroom at the end of the day. Right. Okay. And I'm just interested, Heather, in where our minds are set in terms of our approach to clutter. Is this something, is it genetic? Do you inherit this? There's certainly no gene for it. And I think it's mainly about life experiences that have happened to us. And, you know, the current life stresses that we're

under, for example, in lockdown, you know, this has been a big disruption to normal routine for most people. And for some of us, we found ourselves with more time, and that's been a big disruption to normal routine for most people. And for some of us, we found ourselves with more time and that's been a real stimulus for decluttering and also for organizing because it's been a really effective way of feeling more in control. But for other people, we just had more and more stresses. We've had homeschooling to do with, we've got caring for others, we're working from home and perhaps we haven't got a home office we're having to work from our kitchen table or our bedroom so there's more clutter about yeah and all these additional life stresses plus the physical material itself can really build up so it's not a simple answer no it isn't a simple answer it's not a simple

business i have to say when things began to open up i was stuck in a mysterious queue of traffic which i really didn't understand why it had built up or why it had built up where it had. And it turned out to be the queue for the tip that people had just decided as soon as they could, they were going there with some urgency. I mean, to be fair to me, it's one of my happier excursions of the of the year, the trip to the tip. Thank you both very much indeed. Rachel Burdett, who runs a business helping people declutter and reorganise, and Heather Sekira, who is a psychologist. Now, tomorrow on Woman's Hour, PC Andrew

Harper's widow is going to talk to me after her meeting with the Home Secretary Priti Patel, and I'll chat too to Stephanie Yeboah about her new book, Fatally Ever After. Stephanie's a really popular influencer. She'll be with us on Woman's Hour tomorrow. Now, what about Botox?

Is it being normalised? More and more people are talking more and more honestly about their interest in Botox and, in fact, their use of it. Katlin Moran famously was against it. Now she's an enthusiast. Melanie Abbott is a reporter for You and Yours. Alice Hart-Davis is a journalist and the founder of thetweakmentsguide.com. Mel, good morning to you.

Good morning. What is Botox? Well, Botox is a trade name. It's made by the company Allagan. It's a real money spinner for them, a multi-billion pound product. It's made from a toxin, which is the same one which can cause the food poisoning botulism, but it's used in incredibly small doses and it's injected into your muscles in small amounts and then it causes temporary paralysis by disrupting the nerve signals to that muscle. And that's where you get the frown lines that stop appearing.

Right. And how long has it been a part and parcel of the beauty business? It's been around for quite a while now. I mean, it was initially used for things like spasms, facial spasms, twitches. It's also been used for quite a long time for things like cerebral palsy in children. But apparently it was discovered, its kind of beauty effects were discovered by a woman who was having it for eye spasms. And then mentioned that she had found that her frown lines were disappearing and was saying, you know, can you put a bit more into my brow? So that's when it started to be marketed as a beauty product. Right. And it's now available, some would say worryingly, on the high street.

Well, that's right. Two years ago, Superdrug began providing it in its clinics in store. You can get it there for £99. It's only just actually reopened two of its clinics in london you can only get it in two london clinics at the moment because of lockdown but there were people who were saying that you know that was what was making it seem like popping into the hairdressers you can pop into a pharmacy and get it done that was a lot of people said that that was when it started to be seen to be far more normal. I mean, I think in truth it was. Well, I've got to be honest, I dye my hair. What's the difference? Well, that's what some people argue. But I mean, the difference is, I suppose,

that this is a medicine. It's a prescription only medicine. I mean, there are those flying under the radar who are getting around those rules. But it is a prescription-only medicine. Let's bring in Alice Hart-Davies. Alice, how often have you had Botox? I guess I... How often in total? I haven't added it up. It's about two or three times a year. Right. And you started when? I started in about 2003 or 2004,

because I'd been writing about non-surgical cosmetic procedures and beauty for over 20 years and so yeah I was well aware that it was there but I was a bit wary of it at first and the first time I had it done actually it's uh back in those days it was all about just getting rid of the lines so I was given a whacking great dose, which just totally immobilized my forehead. And that was so terrifying. I had to have a fringe cut to hide the evidence because it looks really, really unnatural. We need to move our faces to communicate. And anyway, I went back to it in time, of course, because I was 40. I had small children. I had a full-time job. After a bit, looking at those lines on your job, you know, after a bit looking at those lines on

