Woman's Hour - Carry On women, Unexpected news at baby scans

Episode Date: November 21, 2023

Barbara Windsor, Hattie Jacques and Joan Sims were some of the iconic women who starred in the Carry On films from the late 1950s onwards. From Carry on Camping to Carry on Up the Khyber, the humour relied largely on innuendo, double entendre and slapstick comedy, with the women viewed as objects for male desire. But were they really sexist? Emma Barnett speaks to Gemma Ross, co-author of The Carry On Girls, who argues it was the women who came out on top and were more sexually confident than the men, as well as actor Anita Harris who was in Carry On Doctor.The experiences of staff in the NHS are the subject of a report out today which has found that female NHS workers face an ‘embedded culture of misogyny.’ The campaign group Surviving in Scrubs has gathered testimony of 150 staff members through their website that launched last year and finds "systemic and institutional sexual violence" with experiences ranging from sexism to rape in the workplace. Emma is joined by Dr Chelcie Jewitt, a specialist trainee in emergency medicine at Merseyside hospitals and co-founder of Surviving in Scrubs, and Professor Dame Jane Dacre, former President of the Royal College of Physicians.The podcast series Intrigue - Million Dollar Lover looks at love in later life and the question of inheritance when someone with adult children finds a new partner. Sue Mitchell follows the unlikely love story of Carolyn, who is 80 and has properties worth a few million dollars, and Dave, 57, a former drug addict who is homeless and has spent a decade in jail. Sue joins Emma ahead of the series release on BBC Radio 4 and BBC Sounds.Coaching for sonographers, the professionals carrying out the scans, on how to deliver unexpected and potentially devastating pregnancy news has been successfully tested in new research from the University of Leeds. We hear from the lead researcher, Dr Judith Johnson, and also from Karen, who says she was left with PTSD after receiving unexpected news about the health of her baby during a scan.

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. Hello, I'm Emma Barnett and welcome to Woman's Hour from BBC Radio 4. Good morning, welcome to the programme. Words and how you deploy them, they are some of the most dangerous things we have at our disposal. And once things are said, they can't be unsaid. And how you use them to deliver the difficult stuff of life is what I'm interested in talking to you about today. On the programme we will be discussing training for sonographers in how to deliver bad news to pregnant women. In the particular setting and in that

setting if I have to think about it and share my personal preference has been for a sonographer to keep talking the whole way through the scan, explaining what they're looking at. The silence is where the fear lives, as I found out during a deathly silence scan which revealed our miscarriage a couple of years ago. In fact, I found myself demanding to know whether there was a heartbeat during the total silence. I was told there wasn't.

I haven't been particularly comfortable with silence in a medical setting ever since. But personally, nor am I a fan of the old, Emma, I've got some news for you. It's called a warning shot, that approach, apparently. I don't like that moment to process the unknown and make it potentially worse in my own mind. I think I like bad news delivered quickly, but warmly. How about you? Can you today on the programme, as we're discussing training in a very

difficult area for those working as scanners, as sonographers, can you share some examples of difficult news you have given to somebody or received that was handled well? It could be in a completely different scenario, but what was said, what wasn't said, if you were the one on the receiving end, what do you remember about that experience at that time? There isn't a good way most of the time, but some must be better than others. Get in touch today to share your view on this, your experience and perhaps something you've learned. The number is 84844.

That's the number you need to text. Text to charge your standard message rate. We're on social media at BBC Women's Hour or email me through the Women's Hour website or if you prefer WhatsApp or a voice note 03700 100 444. How do you share bad news? How have you had it said to you? What works? What doesn't?

Also on today's programme, we're looking at power and women in two different ways. One from the point of view of the NHS, we'll get to that in just a moment, and one from the film studio, with a reappraisal of the role women played in those carry-on movies. Matron, indeed, all that to come.

And one woman who was in one of those movies will be joining me. And the intriguing tale of a wealthy woman who finds love again in later life with someone her children definitely do not approve of. So anything you want to get in touch with, get in touch about, do do that. And also anything you want to say, those are the same numbers and all that to come on the programme. But the experiences of staff in the NHS are the subject of a report out today, which has found that female NHS workers face what's being called an embedded culture

of misogyny. But what does that mean? The campaign group Surviving in Scrubs have gathered testimony of 150 staff members through its website that launched last year and find systemic and institutional sexual violence with experiences ranging from sexism to rape in the workplace. Now we know the NHS workforce is much larger than 150. There are well over a million staff members. And just to remind you of this fact, the vast majority, nearly 80%, are women. This, however, is not the first time

it's been in the news in this way. Earlier this year, female surgeons said NHS operating theatres were still boys' clubs, rife with sexual harassment. At the weekend, the Health Ombudsman said patient safety is being put at risk by the toxic behaviour of some doctors in the NHS. Well, on the line is Dr Chelsea Dewitt,

a specialist trainee in emergency medicine at Merseyside Hospitals and the co-founder of this group, Surviving in Scrubs. And in a moment, I'll be talking to Professor Dame Jane Dacre, former president of the Royal College of Physicians and Emeritus Professor at University College London Medical School. But Chelsea, if I could start with you. Good morning. Good morning. Surviving in scrubs, just remind us what you're seeking to do. So at our core, we're a campaign group that's trying to end sexism, misogyny and sexual misconduct throughout the healthcare workforce.

Predominantly, that focuses around our website, survivinginscrubs.co.uk, where anyone who works in the NHS or other healthcare organisation can write to us and tell us of their experiences. So this isn't just doctors that we're talking about. We're talking doctors, nurses, physios, OTs, occupational therapists, I mean. And we've also got stories from administrative staff as well. And an embedded culture of misogyny. This is the latest from your organisation, your group. What does that mean? It just means that it's everywhere.

