Woman's Hour - Coronavirus and pregnancy, Social workers, Calamity Jane

Episode Date: March 30, 2020

The Royal College of Midwives says that coronavirus may mean its staff have to work elsewhere in the NHS, rather than looking after pregnant women. Dr Mary Ross Davie explains the RCM's concerns. Social workers are trying to keep working safely and effectively despite restrictions around Covid-19. However, a survey by the British Associations of Social Workers says many haven't been given solid advice or the right personal protection equipment. Dr Ruth Allen, Chief Executive of the BASW, describes the challenges that social workers face right now.We hear from two healthcare workers who've cared for SARS patients and Ebola patients. How did they cope during those pandemics and what can we learn from them now? And Calamity Jane: you're probably thinking of Doris Day right now but Calamity Jane really did exist in real-life. Professor Karen R. Jones from the University of Kent tells us how an American called Martha Jane Canary was the real Calamity Jane.

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 and this is the Woman's Hour podcast. It is the 30th of March 2020. It is a very good morning to you. I hope your weekend was all right. Keep us in touch with how you're doing. We'd love to hear from you at BBC Woman's Hour on Twitter and Instagram or you can email the programme via our website.

Particularly interested in hearing from people who are working from home, sharing the childcare. How is that going? How's it working out? Has it been actually really smooth? We'll talk about it a little bit more later on in this programme. Or have you faced a few challenges? So let us know how WFH, I think, yeah, that works.

The hashtag WFH is working for you right now. Lots to get through this morning. I'm first of all going to check in with the Royal College of Midwives. Today, it's made a plea to the NHS to protect the safety of pregnant women by ring-fencing maternity services in the current crisis. Dr Mary Ross-Davie is from the Royal College of Midwives. Mary, what is it you're worried about specifically? So what we're worried about specifically is that we know that we had a shortage of midwives before this pandemic, that we were short of around 2,500 midwives across England

and heads of midwifery have told us over the last week that that has now doubled to around a 20% shortage because midwives are either having to self-isolate or they've been off sick and so there's been a real increase in midwifery shortages. So what we need to make sure is that we're keeping maternity service staff within maternity services and they're not being drawn out into other services. So that's midwives, maternity support workers, student midwives and obstetricians. But you appreciate that across the NHS, people are being diverted to deal with COVID-19. Are you actually saying that your staff are a special case and they should remain so?

There are areas of healthcare, obviously, that are less urgent and more routine care. And so those staff are more able to be diverted to other areas. But what we know is that people don't stop having babies during a pandemic. And so it's really important that we keep the level of care high and safe for women and babies throughout the pandemic. Right. I mean, your message essentially is hands off our people, don't go near them. That's right, absolutely. And also that we want to make sure that the staff, when they are working, when midwives are caring for women, that they have the appropriate PPE, they have the appropriate protection so that they're less likely to

become unwell. And that we're also calling for this really rapid testing to come into force so that midwives are able to be tested, so those who are having to self-isolate at home can come back to work. How many midwives, if any, have been tested so far? I'm not sure of the actual figures for midwives across the UK at the moment, but we know it's not enough yet. We know those tests are coming and we have put out a plea to make sure that maternity staff are included in those numbers. Are antenatal clinics open or are they all shut? Antenatal clinics are open, just not the traditional physical clinics with a waiting room.

Obviously, we don't want women sitting in a waiting room together. So we've done rationalisation in different parts of the UK. They're at different stages, so different things are happening. But maternity services are trying really hard to use virtual clinics as much as possible. So online video conferencing or telephone calls to stay in contact with women and have virtual antenatal clinics. So they're trying all sorts of different ways to stay in touch and make sure that women are still getting antenatal care that they really need. But what about the stuff like checking blood pressure, for example, can that be done this way safely? No, so when women are needing physical checks, what we're aiming to do is have

one-stop shops. So if you're coming in for your scans, which will continue, then we're aiming that those physical checks are done all at the same time so that you can have a scan, you can have a blood pressure check, and all of those things can be done at one time to reduce the number of visits and the number of people that you're coming into contact with. Can I ask you about home births? Can they, should they take place right now? Again, there's rationalisation in some areas and it's really variable across the country. What we know that in around 50% of trusts and health boards across the UK, home birth is still available and still going ahead. We're able to support it in those areas. But we know in some of the really acute areas,

particularly in places like London, that home birth services have been put on pause for now. And that's to do with midwifery staff shortages, but also particularly around the availability of ambulance services. Because what we need to have for a safe home birth service is the ability to transfer women and babies if we need in an ambulance. Right. It might just be that women, and I really feel for them, might have to accept that they will not be able to have the sort of birth they might have wanted. Is it as simple as that?

