Woman's Hour - Cumberlege Review Reaction; Leaving School Rituals; Motherless daughters

Episode Date: July 8, 2020

The Independent Medicines and Medical Devices Safety review has been released this morning. Baroness Cumberlege led the review into the the effects of vaginal mesh, the hormonal pregnancy test Primodos and the epilepsy drug Sodium Valproate. She discusses its recommendations and her experience of hearing so many moving testimonies from women across the UK. Jenni also hears some initial reaction from Mary McLaughlin, who has campaigned for women affected by pelvic mesh in Ireland, and Clare Pelham, the CEO of the Epilepsy Society who gave evidence to the review about the effects of sodium valproate. School leaving rituals – the sweatshirts, the prom, the signed T-shirts, the school trip and primary school final assembly. How important are they and what impact has the Coronavirus pandemic had on this year’s leavers? Jenni speaks to Juliet Benis, Head Teacher at Ambler Primary School and to A' level student Anna from Bacon's College. Motherless daughters can experience persistent grief for years which peaks during milestones. After the death of her mother Emma Winterschladen has gone through what she calls ‘missed mum moments’ including graduating university, her first job and more recently her engagement. How do motherless daughters navigate these big moments without their mothers? Freelance Editor, writer & illustrator Emma Winterschladen and psychologist Anjula Mutanda discuss the relationship between grief and joy.Presenter: Jenni Murray Producer: Caroline Donne Interviewed guest: Baroness Cumberlege Interviewed guest: Mary McLaughlin Interviewed guest: Clare Pelham Interviewed guest: Juliet Benis Interviewed guest: Emma Winterschladen Interviewed guest: Anjula Mutanda

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BBC Sounds. Music, radio, podcasts. Hello, Jenny Murray, welcoming you to the Woman's Hour podcast for Wednesday the 8th of July. By the end of July, schools across the UK will have closed for the summer. What impact has coronavirus had on school leavers whose rituals, the prom, the sweatshirt, the signed t-shirt or the school trip are not taking place? And how does a daughter cope when her mother dies when she's young? How does she navigate the milestones in her life as an adult without maternal support? support. Now as I'm sure you've heard in the news or read in the papers the results of the

Independent Medicines and Medical Devices Safety Review has been published this morning and has revealed that tens of thousands of women and children were catastrophically harmed by three avoidable health scandals, and women were ignored. The review investigated vaginal mesh, used as a treatment for incontinence, primidos, a hormone pregnancy test which became associated with damage to infants born to mothers who took it, and sodium valproate, a treatment for epilepsy known to harm the foetus if taken when pregnant. It was Baroness Cumberledge who led the review.

Jane spoke to her yesterday about how it was carried out, her insistence that those affected should get an apology and the recommendation she has made. Well, one of our major recommendations is that we should have a patient safety commissioner. This is somebody who will really listen to patients, hear what they say and monitor what is going on. They will also call the healthcare system to account. And that is important because people have been going on and on and on, promising things, and nothing has

happened. So we want action as soon as possible. I think a lot of people, a lot of our older listeners, will obviously think back to thalidomide and they will simply not be able to believe that these three separate scandals were allowed to happen. Can you understand that? I am deeply shocked. I think this whole thing has been a mega disaster. And it's not just about looking at one rogue surgeon or a hospital that's fallen apart or whatever. This is about thousands of women in three different areas who have been ignored. And indeed, in one, sodium vulparate, which is taken by women who are epileptic and it controls that, it is still happening today. And those women, if they are not told, if they are not aware that this drug will cause them damage, then they have a chance of one in two babies being seriously harmed.

Well, let's start then with that anti-epilepsy medication, as you say, still being prescribed. Should it be banned? We can't just ban things because for some women, it is the only medication that really controls their epilepsy. stop or at least consider, talk to their clinicians and possibly not continue with that particular drug, but see if there are better alternatives. And Primidos, that now isn't in use, but the impact of that was absolutely colossal. It was.

And again, the really shattering thing about that particular event is that it could have been stopped. People knew it was harming. The concerns 50s, 60s, whatever, who is going to look after them in the future? That is a real worry for them. When Primidos was being prescribed, the impact was felt, if not acknowledged. And yet again, people suffering were ignored. Did this happen at every level of the NHS or were some people more inclined to intervene and acknowledge the mistakes that were being made? really has failed. It's failed these women. And we need an apology from the Secretary of State to say that they have heard that these things should not have happened. And he should apologise to the nation for the harm that has been done. What about the people you spoke to? Because this has been an effort that has taken a huge amount of your time. I think you and your fellow members of the review have travelled the length and breadth of the land talking to people.