You know, we've analys analyzed 150 of the testimonies that we've had submitted to our website and some of them being a few sentences long some of them being pages and pages long of people you know detailing what's been going on what's happened to them um throughout their throughout their careers in health. And it's happening to people regardless of what their job role is, what their seniority is, whereabouts in the country they work. So it's rife, it's everywhere. And I mentioned it's only 150. You've said there about the analysis there.

Do you think this is representative? That might be a concern. I think that this survey that we've, sorry, this report that we've put together, it shows that there is evidence out there that we need to do more research. And towards the end of our report, we have put some more research recommendations out there we think um we've been very supportive of the work out there that's happened so far particularly the the working party of sexual misconduct um in surgery that report a few a few months ago and i myself started the sexism and medicine survey from the bma so we're very supportive of the work that's been out there so far but we're very conscious and myself and the co-founder becky cox that it's very doctor centric at the moment. And actually, the medical workforce doesn't make up that much of the whole workforce of healthcare. So that's why we set up our website and why we wanted to get some evidence and some stories from a wider cohort of professionals. Do you think also, I mean, again, the idea that you're trying to capture something, I get that, but going from, you know, sort of sexism through to rape like this,

in terms of the range of experience, do you worry about that being such a broad range that you're trying to represent in this way? No, the sexism, misogyny, the more daily occurrences that happen, the attitudes, the behaviours, the comments, those kind of things, they feed into what eventually becomes the more violent end of the spectrum. Behaviors aren't challenged. Those attitudes aren't challenged at a low level. And there ends up being this culture of tolerance, this culture of acceptance, this culture of, oh, that's just them. You know, they've always done that. And that's not acceptable. So we want to highlight both ends of the spectrum. So when we can empower people to feel confident to call out those low level daily occurrences so that perpetrators don't escalate and escalate their behaviours. And that's one of the themes that we're seeing through the analysis of the stories is that there have been perpetrators out there

who have just started off with a couple of comments and it has escalated and escalated and then become more towards the violent end of the spectrum, unfortunately. Do you know about, in terms of, I don't know what proportion of the 150 is at the more violent end, but do you know if those people have also taken action in terms of police, criminal proceedings? I know you're not going to name anyone, but do you know what's happened there? We don't know in terms of the individual testimonies what the outcome was. What we are hearing and again what we're seeing through some of the testimonies and our stories, but also when people come up and talk to us when we do talking events,

is that people are very, very scared of reporting in any way, shape or form, whether that be to the police, whether that be to the NHS organisation in which they work, or whether that be to the governing bodies, to the GMC, the NMC, etc. There's a real sense of fear for one's own career, for one's own personal safety. There's a fear that victims won't be believed. And there's a real sense through the narratives that we've seen that there seems to be a women seem to be less valued than their male counterparts in terms of the value for the organizations for the nhs and therefore

that makes women scared to speak up stand up and report this just before i talked to professor dame jane dacre is there a particular example that has stayed with you or surprised you? Oh, there's quite a few that have stayed with me. I know, but I always find when, you know, you're the specialist on this, you're looking across it. But for our listeners who may not have read the reports about this today, to bring this to life to them, this is about, you know, a health force that they care about typically,

or they may work in or their partner works in it'd be good to hear from you on that yeah yeah no i understand um i think the thing that always sticks with me and the thing that always kind of sends a chill up my spine is how this is happening on a cycle and that there's one story where we hear from a medical student who has been scrubbed up in theatre and has been inappropriately touched by her senior, by her supervisor. And the fact that that happens in a not you know a normalized culture as more generations of of medical students and healthcare students are coming through and that that's what really upsets me if i'm honest thank you for that chelsea let me bring in jane at this point good morning morning a normalized culture is that what you find is that what you think you you've been in

medicine a rather long time and you will have seen some changes. People may be hoping it's going the other direction. Yes, I think people do hope it's going in the other direction. And sadly, yes, I think it was normalised. During my career, these things happened and you rolled your sleeves up and got on with the job. And I think we now realise, those of us who are a bit more senior, that perhaps that wasn't the right thing to do at the time. However, for all the reasons that have been discussed already, women are frightened of speaking up when it does

happen. And quite often when it happens and when people do speak up, the organisations don't know quite what to do with it. So a lot of buck gets passed. Certainly when I was the director of a medical school, it happened in the medical school between students and sometimes with senior members of staff. What happened? Sorry, just to be clear, because that's what's unclear about when we're talking about this report. There's such a huge range of what we're talking about from verbal through to physical. Yes. Well, the interesting thing about that is that the more there is, the more is tolerated in relation to verbal, the more likely you are to have things going on to physical, going on to even rape. So that's why the zero tolerance is important. So the sort of thing

that medical students might have to put up with is a surgeon when they're scrubbed in theatre, standing at the back of the room, and the surgeon will say, I like the look of her, can you get her phone number? So there, there's a huge power differential and the young woman is made to feel very uncomfortable. I myself, when giving a presentation with a male colleague, has been called the lovely lady assistant. Now, that's not appropriate. At the time, people feel annoyed about it. They come and talk to me afterwards, but they don't do anything. And if you do pass it on to your organisation, it's either, well, that's just what he's like, or the medical school says that it's the trust's fault.