Yeah, this isn't somewhere where any of us would like to be. You know, the Royal College of Midwives always support women to have choice of place of birth as far as possible. And we advise women to think about home births and midwife-led care settings as much as possible. But yeah, things do need to change in order to keep things safe if there are a lot of staff shortages and particularly if there aren't those ambulance staff. But the midwives

will be there. That's what you need to remember. Wherever we're looking after you, when we shut that door to the labour room, we're still going to try and make that experience as special for you as possible. And we'll be there to support you, talk you through all the normal things around pain relief to make that as positive an experience as possible. Now you mentioned midwife-led units. We know that some of them have closed as well, haven't they? That's right. In some areas, the services are being rationalised and centralised into the larger obstetric units. That's not everywhere. What I'd say is it's really important that you look on your local trust or health board website to see what's happening with your local services.

What has happened in some areas that small midwife led units have been requisitioned to be used as COVID triage or care units, because in some ways they're really appropriate for that because they're single rooms and they have piped oxygen and they have a separate entrance. So we can see why that's been felt to be needed in some areas. But that's certainly not the case everywhere. It really does depend on the progression of the pandemic in the different areas. And if you are hoping for a home visit, is that likely to happen or is that highly unlikely in the current circumstances? We are trying to make as many contacts with women, virtual contacts,

so through means like video conferencing and telephones. But we do recognise that there is still going to be some need for some face-to-face home visits. What's really important is that we're not putting midwives at any risk. So women need to make sure that they call their midwives ahead of any visits to let them know if they're experiencing any symptoms or anyone in their home is experiencing any symptoms but there will still be some home visits available available for women yeah we're going on a little bit later to talk about social workers and the very real challenges facing them right now but you deal too with vulnerable women who probably are at the bottom of the heap in terms of accessing services. Some of them don't access or don't feel able to access antenatal services at all in any circumstances. Are you worried about them right now? Absolutely, we're worried about them,

the most vulnerable women in society. There's been huge progress in terms of the support that we've been able to offer to vulnerable women as midwives over the last 20 years. We know that vulnerable women are accessing antenatal care services much more than they used to much earlier in the pregnancy because we're doing really much better outreach services for those women. So we're going to make sure that we focus, you know, when there's a need to rationalise services, we need to make sure that we're focusing those services on the most needy in society and really making sure that we're able to stay in touch and support those women. So there is going to be a need to reduce some antenatal appointments and some postnatal visits, particularly for women who've had babies before and they're very healthy.

And it's going to be really important that people access virtual support so chat rooms for parents mental health support as well there's lots of that going on online now so I'd really make sure that you you look for that kind of support also look for really reliable sources of information so look on the NHS websites around pregnancy, look on the RCOG and RCM websites for the latest up-to-date information about pregnancy. Thank you very much. That's Dr Mary Ross-Davie from the Royal College of Midwives. Also confusion last week about what is happening about abortion. So from elsewhere in the Royal College of Midwives, we're joined by Suzanne Taylor.

Suzanne, last Monday, Matt Hancock, the Health Secretary, announced that early medical abortions could indeed happen at home. Then that was rescinded. Not really clear why. Then there was an apparent U-turn yesterday. So what is happening? Yeah, we're really pleased that yesterday Matt Hancock signaled that he'd heard women's voices and and I think that's a thank you to Woman's Hour as well for being part of that. He signaled that early medical abortions are now to be available using telemedicine

and that's going to be a huge relief to all the women who need them and to the staff in abortion services who are endeavouring to provide safe care. Now, as yet, we haven't seen the details. But I know that our colleagues in the gynaecology community and the abortion clinics will be advising on how to do this safely, securely and compassionately. So what do you do? Let's say you found out you're pregnant, you're perhaps five or six weeks, seven weeks pregnant. What happens now? So I think any woman who finds herself pregnant today and wants to end that pregnancy should contact her local clinic. So you'll find the address and the contact details for people like the British Pregnancy Advisory Service and Mari Stokes. You'll find all of their details online and they'll then be able