your face, you think, would it be so bad to try this? Yeah, sometimes I wonder whether being short-sighted has actually protected those of us who are short-sighted from some of these some of these worries. I've just never really seen myself all that clearly for so long. Is it, do you regard it Alice as a an indulgence or a necessity i think for me it's lucky and different because it's part and parcel of of my job but it would indulge it's totally an indulgence nobody has to do these things my goodness um and a lot of people are very vocal about why we shouldn't it's totally a choice for the individual but there are quite a few people who were getting very twitchy during lockdown because they have come to regard it as

a vital part of their beauty upkeep you know to your point about um about about being like sort of hair dye or something you know it's not because it's a medical procedure but um a lot of people just are not interested in knowing what their faces look like when um when they're left to go go natural so you're talking about the impact of zoom and all of us having to those of us who do work from home occasionally having to see ourselves in a way that we we may not have done in the past yeah but you were very young when you first had it done can i just ask did it did anybody notice? And if they noticed, what did they say? I was 40. I wasn't that young. Well, that is young.

Except that you now get a lot of 25-year-olds doing it preemptively, which I think is awful. But that's another point. Back to what you were asking. Nobody did notice because I got the fringe cut quite quickly and it was very uncommon in those days. I was already writing articles about how it's so normalised that Kensington ladies think nothing of dropping their other appointments in order to accommodate their Botox practitioner. I was writing that in 1999, but that's a minority. There's nothing all that normal about living in or around talking about in 1999 minority it's there's nothing all that normal about living in or around kensington in west london is there totally totally true yep and and this was this was you know that that kind of um london features stuff trying to

make it make it all sound like whatever but it was it scared me not being able to move my face so that's why i didn't go back to it but then you know then you discover the better practitioners who have a more subtle touch with it because all I want really is softening the kind of pleat I get between my eyebrows and what drove me to it was when people like my mother started to say why are you looking so anxious when I wasn't anxious at all I was just thinking yes um this opens the rather large maternal can of worms doesn't it but um what is wrong we're all going to die we are all mortal what is wrong with just growing old and looking like you are because it's better than

frankly not being alive at all there is nothing wrong with that and we know we are lucky to be alive but a lot of women choose whether because of those embedded societal pressures to want to look fresh they want to look good for their age. Do they look fresh or do they just look like they've had Botox? Well that depends who you go and see you know what puts people off is trying tweakments is because of all the judgment around it because we've seen so many examples so many people looking weird hollywood celebs um you know footballers wives um love island people there's a very done look that is easy to spot and people are becoming better at spotting that that is work rather than just looking weird. But there's also.

Sorry, I just want to bring back Melanie, Alice. Thank you. And by the way, I should say I happen not to have had Botox, but I can't. Can I honestly say that I never would? No, of course I can't. Melanie, do we know how many men are having it? Well, it is still predominantly women. But there has been a survey done by the British College of Aesthetic Medicine. Now, a caveat, they do only represent doctors and dentists who carry out Botox in the UK.

And of course, there are procedures done by nurses, too. But they say that men make up less than 10 percent of their clients. Now, interestingly, during lockdown, I was doing a piece on how many people were trying to get around the rules where you shouldn't be going to a facial clinic. And I did talk to a young man, quite a young man. He was a hairdresser and he had had it done in lockdown against all of the rules because he was so desperate to keep up appearances. Right. So there are men out there. Yeah. No, Alison, I think you'd echo that, wouldn't you? Yes, men are increasingly keen on this and the surprisingly growing proportion of middle-aged men either because they've come through divorces and want to sharpen themselves up again or because their wives perceive them to be getting on a bit and send them into the practitioners who they, the wives, are seeing. But, you know, it is a small proportion. It is kind of 10, 15 percent, I'd say, a bit more than that BCAM number.