The trust says you should go to the university. Everybody says you should go to the police and everybody ends up not doing anything. And so it continues. In terms of where this can go now, I mean, there'll be some who'd be listening to this and perhaps they don't relate to it. Perhaps they're shocked by it. I mean, you don't sound like you are shocked by it. But has there been no improvement? There have been, you know, there've been quite a few reports like this. And I wonder why when you've, you know, you've been in a position of authority yourself,

why things are not going in the correct direction, if that's how you see it? I think things are going in the correct direction. If I could revert to using a medical model in order to work out how to manage an illness, you first make a diagnosis. And what we've done is misconduct in surgery group, have called it out. Everybody now knows, A, that it happens, and B, that it's inappropriate. And I suspect that that will go some way towards changing the culture. The culture in the NHS was set up for a male dominant workforce in 1948. It hasn't kept up with the times, and it needs to bring itself up to the modern day. But the fact that it's majority female as well might also lead some of our listeners thinking, well, you know, surely you have critical mass. Is there not more now with more women in these positions of power? You've been in a position of power. Why, if the diagnosis has

been known for some time, why is there still not the action? I think for the same reasons that it's been allowed to happen in the first place. There is a power differential. There is a worry that women have about speaking out because of the potential negative impacts on themselves, their own career, their reputation. And it's a very difficult thing to change. However, I think that the work that's been done recently is a really good step towards changing it. I think people like me that may have just thought, well, that's just what it's like. You've been told if you can't stand the heat, get out of the kitchen, for example, are now much more vocal about calling it out and much more prepared to stand up and say, look, this isn't right. So if you get touched up in a surgery in the way that we've just heard, and I'm not saying that blithely, I'm saying it just as it is, you know, that's what's just been said. If that happens to you now, what should you do as a woman?

I think it's very difficult because if you think about it, you're standing very close to the perpetrator. You've got your hands scrubbed and in front of you so you can't move. So what you should do is speak after the event to people who can do something about it. And that would be as a trainee, your educational supervisor. The NHS are taking this much more seriously now. So it's more likely to get traction because people like Chelsea have called out the fact that it didn't get

traction in the past. Chelsea, final word to you. Do you think that's the right way of handling this? In that particular situation, it has to be said that each incident needs to be dealt with in a slightly different manner. The reason being, it's all about the safety of the survivor, of the victim in that situation. If someone who is the victim of these attitudes and behaviours feels that they can say something right there and then, then they are more than, you know, capable of making that decision themselves and speaking up for themselves. But in a vast, vast, vast majority of these issues, there's a huge power dynamic, the victim's usually, you know, bottom of medical hierarchy. And they need to, if they feel able to speak to someone after the event, speak to a supervisor who can deal with it,

or if there's someone witnessing these incidents, then they need to call it out either at the time. But I'd probably say it's more realistically going to have to be afterwards, even if it is just speaking to the victim saying, are you OK? That wasn't OK, but I want to make sure that you're OK. Even starting that conversation is going to have a huge impact on the culture going forward. Do you find men engage with this by the way your work um yes and no um we've had talking a lot about what women should be doing aren't we yeah but equally men need to be calling this behavior out so when i'm well they need to not they need to not be doing it exactly but i meant those those those men i'm not you know not not necessarily the bystander discussion, but are you having any impact? Is there any evidence that you're, I mean, evidence, but any even anecdotal awareness of what your ask is this okay is that okay but even just that awareness that there is a line um that's definitely seems to be coming through um we need more men to

be talking about this we need more men to be reflecting on their own behaviors their own attitudes but we also need them to be talking to each other about this because this yes this is a problem for women but actually it's a problem for everyone and men really need to start getting involved in this conversation well there's also as i mentioned right at the beginning concern about if the um the workforce is not in a good way then patients also are impacted and what that means for for health generally thank you very much to both of you dr chelsea jewett there professor dame jane dacre a message here, a statement from the chair of the NHS England's National Clinical Network of Sexual Assault and Abuse Services, Dr Binta Sultan. A statement says,

no one should experience sexism, sexual harassment or sexual assault in the workplace. It is totally unacceptable. The NHS is taking steps to ensure that healthcare environments are safe for staff and patients. The health service's first ever sexual safety charter, which was produced with people with lived experience, commits to providing more support and clear reporting mechanisms to those who have suffered harassment or inappropriate behaviour. Now, you've been getting in touch while listening to that. There's a message here just on that particular discussion, but also some coming in about how to break bad news, which falls sometimes to those staff working in the NHS.

But a message on that discussion, I feel it's also important to accept that there's likely to be many incidents of female NHS staff sexually harassing male staff. I've had a senior female ward manager telling a group of women, including me, about her habit of trying to embarrass young junior medics in front of colleagues. She was nothing short of predatory and proud of it, reads that anonymous message.

Feel free to get in touch in response to that or in response to the bigger conversation. Morning, Emma. I'm a sonographer working in the NHS. That's great. It's good to hear from you today. We're going to be talking about your role in just a moment. I try to deliver unexpected, usually bad news in a direct but empathetic manner where there is no ambiguity.

Usually these moments or those moments of silence you mentioned are filled with trying to figure out what I'm going to say to the patient whilst trying to obtain all the information I need. I have had occasions where I've delivered the news too early and then struggled to complete the scan as the patient's too upset. Nobody wants to have to give bad news but where necessary I strive for it to be delivered in the kindest way possible. I'm sure you do and thank you for that. And you sign off your message with thank you. Delivering bad news. I was washing up breakfast one morning after the children had left for school.

My husband came up behind me, gave me a big hug, saying Dominic's fine, but he's been hit by a car. It was a brilliant way to deliver bad news. As I first got the hug, then that our son was okay, and then the bad news. So the shock was hugely absorbed. Our son was taken to hospital concussed, but ultimately was fine. There you go. Another one. When do you, in terms of bad news, when do you tell your good friend that their partner is having an affair? Is it your call? Maybe they know, but they don't want to know. When are you being a good friend? When is it gossip? Sometimes is it better to keep shtum?