to guide you through the process and what kind of care is right for you and instead of an in-person consultation they will be able at some point to be able to do this by phone or skype and if you're if you want an early medical abortion and it's an appropriate care package for you, then after that consultation has been done, for history has been taken, symptoms, everything that would happen in a face-to-face consultation, then the pills will be sent out in the post. So no unnecessary travel? That's right. I mean, we're all being told to stay at home

and there's no need for women to be travelling to abortion clinics. There's also no need for all of those staff necessarily to be going into the clinics too. So let's make sure that women can stay at home but access the care they really need. Thank you very much for being so concise. I appreciate it. Suzanne Taylor, who's Tyler, I apologise, who's also from the Royal College of Midwives. If there is something on your mind and you feel you haven't had your questions answered, please do let us know at BBC Women's Hour on Twitter or you can email the programme via our website as ever. Now, another group of workers and a predominantly female workforce at that, social workers. They are really struggling at the moment to carry out their jobs, not just safely, but effectively. And a survey by

the British Association of Social Workers says many don't have proper advice on keeping safe or the right personal protection equipment. That's a PPE. We're hearing a great deal about that at the moment. The chief executive of the British Association of Social Workers is Dr. Ruth Allen. Ruth, let's first of all deal with the equipment or lack of it. What's happening? So we heard a lot in our survey, as you said, about the fact that social workers don't have access to equipment and they wouldn't have training necessarily in how to use it in their particular context. What is happening is we're i think getting through now uh we've heard announcements about the availability of ppe personal protection equipment coming into social

care more widely and we're also beginning to see some personal protection equipment coming into some parts of social work particularly those who are working in the mental health field undertaking mental health act assessments but at the moment it's quite ad hoc, and I think we still lack clarity from government about the use of PPE in the kind of complex community settings that social workers work in, certainly in child protection work, work with children and families, ongoing contact with families of young people, and in some aspects of adult social care, I think we still

lack clarity from the government about expectations and provision of that protective equipment. Right. And you dearly love some clarity, I'm sure, very, very soon. In terms of carrying out roles effectively, and these are vital roles, and when things things go wrong it's always social workers who are in the well who tend to get the blame obviously i'm not saying that's right but we all can think of those cases in which that has happened how can you look after for example a vulnerable child whilst observing social distancing yes that's exactly the sort of issue that social workers are dealing with and social workers work um with adults families uh children in often quite a lot of conflictual situations um and are often investigating uh things where things have gone wrong um between

between people and they're safeguarding so um but however But however, there are lots of innovations that we also heard in our survey, and in particular, prioritisation and obviously identifying those people who are most at risk or where there might be the most challenge for people. Using technologies in new ways, using remote forms of communication, FaceTime, Skype, particularly with young people,

with teenagers, using those also with families to monitor how people are getting on and to maintain rapport and communication. And of course, working closely with other professional colleagues. So when home visits are needed, what social workers need is clarity of the protocols they need to use to make that risk assessment so is assessing and seeing a family or a child with social distancing appropriate would it actually be better if they have personal protective equipment to get closer and have the conversation with that family about why that's being used we are all as a society getting used to the need for these kind of clinical barriers at the moment, which are normally quite alien to social workers.

It's not something we do, but we have to have a conversation about whether those are needed. Right. In a nutshell, Ruth, I simply, obviously I'm a total outsider, I simply don't see how you can assess the safety of a home environment if you cannot gain access to that home. That's absolutely right. And with our partners such as the police and health services, we will continue to need to have access to people's homes when there are, when new risks or ongoing risks have been identified. We're concerned about the pressure on families and individuals of being isolated, and we know that there are concerns about rises in domestic violence as well as people's mental well-being and just general family stress,

particularly where families perhaps are living in very poor conditions. Social workers, of course, work with people who are often in poverty and have few material resources, which adds to the stress. And so we're anticipating, and I was even hearing over the weekend from a colleague who runs an emergency service, about a sense of a rising call-out for those kinds of problems. And we need to monitor that as we go forward. And social workers will be at the front line of it.