What have you heard and what have you seen? Huge suffering. Terrible, terrible things happening to families. We've seen women who've had mesh inserted, but they have been active previously. They are now reduced to a wheelchair. And this is because of the enormous harm that has been done to them. And we have heard the suffering in all three areas. And this should not happen. It was avoidable. And that is the thing we want to really put right for the future. And some of our recommendations are about the future, because the nation should not go through something like this again. But what is terrifying is that there appears to be a culture of denial here at work, going back many, many decades. How do we change that? Well, you are so right. That denial is absolutely unacceptable. And we have heard even now that that is happening in some quarters. And women are being told, all right,

well, you think you're suffering, but actually it's all in your head. You're just thinking about it. It's not true. It is true. We have heard so many stories of real tragedies, of lives turned upside down, relationships broken. In the past, they've had careers, they've had jobs, and no longer because they are far too disabilitated. And so we're saying that simply must not happen. So we have got recommendations that we think will address these issues for the future and ensure that in the future these sort of things will not happen, especially to the extent that it has in what we have been studying. Vaginal mesh, its use has been paused but not banned.

What's the situation now? Well, we were horrified by what we heard. And we said we must halt these operations. So in July 2018, we halted them. And they have not been reinstated. And we said, if you are going to reinstate them, you must have these safety measures. Those safety measures, two years on, have not been met. And we say, well, if in the end there is a woman with cancer and this is the

only option that she has, we're saying these women should be told exactly what the risks are, obviously what the benefits are, if there are benefits, but the risks, and they should be told the alternatives. And we are convinced that there are many women, if they really knew what these medications, what these devices have done to women, they would think very, very seriously of either taking the medication or agreeing to the device. Of course, this isn't an easy time to criticise the NHS in any shape or form. But if you could point to some of the failings you've seen here, what would you say? Well, I'd say it's not just the NHS, it's the whole health care system.

We're talking much wider than that. We're talking about the regulators, the manufacturers, the policymakers, other people involved in health care. And it is to actually look at the whole picture that is really, really important. But if a woman says that her medication or her treatment is causing her harm, and she believes it to be causing her harm, she must be taken seriously. Of course, of course. And I think women now are of a different generation from mine, where we always believed what we was told was right, but today, no. You should investigate, you should look at Google and all other sources and to see really what the truth is, because you need to make these decisions. It's your body and it should be your decision. And the ramifications for the people

who've been involved for years in some cases in campaigning around these issues, what do you think they will be satisfied by in the future? Well, we are saying it is essential that they get some recompense. And those issues have to be taken seriously. And we want three different schemes for the three different areas to give those women help that they need. And it's not just treatment, it's financial help and non-financial help. agency will not be adversarial. It will not study blame. It will ensure that there is proper learning within the system of the mistakes that have been made. But as you acknowledge in the report, some people have not had their concerns addressed. There are other treatments and other drugs that were in the mix here, but you simply didn't have time to deal with them. So there are ongoing concerns, aren't there?

Well, there are. And we were given three different areas. And I have to say that was very challenging. Usually when you do a review or it's about one road consultant, it's about one hospital that has gone to pieces and isn't working correctly. We were given three different areas. And so it is a very complex report from that point of view. But what we did find, which was interesting, was that some of the issues read across to all three areas. And Jane, you're right. It is about women's consent. They need to be told in real detail what the risks are, what the opportunities are, what are the alternatives are.

And also, it may be something about, well, I'm afraid we'll have to reconsider this later. In brief, are women still getting a shabbier range of treatments than men? And are they more likely to be disbelieved than men? I think to some extent that is true. And therefore, women do need often a companion, somebody else who's going to be with them, who will also listen to what's being said at a consultation or whatever. And also, it's an opportunity today to record it. So you can take it away on your iPhone. You can share it with your family and your friends. And they may say, but he didn't tell you this, did he? He didn't answer that question, did he or she, whoever is treating them?

So I think the new technology, we have to work differently and we can actually make things safer. And it's very likely, of course, that Matt Hancock, who's the Secretary of State for Health, will indeed make the apology. Well, he will make the apology. But will your recommendations be implemented? We will fight tooth and nail to make sure they are. We cannot have these sort of situations continuing. Baroness Julia Cumberledge, who chaired the Independent Medicines and Medical Devices Safety Review. Now, obviously, the issues covered in the report span decades and different governments, but it is of course for this government to respond. And indeed, the Secretary of State, Matt Hancock, has this morning issued a full apology and said it's important to learn from the report.