I plucked up courage for days to tell a friend I'd seen their partner with someone else. I wished afterwards I hadn't said anything but I was worried that they'd been upset. They would be upset with me if it came out later. I had known all along. And so it goes on. You're giving advice and some experience of bad news

and how it's been delivered. I find the worst thing, reads this short but to the point message, is when your boss says, have you got a moment, when they're about to sack you. Yes, I don't like that either. That idea of it, the warning shot method, as I've learned this morning, it is called. I will come back to more of your messages, some brilliant ones and powerful ones coming in. So please do keep them coming in and I'll come to them. Now, a new podcast series for BBC Sounds and Radio 4 this week looks at love in later life and the question of inheritance

when someone with adult children finds a new partner. It's called Intrigue, Million Dollar Lover. You might have heard it being trailed here on Radio 4. Sue Mitchell is the presenter and producer behind the series. Good morning. I should say, first of all, Sue, we're not going to ruin this, are we? We're not going to do any spoilers. No, spoiler alert, no.

Thank you for having me on. And it's a really gripping podcast series. Well, I would say that. But tell us how and where the story unfolded. Yeah, so it's essentially a love affair between Carolyn, who's 80 and very wealthy. She was recently widowed and she meets and falls in love with Dave, who's 80 and very wealthy. She was recently widowed and she meets and falls in love with

Dave who's 57. He was living homeless in the small sleepy California town of Cayucos. It's where my husband has a home so I'm often there with him and I stumbled into this sort of unlikely love story by chance really. Dave had been recommended by a neighbour of ours to come round and do some building work for us, some joinery and he immediately sort of started telling me about his girlfriend Carolyn and so the age difference between them, obviously the wealth difference, the whole sort of way he talked about loving her and then, you know, after meeting meeting her the way she seemed so in

love with him this romance had unfolded so quickly in a couple of weeks she took Dave in and he was having a sort of full relationship with her and over a year I documented that relationship because it raised so many important questions about capacity, about who has the right to decide and about inheritance because Cayuca, where this is all set, is like many places really it's got an elderly generation sitting on property that's worth millions. So in Carolyn's case she owned houses worth several million dollars and her children expected to inherit that. I mean wealth is very concentrated in older generations and yet what happens when a new lover is on the scene you know it can create

all sorts of tensions and upsets in families and in the wider community yes and and just to go back specifically to their story because you mentioned spending a long time with them and they really opened up to you didn't they yes I mean they were intriguing couple so when Dave started work on our house very soon Carolyn was sort of popping in from her she lives just a few doors down and it was like having a rom-com unfold on your front sort of living room they were always kissing cuddling high-fiving each other. They kind of had a... I mean, Carolyn was besotted with him, absolutely besotted with him. She thought very soon she was, you know,

just her whole world had narrowed in on Dave. She treasured him like some rare jewel that she'd sort of acquired. And he was more sort of detached from the relationship in a sense. He liked her pride in him I think he liked that he'd been homeless and he he saw it more in a more transactional terms he had somewhere to live he had a stability in his life and he he valued that and he said he was going to

stand with her and alongside her and stay with her as long as long as you know she was capable of living independently with him and they both had children yes they both got children and Dave's children I mean Dave had a long history of crystal meth addiction he's spent an awful lot of his life in prison his children have had a very very turbulent time and I you know there's a lot of difficulty in that family in Carolyn's case she'd had a very wealthy and loving sort of life with her children and her two daughters thought they were a close family obviously when Dave came on the scene it's you can see subtly how he starts to sort of distance Carolyn from them how he makes it difficult for them to see their mum this relationship they'd had with her, this closeness begins to fragment.

And they're really distraught. They're worried about their mum's safety. They think Dave might abuse her, hurt her. They're worried about the money because very soon Dave wants to start having a hand in the finances and Carolyn's kind of alongside him in that and they turn to all the agencies the police adult protective care they turn everywhere they can think of and no one seems able to help them so they they feel like they've they just hit a dead end and we're going to hear now um Carolyn's daughter Sally talking about their concern for their mum and then a moment a moment when things boiled over and she confronts her mum at home let's have a listen we were a very close family until he came

I could see that he was winning her over and you know that's our mom we're not gonna let you just do that we're not gonna let you it's our family's money should we be okay just giving it to some loser would you but to think that our grandparents hard-earned money would go to him was just devastating look at you brought into your house. A felon drug addict. He's a con artist, mother. OK. Con artist. Ask the neighbours. You will not ever understand. No, I will not. You're out of your mind. And that's why he's using you so he can con you. I mean, it's very obsessive to listen to that. You can hear the frustration on all sides. What did you find out, Sue, about Dave's past?

Yes, well, I mean, the daughters tried everything. They even went to a private detective. And actually, digging around into his sort of backstory, there was a lot there to discover. I mean, we found he was quite open, actually, about some of his criminal past. So he told me he'd spent 10 years in prison for making pipe bombs in the desert that the police thought were linked to a possible attack on Walmart. He told me he'd been in prison a lot for drug dealing.

There was actually a darker thread that we uncover to do with his family life. And he'd almost killed one of his children through neglect. And he later ended up selling her to the couple who eventually adopted her. So there was a lot there. But every time they went to their mum to try and raise this with her, she just would cut them down. She wouldn't hear it. She wouldn't listen.