Yeah, sorry to interrupt, but I mean, people won't be surprised to hear that there's been an increase in those sorts of calls. Are you advising your members not to enter homes without the PPE they need? Or are you currently in a situation where your members are having to do exactly that and may be endangering themselves? So I think it's important to recognise that the employers of social workers, local authorities and others are, we're seeing it in our survey, increasingly stepping up to provide the right kinds of guidance. and that's what they need to do locally because they will understand their local ability to bring together, for instance, multidisciplinary partners to agree who goes into the house

and who is using protective equipment and so on. So that's really important. We are advising our members that personal protective equipment should be available to them to make a risk assessment each time that they have to go into an unknown environment. And that is in line with Public Health England advice for health workers, and it applies equally to social care workers as well. I really want to pin you down on, just briefly if you can, on the practicalities of this. Let's say

I'm a social worker. I'm looking after vulnerable vulnerable children i am concerned about a child at the moment are you saying the only way i can safely assess their safety or lack of it is to facetime them and hope they'll be in a position where they can tell me the truth no i think that's i think that's an oversimplification there are social workers will be very clear about the families they're working with, where they will know where using a Skype call or FaceTime call or a socially distanced visit to the home or where they need to muster other support. Perhaps the police need to be involved in certain circumstances.

Perhaps mental health professionals need to be involved. They will know the different steps that they need to be involved in certain circumstances. Perhaps mental health professionals need to be involved. They will know the different steps that they need to take in order to make a risk assessment and to keep children safe. It is a barrier. Of course, we're all working now in this extraordinary circumstance where we're having to think on our feet and make decisions that we weren't anticipating making. Social workers can make those risk assessments.

They need good backup from their managers. They need good local advice on infection control. And they need to have the equipment and the protocols available to them to do that as safely as possible. Social workers will keep trying to protect children and adults throughout this. But it's absolutely essential that the teamwork, the physical resources such as ppe and the local guidance as well as national guidance is in place so they can make those

decisions securely thank you i appreciate your involvement this morning that's the chief executive of the british association of social workers ruth allen and if you are a social worker and you're up against it at the moment we would obviously welcome your emails as well. It'd be really interesting to hear what it's like trying to do your job in the most challenging of circumstances. Now, COVID-19 is not the first pandemic of this century. I've been talking to a doctor and a nurse who volunteered in both cases to give health care in two frightening outbreaks of new diseases, SARS in 2003 and Ebola in 2013. Monica Avendano is an immunologist and was working at the West Park Healthcare Centre in Ontario when SARS reached Canada, and she volunteered to go into isolation to give round-the-clock care to 12 SARS patients. Mariatu Kamara is a nurse supervisor in Sierra Leone.

She went to work at an Ebola treatment centre run by Médecins Sans Frontières in Freetown. How hard was it for her to make the decision to go in and work there? It was really, like, not easy for me. But I look and say, oh, I need to serve my nation. I need to be part of our country's history. And so, you know, like I could not sit at home doing nothing. I think I need to take up the bold step. And then that's why I decided to apply again for MSF, which was having a treatment centre at Prince of Wales in Freetown. And what was it like working at that hospital during the Ebola outbreak?

It was really like scary. My initial period was like scary, but indeed, with the help of the MSF, which I think their priority is to ensure the safety and security of their staff, I was able to overcome the fear which I got earlier. And I continue working as a nurse. But can you describe what the symptoms of Ebola are? Tell us about the condition itself and what happens to patients. Initially, they have high fever, headache. Sometimes they have red eyes, which is called conjunctivitis. When it gets severe, then maybe we start having bleeding from maybe injection sites, from the mouth, nose and all the orifices.

And so those were some of the symptoms that most of the cases ended up having when it becomes severe. Is it very contagious? It is. It is. Because during those periods, when we get into the various wards to attend to the patients, we have what we call our personal protective equipment, which we put on going into the wards. That is to protect ourselves and our family as well. Well, we'll talk in a moment about what your family thought about what you were doing. But Monica, can you tell us a bit about SARS and when it hits Canada? Because this

is, well, it's 16 years ago now, isn't it? 17 years ago. 17. Well, tell us about it. It was a fascinating, medically very challenging, breaking new grounds and frightening. In what way was it frightening? It was frightening because we were facing the unknown. You know, we didn't know what we were dealing with. The patients were extremely sick and they developed terrible compromise of all the systems. And the treatment that we have was basically symptomatic supportive treatment, you know, other than try to decrease the fever and the pain. It was not much more than we can do.

And you went into isolation with your patients, didn't you? Oh, totally, yeah. I was straight there because it was a unit that was open, especially for all healthcare workers that had been infected by the patient that came from Hong Kong, I think. There were physicians, doctors, there were nurses. There were even people who cleaned the wards. Yeah, I was straight there. I stayed there all the time.