Right. And there are no harmful side effects at all, Mel. Are we sure about this? Well, there appear to be no longlasting side effects from Botox. The complication rates are really pretty low, but you may have a problem, according to the stats from the British College of Aesthetic Medicine, in five out of every thousand treatments. Now, the thing about Botox, though, is it does wear off. So you can, if it's injected into the wrong place,

you can, for instance, get an eyelid droop. Not very attractive, not the effect you're after. You can also get something called a lip droop, which, of course, doesn't look great either and might make it quite difficult to eat until it wears off. But that would worry me. Does wear off. Well, yeah, you wouldn't be very chuffed, would you? There are slightly less significant side effects. So you can get a headache.

You can sometimes get flu-like symptoms, people report. And there can be redness or even bruising. And as you've also discovered, if too much, or also discussed, if too much is injected, then you can end up with that frozen look that we've all seen on some people. Yeah, I know we absolutely have. And to go back to my earlier point, I pride myself on being able to tell, I think, when someone has had it.

But perhaps I don't notice those people who've really paid a load of money to have it done. And as I say, go on, Alice. But that's why celebs get away with lying about it. Because, you know, most celeb interviews, they will say, I tried it once, it made me look look weird i've never done it again it's my party to go up to doctors and nurses at conferences and say so doc i hear you're doing less botox and they look like baffled say what do you mean you know this is my number one procedure i said well so many interviews so

all these people have given it up you must be going out of business and then we all laugh and they say you know it's because we do such good work such subtle work all those people can get away with fibbing about it also so there are other brands of toxin which aren't botox and a lot of practitioners offer more than one of those brands and a lot of their clients will come in and ask for specifically the other brands so that technically they can say they're not having Botox because they had Dysport. They have had Botulinum Toxin A injected in there for it, but it wasn't actually Botox. Yes, it makes it sound so appealing when you put it like that. Just very briefly, Alice,

is there going to be a time when you just stop? Because let's say you've got to 65 or 70 and you think, well, I know I don't need to worry anymore. It's over. No more Botox for me. Me for myself? Yes. I don't know. I always think the key thing in any of these treatments area is to know when to stop with any procedure before you look weird. So I don't see myself stopping.

But there may come a point where um, where I think what's, what's the bother, but mostly, I mean, it's also because I got a professional curiosity in this area and I want to see what these things can do. You know, I don't just have Botox in my forehead. I have it in my chin, um, down the sides of my mouth, you know, where you pull it down around the sides of the eyes to stop the crow's feet being quite as bad as they are it's just like my name was saying to damp it down it's not to knock it out so um you know in my forehead is looking pretty natural after after after lockdown i haven't had any more since but i will go and have some more at some point so to your question i don't know i don't know you've been incredibly really honest

and i really appreciate it thank you very much al-Davis, who's a journalist and the founder of thetweakmentguide.com. And you also heard from Melanie Abbott, of course, who's a reporter for the formidable You and Yours. Thanks to Mel for taking part this morning. Your thoughts on that, very, very welcome indeed. At BBC Women's Hour on Twitter. Now, it was watching Christine Blasey Ford testify against Brett Kavanaugh that finally convinced Deborah Harding that she really did need to write her own memoir. And the result is her book Dancing with the Octopus, telling of a true crime. It's the story of her kidnap and rape at the age of 14 in the States, and indeed, the aftermath of what happened to her at such a young

age. Deborah, good morning to you. Good morning. We'll talk about what happened to you, but we'll also talk about the fact that it was, as you say, as the blurb for your book says, it wasn't the most traumatic, defining event in your childhood. So what did happen to you when you were 14? Thank you, Jane. On November 22nd, 1978,

I left my school to make my way over to church choir practice and there was an ice storm descending and when I got to my church, the doors were locked. I found out it had been cancelled and so I turned to go back toward my school and a van pulled up in front of me. A man in a ski mask thrust a knife at my throat, hurled me into the van. After about a half an hour, it became clear that he was holding me for a ransom and forced me to call my father.

After that, I thought I'd be safe, that we'd be going to the pickup point. And instead, he put a burlap bag over my head, tied my hands, took me to an abandoned area, assaulted me brutally, and then left me basically to die near stockyards in Omaha. A truly horrifying experience. And I'm very sorry to make you relive that again. But it does, it has to be said so that we understand that the setting for your memoir, because the truth is that your home life was actually pretty wretched. This really wasn't the, incredibly, it wasn't the worst thing that happened to you.