And the more they tried to prise her and Dave apart, the more she sided with Dave. As you'll hear in the podcast, she feels that really he is her future now and she's almost prepared to abandon her daughters altogether. And they think that dementia can be the only thing that explains this. They think their mum was very lonely. I mean, like in the UK, you know, three million elderly people live alone. Cognitive decline can leave people very

vulnerable to strangers coming into their lives. It's something we do see in a number of cases now, and especially at this time where the older generations have this wealth, you know, it makes them even more vulnerable than they would have been. So for the daughters, they felt that dementia was the thing that explained it. And they kept trying to get her to have a diagnosis. Her GP had said that she wouldn't diagnose dementia in Carolyn. They tried several times to do that because that would have given them, they could have taken power of attorney. They could have taken control of her finances. And I asked Carolyn about this.

They took me to the doctor. They gave me the test. I did pretty good on it. Yes, I forget. I forget a lot of things. But I have too much stress, which is my biggest problem. Do you feel you're able to make decisions about your life and about things like this?

Yes, I do. Do you? Why? Because I've done it for so long and my daughters just don't like the way I make my decisions because it doesn't involve what they want. Did they end up managing to take control of their mother's finances? Well, that's a good question. You'll have to listen to the podcast because actually the way it unfolds I would never have predicted I mean in starting the recording I

had no idea where the story would go I recorded it over a year with the permission of everyone involved in it and I would never have predicted how it actually sort of unfolded towards the end but one of the things I really took from it was that this is a problem that we're seeing in in lots of families when you start talking to people everyone says oh I know someone who's you know this has happened to where a parent takes a new lover and there is this question about who has the right to love in later life and it's something in America they're working on with the banks. So the geriatricians there are trying to find a way to protect older people from financial abuse.

So that instead of just being able to assess people's mental capacity at a GP level, when you go into a bank, say, there would be questions that assess your decision making abilities. Are you really thinking through the consequences of your decisions when you're older and you're giving money in such large quantities to someone new in your life or someone a carer a lover even family when you're giving away large sums of money what responsibility do the banks have what responsibility to the service protective services have and how can we better protect older people who find themselves in this position of wanting love seeking love that yearning never diminishes with age and yet

you know you are liable to be exploited and you are vulnerable see mitchell thank you very much the podcast is called million dollar lover it's on radio for this thursday at 8 30 in the evening for eight weeks and the full series is available on BBC Sounds from Thursday. Now, many, many of you getting in touch to talk to us about how to deliver difficult news. This is because we're going to talk about some training that is needed or is felt to be needed for sonographers. Pregnancy complications can be picked up on routine ultrasound scans,

but sonographers are not routinely trained in how to deliver that news. This can be incredibly distressing for patients and stressful for those carrying out the scans. Expectant parents watch their faces very carefully as they scan and then they have no time to plan how they're going to share those findings. The issue was considered by the government's Independent Pregnancy Loss Review, published in July, which has recommended that guidance on how to give unexpected news be incorporated into all sonography training.

Karen is a mum from Yorkshire who received unexpected news about the health of her baby during a scan. And Dr Judith Johnson is a clinical psychologist at the University of Leeds and the lead researcher on a project published today. Karen, I'll come to you in just a moment. Good morning. Welcome to Woman's Hour. Judith, though, I wanted to start with you about when you started looking into this issue, because there may be some, I mean, we've had some messages about scans that happened in the 90s and people thinking things might be different now, but there may be some who's very surprised that this isn't included in sonographer training already. I began working in this area in around 2015

and I looked at some survey data that had been collected in parents who had had a baby with a limb difference, we call that dysmelia, and data from about 400 parents worldwide had been collected and the results really shocked me because generally if you ask people about how they find their healthcare they're quite positive about it. They want to say good things about it. But actually, the majority of people who responded to that survey said they had a negative experience and they received the news. Yes. And the training is missing. Yeah. So in the UK, most of our sonographers are still trained in a year long course. So they start out as mostly radiographers or sometimes as nurses and midwives and they get a year's top up training. And they have to learn everything about ultrasound in that year. It's really jam packed.

And I work with the sonographer ultrasound programme leader at Leeds and she's desperate to incorporate more of this in there. But there isn't very much time for it. And up until recently, there wasn't even guidelines on what should be trained. And there's very little support around that. It's not standardised or mandatory. Karen, let me bring you in at this point. Good morning. Hello. What happened with you?

So at my 20-week scan um the sonographer um scanned me and found something that she um that she didn't recognize that she wasn't sure what it was um she i i the thing you talked about earlier about that kind of silence was exactly what i experienced um there was silence and she said she'd just have to go and find someone else so she then went to go and get someone else who came into the room and also realised it was something that they'd never seen before. There wasn't that much they could tell me at that point in time because they needed to refer me on to specialists because it was as I said it was something they'd not seen before so they did there wasn't much they could say to me. They did try to give me some reassurance I do remember that kindness of me kind of saying, what on earth is going to happen next? And the sonographer

trying to give me some reassurance, albeit that she had no idea really what was happening. But I do remember distinctly that kindness of her trying to give me something to kind of go on. I then went to see specialists because of the nature of what they'd seen. And so I've had a lot of scans. I've had scans from all sorts of specialists throughout the whole of my pregnancy because it became very complicated. The second scan that I had, that was with a specialist who was unable to have a bit more of an idea of what might be going on. But again, it was something that they hadn't seen before, so they couldn't give me much of an indication of what might be going on but again it was something that they hadn't seen before so they couldn't give me much of an indication of what it was um they then went away and did some um kind of more research to see what they could find out um and i then had another um another scan another