We couldn't leave because we were only two physicians and we were all the time busy. I was concerned about my family, but I knew that they were okay. So, yes, that's very interesting. Your perspective is unusual because you were, in a way, protected from what was going on outside. We didn't have time to watch the television, the news or anything, you know. We tried to sleep at 2 and 4 o'clock in the afternoon, sometimes in the middle of the night, but we were always, always working. Did you...

Always working. Did any of your patients die? No. No. Not a single one? None of our patients died. None of our patients died. none. And I think that part of the result that they all went home is that we were completely aware of anything that was happening to them. We were only the two physicians, we were all the time there with them. We didn't need to communicate at the end of the shift. No, we were completely

on top of everything. And you knew your patients intimately? Very well, yes. Very well. That's very interesting, isn't it? Mariato, I know that unfortunately many people died in Sierra Leone, didn't they, of Ebola? Yes, yes. All over Sierra Leone we had so many deaths. Health workers, there were so many deaths. But what I know is we tried our best. We really like fought a good fight. I remember we had a mother who was admitted in the centre with her two kids. We lost those two kids and the mother was the only one who was able to survive it.

It was really not easy. Yeah. And I said I wanted to know about what your family thought. I think it's fair to say that they didn't want you to do it really, did they? They never wanted me to work. In fact, I even applied for the job without them knowing. Yes, I applied and then MSF had to call me for an interview. I went to the interview without them knowing also. It was only when it reached the time like they called me and said I should start walking that I decided to inform my family. But they kicked against it really. They were like, Adama, that

I should not walk. But I tried my best. I tried to convince them. And with the help of my elder sister, I was able to pass through. And she was the one that was able to convince the rest of the family. They allowed me to walk, but yet they were still not okay with me. But I proved them that I can do it. Well, did your friends and neighbors avoid you in the street? What was it like? Yes, yes, they did. I experienced that stigma, really. That moment I never had friends. I'm not going out and when I'm from work,

I come home, take off my dress. And even my own relatives, that moment, when I'm coming from work, they will not come around me. They will never come around me until they see I take a shower. And my neighbours were asking me all sorts of questions. Why should I go and work for Ebola? It was really not easy, but I tried to convince them. I tried my best to convince some.

So can I ask, was your health ever compromised? Did you catch Ebola? No, I never catched Ebola. I believe I know how to be very much cautious and try to observe my standard precautions in times like that. Now, as I'm speaking to you, it's the 24th of March. It's a Tuesday. And I don't think Sierra Leone has yet had a case of COVID-19. Is that correct? Yes. For now, there is no case recorded yet. And we are hoping and praying that we don't have such case in Sierra Leone. We very much hope that that stays the case.

Monica, we know there are cases in Canada. I know that you are You know, really SARS was the first infectious disease in the century. And it was characterized by the striking healthcare workers, the same workers that had to be vital for the control of the disease. And it's happening now. I have seen that doctors in Italy, nurses in other countries have been dying. And unfortunately, so far, for SARS and now for the COVID-19, you have to resort to infection control tools dating back more than 100 years, basically isolation and quarantine. So what did you learn 17 years ago that you want people to pay attention to now? That this disease took advantage of the opportunities provided by international travel

and it's the same thing that's happening now and now it's much worse. I mean I have a lot of admiration for the people who is working now because it's just non-stop. It's just increasing. SARS was one shot and that was it. Two waves, but nothing like this. I mean, we had like 400 patients or something in total. Although it must have been a very hard time for you, it must have been also incredibly energising. And you must have emerged from it a different person.

What would you say about that? Really, you were a physician, but nothing has taught us what to do with this patient. Our patients have problems with the lungs, of course. I'm a respirologist. And also with the kidneys, with the heart, with the brain, with the liver. Every day there was something new, very challenging, you know. We have to work fast, think fast about what to do with them. But as I said, for the first and probably the only time we were doctor-like in the last

century. Yes. So although it was the worst of times, it was also the best of times because you were able to prove yourself. Exactly. Yeah, I think so. I think that with my colleague, with Peter Derkacz, my colleague, excellent clinician, we were all the time, you know, challenging ourselves. And Mariottu, is that how you feel? You've already said it was a privilege to do what you did. Yes, really. I see it as an opportunity for me, which I grabbed. At least I was able to serve my country. I was able to stand firm and at least prove to others that not all health care workers will die of any outbreak. So I believe I was able to like prove myself to people. Right. Two really humbling contributions there from Mariatia Kamara and Monica Avendano. And