Yes, Jane, it's very interesting having these conversations, because I have to tell you, it's taken 40 years to pull the different threads of this book together. Because what I was really interested in doing was looking at the longterm consequences of this crime, the four of us that were involved in it, and the way it continued to act on each of our lives as we worked toward a narrative that encompassed the real true elements of what was working on all of us. And I felt like at the age of 56, I was in a unique position to come back and

basically kind of take true crime on in a recalibrated form, in terms of memoir, by really looking at the empathy that we give offenders and reframing that from a survivor's perspective and a true storyteller's perspective. So the people involved, you mentioned four people there. You're talking about your assailant, about your parents and you. Is that right? That's correct, yes. Your mother was a really, really difficult woman.

And she simply, she didn't offer you anything like the nurturing and the comfort you might expect from any sort of maternal figure. Is that fair? That would be fair. That would be probably the surface beginning of it. abuser, drunk, somebody who has no need to check their moods and is incapable of imagining the reality of anybody else in the home. So in, in, in separating her from actually the cruelty I experienced from the crime and the cruelty she inflicted on my, my sisters and I, literary was a difficult thing in terms of unfolding it. But yeah, she is what a child abuser looks like. When did you realise that in fact, you had PTSD?

Well, I'd like to say when I arrived at the door of hard-earned adult happiness, I had just moved to London to be with my husband at the age of 28. After having experienced 10 years of real professionally rewarding career and friendships and everything else. And that's when the night terrors started. And my husband was there to witness them. I think I experienced them actually, you know, all the way back to the age of 14. But it was the first time that I was actually sharing sleeping hours with somebody so that he had a real glimpse of what was going on. And the fact that you've written this now and the impact of Christine Blasey Ford, I'm really interested in that. What was it about that that just made you think,

now I've got to do it? It really pushed things over the edge because I had a unique opportunity with this book because of the restorative justice system that I went into to get the truths and the facts of my crime 25 years after the event. To see her memory being interrogated on national television and to see the courage it took for her to step up, not knowing the tidal wave of hostility and violence that she was going to have to take on in doing that. And when she with such dignity, such dignity shared how traumatic memory works as a psychologist. I just felt like, you know, I had sat on this story for so long and was so, you know, it's no longer part of my identity. You actually go around, you know, its layers, and you tend to return in fragments as a victim in terms of trying to put the narrative together

and how it fits in with your evolving self. And I think it's when I saw her and that courage that I realised I really had to pull all stops out and stop being concerned of telling the story with my real literary voice, which is slightly irreverent. Well, I was going to say, we can't do justice to your memoir in the time we've had available this morning. But there is humour there. Just the title of the chapters, for example,

the titles of them, that there's a real pithiness and there's a spark about the way you write and what you write. Thank you. I actually, one of my first inspirations was Michel de Montaigne, the French essayist, who I was listening to your piece right before me on Botox and grey hairs. And funny enough, he's got a section in that made me think about how perennial these issues are. That's the 16th century. He was writing about women plucking their grey hairs. But he had a sense of humour. He had a sense of humour. He was also writing from a similar place as me because I was experiencing severe grief. That was the incredible Deborah Harding, author of a memoir.

I think it's fair to say, like a few others, it's called Dancing with the Octopus, the telling of a true crime. Really difficult in the time we had available to do justice to that work. But I do recommend that if you were interested by what she had to say, that you seek it out. It is available now. Now, to the programme today, Andrea says, I know a woman who lost her baby at 35 weeks, then she and her partner tested positive for COVID. The postmortem concluded that COVID was the cause. As the baby was a last attempt IVF, it broke the hearts of the couple and the extended family.

Oh, Andrea, I don't doubt it. That is, that's dreadful, isn't it? Jen says, I signed up to the Zoe COVID symptom tracker and it took months for it to ask about pregnancy in the profile questions. If you don't disaggregate the data,

you will never know. And from Kirsten, I thought that was an interesting section on your programme. I'd be half tempted to share my HRT with my male partner, she says. Half tempted. She's obviously not all that enthusiastic about doing so. But wasn't that interesting? There is obviously something very, as if we didn't already know, something very, very powerful about oestrogen. We may have to do a lot of rethinking, I suspect. Decluttering was something else that featured today. And Annabelle says, we underwent an extreme decluttering.