appointment um where they did then talk to me about what they well it was still in a position where they didn't know what it was that it was something they hadn't seen before. But then they started to give me messages about what that might mean, which is where the kind of the issue started to come in, in the experience, because they started to talk to me about sort of dire consequences that might be the case. But they didn't really know what they were looking at. So the couple of things that I think you spoke at the start as well about things sticking in your mind and words you can't unsay words once they've been said and and those words sticking so I have was told lots and lots and lots of information um but the things that stuck with me were that they thought my baby wasn't going to survive after the birth um if he did survive he might not survive for very long um and that the um the medics would have to be there at the birth and take my baby away immediately after birth um in order to to try and help him but that

that my baby was going to be taken away from me as soon as he was born um which were two things that were very hard to to deal with um both both knowing that the baby might not make it and having to know that for the duration of the pregnancy and And also that for me, the moment the baby's born and the baby's put into your arms and you get to cuddle them was such a special thing that I was looking forward to. That to be told that, no, you wouldn't get that moment. The baby would be taken away and then might not make it anyway was something that haunted me for the whole of that pregnancy. Yes. We should say your baby was born. Yeah. And there were some complications, but again, wasn't how was predicted.

Yeah. So as the pregnancy progressed, the prognosis started to get better, although they still didn't know, but the prognosis started to get better. When he was born, yeah, there were a few complications. He was a neonatal for a brief spell, nothing to do with the thing they'd found during pregnancy but yeah he's he's fine he's at school today um he's a healthy healthy child now well that's wonderful to hear it would be remiss of me not to point out and you know people always want to know if you've been kind enough to come on the radio what happened next and and how that played out but but staying with that moment because you still had a whole pregnancy to traverse uh dr judith johnson listening to that

what could have been different do you think uh in karen's situation karen's situation i guess is a bit unusual in the sense that it involved lots of scans but i think what really comes through strongly for me from listening to this is that it sounds like the sonographers especially the first one they just didn't know how to communicate uncertain news with you. They'd found something, they weren't sure exactly what, they thought it might be concerning, but no one knew how to communicate that. And what that meant was that there was delays, there was uncertainty, there was an unclear picture being presented. And that left, I think, Karen, with just a lot of distress, which could have been, I think, with just a lot of distress which could

have been I think more carefully more empathically managed had people had more confidence about what they were communicating. So with your your training and we should say we've got a lovely message here apart from all the messages around how to deliver difficult news someone's saying I've taken part in Judith's research into sonographers delivering bad news the feedback from her coaching has been invaluable in my practice hopefully her coaching will be integrated into sonographers delivering bad news. The feedback from her coaching has been invaluable in my practice. Hopefully her coaching will be integrated into sonographer training to enable new sonographers to develop effective and kind methods of delivering bad news.

So that's a lovely message to share with you on the radio. But what are you saying to those doing this about the best way to deliver the news? Can you give us some practical tips? Yes, so we do have a 12-point framework, which I won't run through, don't worry, but there is a few things in there. So we encourage sonographers to use neutral language throughout, so we don't actually talk about bad news in pregnancy, we talk about unexpected news, because of course it can include

a range of possible physical conditions, and we don't want to, I suppose, make a value judgment around that. So we talk about unexpected news, we don't use to, I suppose, make a value judgment around that. So we talk about unexpected news. We don't use the words normal or abnormal. We discourage those and we encourage instead expected and unexpected. For example, we don't use disorder either. We encourage sonographers to use the term condition. So we use that neutral language. We also encourage honesty. So actually, even quite recently, I've given talks and had sonographers come up to me and say, I was told not to be honest. If I'm not sure, if I think it might be a miscarriage, but I don't know yet, I've been encouraged just not to say anything.

And we say no, because parents pick up on cues. They suspect that you might have found something and they prefer honesty. So even if you're uncertain, it's best just to be honest about that uncertainty. And then possibly one of the most important things that I coach sonographers to do is about naming emotions. So often women who come in and receive unexpected news or there's a possibility of it, they'll be quite anxious and that will be displayed. Or, for example, after they've had the news, they might be quite upset. So we encourage sonographers just to name that, to say something like, I know this is an anxious time, or to say, I recognise this is really upsetting news and I wish I had different news for you. Because that can communicate to

expectant parents that the sonographer means well, that they care, that they recognise, and that can make all the difference for people when they're receiving this kind of news. And I suppose there's also body language, isn't there, as well about how you come across, which must be, you know, it's important to be yourself, I suppose, in your job, but equally manage the cues that you're giving out. Yeah, absolutely. And we do give some recommendations and the long guidelines around that. Unfortunately, at the moment, I haven't been able to coach on that. And the reason for that is that we only use audio recordings. This is really new. And that sonographer who came on, I'm so grateful to them for their comment, but also for the fact they took part in the study.

Most sonographers chose not to take part in the study because it's scary. So while we would love to video record their sessions and be able to give feedback on body language, at the moment it's only audio recordings. That's the most we've been able to do. That's interesting in itself. Karen, the other thing to say here is having heard about how this might be changing, and I know you're keen for it to change, and it's still to me very interesting that it's only now, this is a new piece of work, a new focus, that this is coming to light. And that you know against sonographers doing really important work but that this piece of it hasn't been part of it even though you have your boy it's lasted with you hasn't it that that experience and you know you you've had to you've had to make that part of of

who you are oh absolutely yeah yeah it's um it um I had I mean I had a fantastic counsellor at the time who helped me a lot if it hadn't been for her um I don't know where I'd be um because I needed a lot of support through that whole process um I have now got another child as well um and it cast a shadow over the pregnancy with him I had to also have um support from the counsellor during that period of time um the the hospital did give me some extra scans just to give me some reassurance um in relation to that um because it did yeah it cast a shadow over that pregnancy and still does now you know both of them are of older children but um yeah it still leaves me now that there's moments where like there's certain songs i can't