how grateful the rest of us should be for people like that being around right now or indeed at any time. Now, tomorrow on the programme, we're going to talk about co-parenting during the current situation. But during an idle moment yesterday afternoon, and let's face it, we've all had a few idle moments. I was tweeting about how working from home was working out, quite simply. Got some really interesting responses. Here's one. It's a nightmare and a lot of management don't get it. It's one of the hardest things we've done. The kids are six and one. We're swapping shifts of parenting, working, homeschooling between five in the morning until 10.30 at night.

We've got ace kids, but this is gruelling. Here's another one. Two parents here and one almost three years of age are both able to work from home. I do six to 12. He does 12 to whenever it's finished. Our three-year-old demands attention so neither of us can work and parent at the same time. And then obviously a lot of people just said, what about single parents? Single parents with perhaps two or more children are really up against it.

So we'll talk about that. And yes, about the gender politics of working from home and who has the top job, so-called, and how that all pans out in the home. So that's later this week. You can keep your emails coming on that one. Now, when you think about Calamity Jane, and who doesn't, we all tend to focus on the campathon that is the film starring Doris Day,

but actually Calamity was a real woman and she had the fantastic real name of Martha Jane Canary. Professor Karen R. Jones has written a book called Calamity, The Many Lives of Calamity Jane. I asked Karen how to place her in history. So she was born in the Midwest to a farming rural family. They, as many families did, were quite mobile, moved around from place to place, always looking for that fortune, the American dream over the horizon. They migrate to the Montana goldfields in the mid-1860s. So she's born in the mid-1850s, the eldest of six children,

and the family moved to Montana. And did they all survive into adulthood, all six children, and the family moved to Montana. And did they all survive into adulthood, all six children? There are sort of convoluted stories about all of them, so their trace is as fragmented as hers. So they sort of disappear from view very quickly, and I think that's part of her genealogy. What makes it so intriguing is there's never a straight tale as to who is who and

who ends up where and and any of that so her real name was Martha Jane Canary yes a name that is actually at least as good as Calamity Jane if not marginally better um where did the calamity come in you know again tracking the reality in in this is is is fraught with difficulty. But the most famous iteration of her origin story, if you like, is when she's travelling with the army in the 1870s. She says she's on a patrol and an officer called Captain Egan is about to fall off his horse. They're ambushed by Nez Perce, American Indians, and Calamity rides back from the front of the military train

and stops him falling off his horse. He's very pleased with this and names her Calamity Jane, the heroine of the planes. So she's called Calamity because she saved him from calamity, which is a sort of a curious reason for the naming. What I didn't ask you was how she got to be out riding with him in the first place. Okay, so again, this is where the difference between her legend and her reality really crunches up together. So from the 1860s, she's in Montana, she's orphaned, and she lives a real hand-to-mouth existence, doing any jobs that come her way.

So some are more traditional for women, others much less so. And she ends up travelling with the military as well as railroad gangs and mining teams and such like. So she's with the military caravan and these are the years in which people start talking about this curious woman who's dressed as a man who's travelling with the army and who is she. She presents herself as a female scout.

She's out at the front doing her thing, you know, for the cavalry. And was it really uncommon for a woman to be doing that? Regardless of how she was dressed? Yeah, very uncommon. It was, OK. So women did travel with the military train in a sort of clandestine capacity. So prostitutes and other people who were just sort of travelling at the margins. And some did dress as men in order to pass without being detected

because women weren't allowed to be present. Officially. So they weren't dressed as men merely because so-called male dress was just more practical? So in that context, there's, I suppose, reasons for disguise to remain undetected. In other contexts, yeah, practicality comes into mind. So there's a whole sort of hidden story, if you like, of women disguising themselves as men in the American West. So we move on now seamlessly to the Calamity Jane gay icon years. Where and how did that start? It depends where you decide to pinpoint the revisions to her story. So in sort of tracking her afterlife, it's really the 1990s onwards that we see, particularly playwrights toying with a different version of Calamity,