But what do the people at the heart of this review the women affected make of it all well mary mclaughlin is a campaigner for women injured by pelvic mesh in ireland claire pelham is chief executive of the epilepsy society they both gave evidence to the review and they've both had a chance to read the report so claire what's your reaction to the report from the perspective of those affected by sodium valproate? Everyone at the Epilepsy Society and those who've been most affected, who've had the opportunity to look at the report's conclusions, warmly welcomes it. From our perspective, it's absolutely brilliant. Baroness Cumberledge has not only prescribed justice for the hundreds of thousands of women who've been harmed by Valparait, Primadoss and the mesh, but much more than that, as she said,

she's had the opportunity to look at the underlying reasons why these disasters affecting hundreds of thousands of women have happened. And let's be clear, will continue to happen if nothing changes. But Claire, it seems it's been known for ever such a long time that the sodium valproate had a high chance of causing harm in pregnant women. Why did nobody do anything about it? It's absolutely been known for four decades and it's still going on. Hundreds of babies will be born this year to women taking Valproate who are not aware of the risk.

And there's just been a complete failure of leadership in the healthcare system. And this is a staggering thing for a review of this kind to conclude, that the health care system does not recognise patients as its raison d'etre. So, I mean, that's just staggering. What is the point of our health care system if it's not to support patients? And that's a really damning finding. And I hope that the Cumberledge review will be as influential as McPherson. Just as McPherson said the police were institutionally racist and that was a trigger for change, Cumberledge says the healthcare system is institutionally elitist and it must change. Now Mary, I know you have been affected by pelvic mesh and have long been a campaigner on behalf of other women. What do you make of the report's findings? Well, as a mesh-injured woman,

I've had my implant implanted in 2008 and had it taken out in 2019 in America. Of course, all the campaigners welcome the system-type responses, putting in place a commissioner, putting in place a task force, putting in place lots of institutions to ensure that the women don't fall through the net or other patients injured women and for the women on my group and they're from the north of Ireland and from the south of Ireland I fear that we have a real problem with these specialist mesh centres and that they are being promoted as something that they will not deliver on. Why are they going to be a problem would you say? Because from my perspective they are old wine and new bottles. The mesh centres I'd like to explain to the public they're not actual buildings or centres. They're hours of clinic time within existing hospitals and our problem is that the women are being sent back

to the same pool of surgeons who put their mesh in, who denied they were mesh injured, and who up until very recently were not even interested in back to the same physicians who have ignored and denied them. And all these physicians belong to clinical bodies like the BAUS or BSUG and the GMC. All their members are doctors too. So we feel that these institutions in our system are just recycling doctors they already had. Mary, why did you have yours removed in the state? Because that is the only search and that the international mesh community um are very confident of um dr veronikis uh dionysius veronikis in st louis missouri um i try i've tried in four in all the devolved governments and in england and i worked with the

cumberledge review as well to bring dr veronikis here. I had asked the doctor if he would do an offer to the women in that he'd be brought in the public health system and that he works through a backlog of patients. He was prepared to come for four to six weeks and he works six days a week anyway he has been he has explanted thousands of meshes i was lucky i escaped the knife in london and got to america my mesh was intact so it hadn't been previously cut or trimmed as the surgeon say once they do that the um the the the ends of the meshes grow new scar tissue from that operation and if women have a few trimmings which can be done very quickly um that scar tissue can prevent even a world expert from accessing the remainder mesh in their body. So I saw this guy on Twitter, and he had put up pictures of the mesh that I have in me,

of him removing the mesh out of the groin sections. And it was, my jaw just dropped, because the surgeons in London hadn't told me, they hadn't been clear how much of my mesh was in my groin. So the mesh that was taken out was 28 centimetres long. And for the trans-opterator mesh, the one that the Baroness has more or less put in the same category as the prolapse meshes, that they're more dangerous

and should only be used under high vigilance regimes. That's the one that the doctors in the UK, and not just in the UK, around the world, don't know how to take it out. Claire, obviously a huge amount of trust has been broken across the years in all of these things how easy is it going to be to rebuild trust which has been so damaged i i think the health care system must use this as a

trigger for change what's really needed is cultural change and i'd like to make it clear that that none of us at the epilepsy society are critical of of frontline NHS staff who've done and do the most amazing work. This is a failure of leadership. And I just like to pick out the recommendation for a patient safety commissioner, because I think this is absolutely critical to getting the culture right for this century. What we need is a Florence Nightingale of the 21st century, a really ballsy woman able to take on the medical establishment on behalf of patients. That's why the health care system is there for patients. And it's about time their voice and their experience was regarded as valid.