listen to because that will make me um reallyressed or certain smells I might smell or messages I might hear or things like that that will still trigger the feelings that I had back then even now and I'm sure probably always will. Thank you for talking to us today. Just finally Judith in terms of what the next steps are, what the government is going to do, the issue is considered by the government's independent pregnancy loss review published in July which recommended that guidance on how to give unexpected news be incorporated into all sonography training. Where are we up to? At the moment, there is no evidence-based or formal training that is delivered as standard to sonographers at any stage, so during their training or in practice. This is a very preliminary, a very small, a very

novel study that we've just done coaching sonographers, but the results are really promising. And I suppose what I would hope is that we would be able to do a scaled up study, a large one, and, you know, be able to say more confidently about the outcomes of it. But in the long run, I would like to see this on offer to sonographers across the country, that they would get this kind of support. Their work is really hard. Doing this job day in, day out is so challenging and they need and they deserve this kind of support. It would also be great to see something like this offered in a training programme before sonographers qualify so that they're never having to practice without this kind of support. Dr Judith Johnson, Clinical

Psychologist at the University of Leeds and lead researcher on this project of support. Dr Judith Johnson, clinical psychologist at the University of Leeds and lead researcher on this project published today. Thank you. A Department of Health and Social Care spokesperson said, we are working to improve support for women who experience the tragedy of pregnancy loss and our response to the pregnancy loss review sets out the immediate actions we are taking. This includes improving care for women who have multiple miscarriages, improving access for women to cold storage facilities for fetal remains and introducing the certificate of baby loss under 24 weeks gestation. We have committed to organising a series of workshops, roundtables and stakeholder meetings

to inform our consideration of the remaining recommendations. This will ensure we can appropriately address the gaps that the review has identified in service provision. Coming back to your messages, on this particular topic, and then I'll just broaden out because you've been kind enough to message in, my sonographer was silent and turned the screen away from me. She then reappeared in a white coat and I realised she was a consultant. She told me my 20-week pregnancy was not going to result in a live baby and I was admitted straight away for a medical termination. I wasn't warned anything was Difficult indeed. if everything was okay. Barely turning towards me, she said the foetus is dead. As a nurse myself, I felt this delivery of bad news was coldly done with no empathy. It didn't help either when she said that she as a senior person

was only scanning me as a courtesy to my doctor husband. In 2001, during an ultrasound resist message, I was told I had a failed pregnancy. I didn't understand what I was being told, which just added to the stress I was feeling. I asked the radiographer to explain, but she just repeated the same phrase. And it keeps going with some of these experiences you've had and some of you talking about maybe things have changed and others of you bringing very recent experiences to the table. Talking about generally bad news and how to break it and things that you've learned, it does seem to be that if you give some sort of hug and some sort of warmth within that, that is very welcome and very helpful. A very shocking one here,

which you seem to have been able to process because it's been a few years ago. My mum was in a nursing home, and this message starts with a ha. She'd been very unwell. I had a phone call saying Mrs. Edelson's not well yesterday. Oh, okay how is she today she's dead now fortunately a few years ago this message ends and it's just bizarre uh and so it carries on but there is a message here uh from from one of our listeners he's got in touch this morning talking about how happy they were with a parental response uh that they had when they had an unexpected pregnancy as a young girl and their father was very warm indeed about it. So that's something that has stayed with you in a very positive way.

So keep those messages coming in. It's really interesting to hear how you've managed to manage difficult news and what words you have used. Now, Barbara Windsor, Hattie Jakes, Joan Sims, if I put those names to you, you know what I'm going to be talking about, potentially, many of you will anyway. Some of the iconic women who starred in the carry-on films that were a staple in lots of British households from the late 50s onwards, from Carry On Camping to Carry On Up the Khyber, the humour relied largely on innuendo, double entendre and slapstick comedy, with the women viewed as objects for male desire. But is it time for a different lens on that? A new book, The Carry On Girls, co-written by Gemma Ross, argues it was the women who came out on top and were more sexually confident than the men. She joins me now along with Anita Harris, who starred in Follow That Camel and Carry On Doctor. Good morning to

both of you. Anita, I'll come to you in just a moment. But Gemma, hello. And why did you want to do this? Morning, Emma. Well, to be honest, it was my co-writer's idea originally to do this book. And he said to me, I want to write this book. And I said, hang on, you can't do this as a man on your own. Where are you going with this story? Because I said these women actually have had some fascinating careers but we also need to put these films into the context of the times and that's really what we wanted to do but it is a book of joy it is a book to celebrate these women and the amazing careers that they had but what is your idea around it was a different way around how I mentioned? I think because we often look at these films and we see the classic photo of Barbara Windsor with her bra flying off and it's straight

away that's objectifying women. When you actually start to watch these films and really look at the characters within them the women are coming out on top. And that, for me, was fascinating to sit as I was researching and saying, they've got the upper hand here. Do you agree with that when you listen and you think back to it, Anita, having been a woman in one of these films and two of these films? Good morning, Emma. Morning. My personal experience was joyful. I was very young and I was in a tremendous learning curve.

And reflecting on probably the writings that had the empowerment of men, but, you know, as we all learn in life, behind every man is a good woman. It was a very, very good time for a family audience the carry-ons were beautifully filmed um peter rogers producing gerald thomas beautifully directing talbot rothwell wrote the two that i was in and it's um the central players all they were all so beautiful in the way they acted together and respected each other. So from the empowerment of men over women, I think I'm doing Panto at Windsor this year, Aladdin, and we're gathering the same audience. It's the family audience and the laughter and the joy of fun is really what I think the carry-ons are about.