if you like, and uncovering the story of a masculine-looking, butch-looking, marginal woman who doesn't conform to what we'd expect traditional frontier women to be. That is where the revision really takes root in a meaningful way. Although, of course, there are ways in which the 1953 musical with Doris Day have been revisited and we've got this far in the conversation without reference to Doris Day and I brought it up as well well I was it was about to be my next question obviously yeah tell me more about that film um I mean this is the by far and away the the most striking representation of her the the the go-to source for most people so you know this is a on one level a glossy 50s musical

where everything is lovely in America. The frontier spirit is alive and well, it's uncomplicated. And, of course, Doris is leaping around in buckskin and entertaining the troops in Deadwood. I remember loving the film partly because it had a woman at the heart of it having an adventure yes a lot of us loved it for that reason yeah I'm sure for plenty others absolutely so in a way the sort of conventional reading of the film is that the character is

tamed and domesticated however lots of people when they've they've discussed watching this film see exactly the untamed calamity as the coolest bit. And actually people have then revisited the film and pointed to the relationship between the two lead female characters. Remind me who the other female character is. So it's Katie. Who was? So she impersonates an actress and is brought to Deadwood as sort of a fake vestige of entertainment, which is then uncovered.

And her and Calamity establish a friendship and they live together in a cabin and they sing A Woman's Touch and they spruce up the place. And then they get engaged in sort of a love rivalry with the lead male characters right so at no point are we supposed to think that they're a couple or are we well do now people think yeah i mean i think that there's there's a subtext there which some film study scholars have looked to the early 1950s and the sort of regulation and censorship of the movies as not really allowing for any over-demonstrations of anything that's not just a sort of heterosexual resolution. But this is certainly a possibility.

And it is now, I think it's a fixture, isn't it, Calamity Jane, at gay film festivals? Yeah, absolutely. But Katie, the character, is she based on any real figure in Calamity Jane's life? No. So the film very much takes a broad brush approach to the actual biography of Calamity Jane. So yeah, there is a character who dresses in buckskin and props up the bar and tells stories which are invariably false. But she's drinking soft drinks. She's not drinking hard liquor. Well, Martha Jane Canary did take a drink, didn't she? And in fact, I think it was, was it alcoholism that eventually killed her?

Yeah, so she died aged 47 of complications related to alcoholism. One of the things that interests me about her story is that she's on one level an exceptional character. You know, she's highly one level an exceptional character. She's highly unusual, unorthodox. She's operating as a frontier celebrity in very much a man's world. But she's also representative of thousands of women who are pushing those boundaries and striving and struggling and making inroads in a really complicated and challenging environment. And she has an itinerant life.

She lives at the margins. She's a drifter and she develops an alcohol dependency. And so, you know, there's a story of vulnerability and tragedy to this as well as the kind of fame and celebrity. Can you just describe the life? I mean, yes, I get the travelling, I get the looking for gold and all the rest of it. But what did they do? I know it sounds a stupid question, but I want to know, did they hunt? How did they keep themselves going? A bit of everything, really. So freighting, she did laundry. There are reports that she was a prostitute for some of the time. She also sold postcards of herself and tried to trade on this celebrity,

regional celebrity and then growing national celebrity that she had. So it's very much a life founded on whatever opportunism comes along in terms of making money hand to mouth. And at the time of her death, was she famous? She was famous. So her death was she famous she was famous yep so her death was recorded and yep so by the time she died she'd appeared in um some wild west shows dime novel stage shows she'd produced an autobiography or a ghostwritten autobiography because she was um to all intents and purposes illiterate so this autobiography was really her her script that she narrated

to those who came to the show. So she was famous and she'd been made famous in various novels about the West and also dime novels, so pulp fiction. So she had this sort of entertainment imprint to the extent that she was eulogised in The Times by Buffalo Bill Cody. So she certainly had a presence at the time of her death, although she died in poverty. That was the fantastic Karen R. Jones

talking there about her book, about the life and times of Martha Jane Canary, the woman you know better as Calamity Jane. And it was one of those something completely different items that we're just gently nudging into the programme right now because it is easy, I guess, to just get completely, I was going to say sidetracked, but to devote every single programme to various aspects of COVID-19.

And we're trying hard to both do that and do our other stuff as well that I know a lot of people enjoy. So to your emails and thanks to everybody who got, I hate saying got in touch, made the effort to contact us today. It's just a personal thing. This is anonymous. My daughter is currently pregnant with a baby due in July and she's booked for a home delivery on the advice of her midwifery service.