And Mary, how confident are you that this will lead to change and won't just be another review that gets shelved i'm not confident i teach law teach legal systems i know that um government uh uses reviews and reports and and the government can pick and choose them which recommendations it would put in place um i am not confident that if we go to the bottom end of all those processes, that a woman going to a specialist mesh centre will be able to assert her right to have her medical device removed. I'm not confident about that because the specialist mesh centres that have been commissioned now in the UK they have a new

complex surgery removal specialist centers so among that pool of surgeons who couldn't help us and were very covert about our injuries they have now put themselves forward as mesh removal specialists and now the women have an extra layer they have to go through going to an MDT at their local clinic and then only when that MDT says that they can have their mesh fully removed can they be put to another layer which is an MDT of this specialist complex mesh removal now that to put it in bluntly if I walked into a hospital today to a mesh clinic they would refuse to to allow me to have my mesh removed because I did not have the mesh erosion which is a visible and palpable mesh coming through your inner and cutting you.

I never had that. I was bed-bound for three years. Mary, we must stop. Mary McLaughlin, thank you so much for being with us this morning and Clare Pelham. We would like to hear from you. If you have had the kind of experiences we've heard about, you can email us or you can send us a tweet. And Mary and Claire, we will stay on this story and see what

happens. Thank you both very much. Now, still to come in today's programme, the experience of the daughter whose mother died when she was young. How does she navigate the milestones in her life? Graduation, first job, engagement without maternal support. And the serial, of course, the eighth episode of Six Suspects. Now, earlier in the week, you may have missed the young artist Abigail Maguile, who won an award for a picture of herself in the bath. Or Ivana Bartoletti, who talked about artificial intelligence. If you missed the live programme, you can always catch up.

All you have to do is go to BBC Sounds and search for Womans Hour and there we will be. Now, children in Scotland have already broken up for the summer. Those in the rest of the UK will be out by the end of this month. But what sort of school leaving will it be for those who won't be coming back because they're moving on to secondary school from their primary or to university, college or maybe even a job? None of the proms, sweatshirts, signed T-shirts, school trips or final assemblies can take place because of the coronavirus. How much will such rituals be missed? Well, Juliet Bennett is the headteacher at Amber Primary School in North London. Anna is an A-level student at Bacon's College in South East London.

So, Anna, what was it like when your school closed down and you all had to leave at the lockdown? What did you have to do then? Well, a few days before it was announced that school was closing, we were told, you know, to clear our lockers, you know, to take everything home with us because we might have to continue our education online. So, you know, take your textbooks home.

And it was, I got to say, the last day was very bittersweet because it was the last day we were going to see everyone together. What chance did you have then to say goodbye to all your friends and teachers? Well, at least from my experience, with most of my teachers, I took photos with our classes, so, you know, we still have those memories. And both our heads of year created this assembly that we just at least six formers got together and we got to say goodbye to each other and right before school finished at 3.30 we had this service sort of thing where our principal

was speaking to us how we shouldn't be scared and that we should take on this challenge and just continue with our education. What leaving events had been planned that now won't take place? The biggest one being prom. You know, that was just the end of your sixth form life. You know, that was how... We had so much to prepare for prom and we were preparing it since the beginning of year 13 and it's so sad to not have that happen anymore.

It's just very nostalgic. Even looking back at my year 11 prom, it's just so nostalgic looking back, thinking, oh, wow, I looked even so different two years ago. So it's sad that that's not able to happen this year. Juliet how important are end of year rituals at primary level? I think exactly as Anna says you know it for primary children there's a whole thing about you start some of them start when they're only six months old as babies in my school.