Although there have been, you know, interviews since with Barbara Windsor and other actors who were involved, you know, where they talked about, well, first of all, that the money that was shared around wasn't as good as it was for the producers. They didn't get any cut of when they were rerun, but they also talk about, well, first of all, that the money that was shared around wasn't as good as it was for the producers. They didn't get any cut of when they were rerun.

But they also talk about, you know, being in, often the women didn't have much on or they'd be up on, I don't know, a roof or in a hot bath that hadn't been tested properly. And they were having to deal with all sorts that perhaps the men weren't. Do you agree with that? that i think um look it was of an era um and uh the humor was always there and the respect for the artist was always there and i think um families that watch this each generation seems to grasp what the carry-ons were about it's not deep deep thinking uh strategy here it's fun oh of course i just wanted to see from your point of view if you no no please don't apologize but if you had fun you know that's it's it's interesting when you look back at what's been

said since some of it is how it seemed and some of it seemed slightly less fun that was all um well on on set it was always respectful fun um and a fabulous job to have i bet uh as a as a as a viewer um i still get so much pleasure from people coming up and saying that they loved uh the carry-on films And I think really that's what it is for me. And as Gemma is saying with the book, it's a little tribute to the girls, really. I mean, the gentlemen were all great in their jobs. Jim Dale, Sid, James, Bernie Breslow, Kenneth, all of them, Frankie Howard,

all so good and skillful at their jobs. And we were a part of that. Isn't that wonderful, really? Still people greatly enjoy watching them for all those reasons that you talk about. Gemma, tell me a bit more about what you were trying to do and what you are trying to do with this book. Well, really, it's interesting, actually, you mentioned about the pay, because that was one of the first things I wanted to look at. Where were the girls in terms of pay? Was there a gender

pay issue there? Shirley Eaton in the second film in Carry On Nurse got top billing and got the most pay of everyone. She was earning more than Kenneth Williams, Charles Hortry, who was a big star at that point. And as I went through it, there was no gender pay issue. So not necessarily a gender pay issue. I think what Barbara Windsor was talking about, I was about to say Barbara Streisand there, what Barbara Windsor was talking about was when there were reruns, they weren't put in and what the male producer did very well out of. Well, those reruns were shown in the 1980s. They've actually not, she didn't have a problem with the films being shown. It's when they put the clips together.

They actually haven't really been shown since the 80s and that's what she was upset about. But that is interesting about the gender disparity and not finding that. I suppose it's also, what do you say to those who say I had such a good time watching them, but now I take a step back or I've looked at them in the modern day

and I wonder what the impact was on women and how they were viewed by men around them in the real life. So not on set, not what they were doing, and here was the butt of the jokes, but how those representations impacted society. Yes, and I think that's what I've tried to address in the book. So one of the things, for example, was about Hattie Jakes' weight being a joke, which actually stemmed further back from radio, and it sort of snuck in a little bit to the carry ons. And I thought,

why were weight jokes happening at that time? And it was post-war, dieting started to come in. I mean, there was an article which was about how to slim yourself by dusting and hoovering. And that was how you began to do your weight loss. And then there was an article in Women's Own in 1969 that was very derogatory about women saying, you know, if you're larger, it stretches out the marks within you. And it was just wow. So there was this pressure, I would think that was on everybody. And thank goodness attitudes have changed. But I also say look at those carry ons because there's a girl for everybody. Thank goodness for the Hattie Jakes and the Joan Sims for being there and showing us different representations of women on film.

Yeah. And with some of the women, you did get to see an awful lot of them, which was also part of the appeal, I imagine. Anita, you seem to look back on it very fondly. You say you're in Panto at the moment. I do. I do. I am. I'm at Windsor Theatre Royal, Aladdin. Wonderful, wonderful cast. And it's such a bright, cheerful, magical show. We've got lots of magic in the show as well. So, yes, we open on Friday. Well, good luck with that. You're the empress. January the 14th.

Listen, I just want to say that Gemma and Robert have done a very marvelous job in the researching of all of the carry-ons and what they brought out is of course there is a more serious side of course to to paying respect for each other caring for each other and it's lovely that you are talking about that on Woman's Hour and and we of course we're all aware we have to care very deeply for each other. And I'm very stressed when we hear that there are problems. But there are times in life, you know, when things do go wrong. And that is when we need to help each other. other and so to be a family or just to be together with someone having a joyful time and sharing

something that is funny and caring I think is something especially at this time of the year is rather wonderful so love to you all and a very happy Christmas actually. Oh my gosh we've had it it's the 21st of November someone said happy, happy Christmas. You are the first. If I couldn't get it from you, Anita Harris, as an empress in Aladdin, who else could I have got it from? That was almost my wish come true. Anita Harris, thank you very much to you. Gemma Ross, thank you. Have a lovely day. Thank you. You too, to you. And the book is called The Carry On Girls, co-written by Gemma Ross. Who's your co-mail author? Robert Ross. We should give the credit there as well at the same time. I'm sure it's been an interesting journey. Thank you for your company and your messages today.

I'll be back with you tomorrow at 10. That's all for today's Woman's Hour. Thank you so much for your time. Join us again for the next one. Hello, this is Marion Keys. And this is Tara Flynn. We host a podcast you might like for BBC Radio 4 and BBC Sounds

called Now You're Asking. Each week we take real listeners' questions about life, love, lingerie, cats, dogs, dentists, pockets, or the lack of, anything really, and apply our worldly wisdom in a way which we hope will help, but also hopefully entertain.

Join us, why don't you? Search up Now You're Asking on BBC Sounds. Thanking you. I'm Sarah Treleaven 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's 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.