We lived in Nairobi. It was an army posting and were repatriated to the UK because of Covid back at Easter. We could only bring two bags a piece and have been living in an empty quarter ever since. What we've realised is that there is something to be said for minimal living. It's easier to clean for one thing but it is joyless. We miss the pictures on our walls, we miss our comfortable bedding, our rugs and our cushions. I realise I do actually attach importance to a milk jug. But you know, I totally get that. In the last couple of years, I keep buying jugs. Maybe that's an age thing. I don't know. Somebody somewhere should start that thesis.

Mike says, I'm an artist living in Berlin and I've got all of my clutter around, which I actually think are mental cues to pursue different collated stems of direction through my art and from Mari I am decluttering as I listen the first day with the kids at school and not having to work in six months it feels very cathartic Mari congratulations I imagine there were quite a few people in exactly that position this morning. My own daughter, now incredibly in the upper sixth, was going back to school today. And I just, I mean, I was going to say I couldn't get rid of her quickly enough. But honestly, we've all been through this home thing. And it's good to be coming out the other side, isn't it?

Now, Botox. Jules says, Botox is botulism. I'd run a mile if somebody approached me with a needle dripping botulism. And I think it makes people look odd. Judith says, I had before lockdown Botox to correct a squint. Cosmetic, yes, but very important for me. My son has cerebral dystopia and Botox keeps his head straight and it's a lifeline, No, absolutely right. And something that Melanie Abbott did outline, actually, at the start of that interview, that it certainly does have extremely important medical uses as well. Tom says,

I was watching Louis Theroux last night, and my partner and I agreed that a 50-year-old Louis is now looking better than ever. Why are we conditioned to view men ageing as handsome and distinguished, but the signs of women ageing as something that needs to be hidden with poison? Tom, absolutely. Yeah, I mean, I wish you'd been on. I wish you'd been me this morning because you could have expressed exactly that. I didn't see Louis Theroux last night. Perhaps I should have a gander. And from Lucy, I wish these women could find more productive ways to spend their time than what sounds to me like pointless navel gazing, perhaps refocusing their energies on something with purpose, helping others, engaging with community or global issues, supporting and being a role model for young girls in care. Surely those things would assuage the emptiness of following cultural dictates from some 1950s model of womanhood. Lucy, there will be many who agree with you. Thank you to everybody who really did get people going, that item on Botox, which obviously was our intention. Tomorrow on the programme I'm going to be talking to the blogger

Stephanie Yeboah. She's been an active member of the body positive movement for years and has written a new book called Fatterly Ever After and also on the programme tomorrow Lizzie Harper who is the widow of the police officer who was killed of course on active duty, Andrew Harper

so Lizzie Harper joins us tomorrow on Woman's Hour. She recently of the police officer who was killed, of course, on active duty, Andrew Harper. So Lizzie Harper joins us tomorrow on Woman's Hour. She recently had a meeting with the Home Secretary, Priti Patel. And we'll talk to you about, I mean, I can't believe this, but are you afraid of your toddler? On tomorrow's programme, we're going to be talking to a new TV supernanny who thinks that some parents have lost a grip on their children's behaviour. That's tomorrow. Looking forward to that. Of course, we want to thank everyone who tweeted so positively

about the announcement at nine o'clock this morning that Emma Barnett is going to be the main presenter of Women's Hour in the new year. Hugely exciting for us and for her. So we're delighted to have her. Well, I won't be here, but we will be. I speak in the royal sense. We will be delighted to have her. Well, I won't be here, but we will be. I speak in the royal sense. We will be delighted to have her. And there were one or two people over the weekend, some of the bigger papers, trying to write off Woman's Hour. Don't bother, because we're not going anywhere.

So and fundamentally as well, I should say, I'm back tomorrow. Still here just about. So tomorrow we're here live, of course, and in podcast form as well. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake.

No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story. Settle in. Available now.