So they've been there for their whole kind of lives. And the final year, year six, is the year where they are preparing for the ending right from the beginning. You know, although we do lots of things all the way along, you know, getting behaviours and qualities developed as they go. They're all really looking forward to the end where they have the time capsule that they can open, that they put away at reception or their prom or the hoodies, as you say, or the ceremonies where we talk about the three words that describe them or the dressing to impress moments or getting a special event like um going to a theme park or a theater trip that is just a big thing especially for them so how much how much is the american influence and and the prom party idea even seeped into primaries well i think some primaries do it more than others and i know a lot of secondaries who go as far as having you know great kind of different cadillacs and transport that takes them to their prom

we don't do it quite like that but we give them a very special event so although you might call it a prom it's more like a dress to impress or an event that maybe many of our children haven't had a chance to do like go to a meal or or do an event in the playground and we are going to try and do something because I think endings are important it's the transition to your next step and they need to kind of take stock and be able to feel that moving on is okay and I wondered if you know some friends might be actually a bit relieved not to have to face the pressure and maybe expense of a prom. I think at least in my school, the expense of a prom was a big thing. So we were doing many fundraisers for it. So the price of the tickets at least could be taken down. But from my experience, because I went in year 12 as well,

having everyone be there kind of, it's worth the money to say goodbye to everyone one last time and have this fun occasion where you get to, as you know, to get to dress to impress. So Juliet, what can you do for your not so little ones anymore the ones you'll have known from when they really were tots? Yeah I think that one of the things is that I guess that every ending is a new beginning whoever it's for and although the children will have really mixed emotions they'll be excited.

But the goodbye is always very sad. That moment of crying, everybody hugs and cries. We can't do that this year. But the excitement is all mixed up with fear. So I guess, you know, I want our children to know that what they've gained and what they've learned and how they've grown. So they can take that all with them and be the kind of wonderful people they're going to be and anna i know you're hoping to go to bath university how are you expecting the teaching there to progress um i've been receiving emails from bath and from what they want is that they want us to go to bath because obviously bath is three hours away from London so that in

itself is an experience so they want to keep the whole uni experience so where you get to move out move in with to your accommodation it's not just about education on its own but it may seem like online education is what's going to have to continue with what is happening currently. However, it personally, I don't agree with it. I wish everyone to be safe. I mean it. I'm paying £3,000 and I want to get the whole experience, not just the education part of it. I want to get the social interaction and going out and being independent and setting up for my adulthood.

Well, Anna, the very best of luck. I hope it turns out just as you want it. And Juliet Benes, I hope your primary children go on to senior school and love it. Thank you both very much indeed for being with us this morning. Now, we all at some point in our lives become motherless daughters and even when it happens later in life, in my case I was 56, she leaves an unfillable gap. There are still times when I'm tempted to pick up the phone and talk to her 14 years on. So how does a daughter whose mother died when she was still young navigate the milestone moments in her life?

Graduation, first job, engagement, without the support of her mother. Angela Mutanda is a psychologist. Emma Winter-Schladen's mother, Jenny, died when Emma was 16. Emma, how did you cope with your grief at the loss of your mother when you were only 16? Well, I think when I was 16, I probably didn't cope very well, to be honest. I sort of put it in a box and thought, because I had such little control over the fact she died, I remember thinking rather stubbornly, right, as I go forward in in my life I can't let this ruin my life and I think for that reason actually that was

a big thing that when I did go forward I just didn't think about it until really only a few years ago and what happened two years ago to make you really think about it well I think moving to London after university and renting my first house and getting my first job as I started ticking off all these different milestones I think I came to a stage where I was far enough away from it to really just start sitting with my grief and looking in the eye I guess uh when it wasn't maybe so raw what do you mean by looking it in the eye I was finding that I was getting caught off guard by it and I think that was because I hadn't really given myself the space to grieve mum uh and really when I say look in the eye it was to be able to

create space in my days for mum to come into them in ways that didn't sort of hijack me and that that was a lot I mean a lot through my work actually my writing and my illustrating that was a real way that I was able to not take control of it but sit with the grief and really think about mum in a way that maybe I hadn't ever let myself do in the over the past decade or so. And Jule we're talking about mothers and daughters here but how does the sex of the parent and child influence a child's response to grief? I think actually it very much depends on the child's relationship with that parent. I mean, I think, you know, in the past, who socializes the child most has usually

been, you know, the primary caregiver has been mum, but they are mums and, sorry, daughters and fathers who have a very strong bond as well. So it very much depends on the quality of that relationship. And I think what Emma's described absolutely beautifully is how the death of a parent can have a huge impact at any point in your life. And when you try and compartmentalize it, to just get on with it, have some sense of control over your life, it just keeps coming up at key moments. So, Emma, do they still keep coming up, these moments? As you go through life, do they still keep hitting you? Oh, absolutely.