After a hospital delivery when she barely got there in time, her previous child was a planned home birth. The baby arrived before the home birth team did, but luckily our husband got home just before his son arrived. Every birth is different, but even if her trust decide that they can't support home births at the moment, she'll probably opt to stay at home on the grounds that it will be safer there, even if the professional help is not available, than the likely alternative of the

baby being born without professional help at the side of the road. Yes, I see the conflict there. Of course, our guest did point out that it was the ambulance service that might be hard to get hold of at the moment, obviously for reasons we can all understand. Catherine on email says, my daughter's a health visitor in Lincolnshire and she's experiencing the daunting prospect of going to see clients at home without PPE. Because of mandatory self-isolating, numerous families are forced to exist in cramped accommodation. And that, of course, exacerbates family tensions and problems. Consequently the demand for the services of health visitors is growing. To my knowledge so far this profession has been ignored in the coverage. Well we'll perhaps do something to rectify that but that's what we're here for.

We're here to fill in the gaps because sometimes what women are up to and the jobs that women occupy, they can get somewhat forgotten, can't they? And from another listener on Twitter, thank you, Woman's Hour, for asking the questions we're not getting answers for. I'm a child protection social worker, disappointed by a lack of direction. We don't have PPE. We have been told to use video calls for child protection visits and we don't have clear managerial direction. Well, that is worrying, isn't it? And I think all those of us outside social work, I think we need to try to understand what social workers are up against because we can all point to those horrendous stories where social workers get the blame um social workers do not harm children um it's the rest of us who do that and then social

workers end up being blamed for her hideous acts carried out by other people um what else have we got here my daughter is pregnant and has been called back to work as a pediatrician whilst i sympathize with parents not used to entertaining their families 24-7, please give a thought to the mothers who would love to not have to put their children into childcare and put themselves in risky situations. They would give anything to stay at home. I get that too and I know there is a temptation for people to say, oh it's horrendous, I can't believe I'm home again with my children and they won't let me work. We all need to perhaps stop a bit of that.

I mean, I speak from the point of view of someone who's cohabiting with a 20-year-old and a 17-year-old. And even in my very fortunate set of circumstances, and they are fortunate, there are tensions. And you do find that you're getting on each other's nerves. So we just all need to make every effort to get along and understand what other people are up against. This is about working from home. I won't mention the name, but there are many families working from home whilst homeschooling children with disabilities, physical, behavioural and emotional challenges. I'm at home trying to care for my son of 10 and my nine-year-old daughter who has a learning, hearing and other

disabilities. Between my husband and I, in addition to homeschooling, we need to differentiate her homeschool work and provide the support that a trained teaching assistant would provide on a one-to-one basis at school. Gosh, it's so difficult, isn't it? Employers do not typically extend care leave allowance for those caring for disabled children. Yeah, you do sound that's a tough call. And I hope over the coming weeks, we will get the opportunity to cover just about every single aspect of the current situation in relation to women and the load that all too often falls on women in situations like this although of course we've never had a situation like this have we um a listener asked please please could you get a child psychologist or psychotherapist to come on the program

and give us some idea of how to approach explaining the sudden absence of close family members. I think that's a good call, actually. The listener says, I've got a granddaughter of 26 months. She lives just a couple of stops away from me on the Tube. Her parents work four days a week now, and I'm very close to her, having at one point looked after her for four days a week, and more recently for one long day and two half days. I'm 73 and I miss her such a lot, but my main worry is that she might think I have suddenly abandoned her. Apparently she often asks for me when she wakes up. That's heartbreaking. And yes, that is definitely something. I'm sure we could get one of our regular psychotherapist contributors

to come on and answer just a whole range of family questions like this. But rest assured, listener, I know your name, but I won't mention it. Your granddaughter will not forget you. You'll be back in her life sooner rather than later. And nobody ever forgets their gran. Absolutely not. Right. Thank you all. And we hope we will, when I say we hope, we will be back tomorrow. Hi, I'm Catherine Bowhart. And I'm Sarah Keyworth. We're comedians separately and a couple together. And we're the host of You'll Do, the podcast that gives you a little insight into perfectly imperfect love. Yeah, forget nights in with this one and hashtag couples goals.

We want to know the whys and hows of sticking with the people we love and asking a few of the questions that are meant to help us develop intimacy. So why not give it a listen and subscribe to You'll Do on BBC Sounds. 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 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.