I think, for me, there's never a time that mum isn't in my day um but that isn't to say that it catches me off guard as much but you know very recently in fact within the last month I got engaged and after the weekend of emoji filled whatsapps and social distance barbecues um I found myself actually sitting on a Monday evening and it really really hit me and I just you know quite simply I just really missed mum and I had to let myself sit with that in a way that I wouldn't have let myself do that and it was it was actually really beautiful in a way and it seems weird to talk about grief in that way. But actually, I've realised that I had to sit with the memories of her and to be able to sort of enjoy the memories I've got of her.

How much does being a writer and an illustrator help you to keep in touch with memories of your mother? I mean, how much do you write about them? How much do you draw them? Yeah, I mean, it's a huge part um it's i've i've just gone freelance actually really to focus on that part of my work um but it's it's a private thing as well you know i've written diaries on and off over the years and that's a really important thing for processing it's very healing for me but actually then crafting it and putting it out there, it's a way to remember mum, it's a way to relive memories of mum actually

because she's very tactile and very affectionate. And just being able to write that and draw memories, actually moments that I can't have with mum anymore, I find that really healing to be able to illustrate moments that I'll't have with mum anymore I find that really healing to be able to illustrate moments that I'll never have with mum and I can almost recreate them through my work so there's that side of it as well you know it's the remembering but it's also connecting what would have been her response Emma to your engagement oh she would have been absolutely just beside herself, thrilled.

I did think about the what-ifs and she would have been the first person I FaceTimed. And she would have squealed probably and wanted all the juicy details. She probably would have fancied my husband to be as well, I'm sure. Oh, really? That sounds dangerous.

Very handsome. And she would have admitted to it my gran did would she have admitted to fancying him or kept it to herself oh yeah she would have said oh he's very handsome that's what my mum's mum who died not that long ago uh that's one of the things she said when she met him she said oh if I was 50 years younger Emma he's lovely and it's just quite nice to think about the sort of gossiping and having a cup of tea with her and in a way I wasn't able to because she died when I was 16 so we never got to have that mother-daughter friendship it never evolved to that stage. Angela what effect do you find grief can have on memories? I mean, Emma clearly now is really enjoying the idea of thinking she might have had a time to gossip with her mum. Yeah, I mean, I think what Emma's described beautifully is how she's moved on in her grief process and she's worked through it and she's also accepted it but is also you know

planning towards the future but wanting to embrace the memory of her mum and that that is a profound loss and there has there have been some studies which show that those who've lost somebody who's incredibly close to them do suffer from you know short-term memory loss because you are consumed by that grief. You're almost flooded by that loss and emotions are intensified. And when you get into complicated, complex grief, some people can only focus on the person they've lost and there's no room for creating new memories. And I think this is where people need support and the permission to talk about that loved one and work through those complex emotions. And for each person, we're going to experience grief very, very differently. For some people, it will be

emotional, some physical, some there'll be changes in their social behaviour. So it's about getting the right quality of support so that you can work through all those very complex feelings that arise when you've lost someone you love so much. Emma, there are now podcasts and online networks talking about grief. How much do you think people are beginning to feel easier talking about death and grief than we used to be when it was such a taboo? I think there are some amazing online spaces at the minute and podcasts. And I do think the Internet has allowed a space for people who are grieving to find other people who are grieving. So there's

real solidarity there. But I would say if you're in the early stages of a grief to not feel that you have to share it with the world or you, I think it's really important to seek out your own support groups, whatever works for you, whether that's online or for me, in the aftermath of my mum's death, I really sought out female maternal figures almost subconsciously, actually, without really realising it, whether it's my friends, mums or professional mentors. And that was a huge part, you know, an in real life support system that I really do value now. you now um sort of i call them my other mothers they'll never replace my own mum but they can they can really um they've really enriched my life in an important way actually i was talking to emma winter schladen and angela mutanda lots of response from you unsurprisingly about the mesh question uh someone who didn't want us to use her name said,

I work for the NHS and I'm also a disbelieved and dismissed mesh sufferer. With mesh, you never feel anyone listens. You really meet a closed door when you ask. So I've been waiting so long for this report and hope and pray we will be listened to now and action taken to acknowledge and fix this. I had TVT mesh in 2012, which was fine to begin with, but over the years since I've become chronically disabled by hip and leg pain and fatigue.

The only thing the NHS will accept is arthritis in my hips because they can see that in x-rays and I'm on a wait list for total hip replacement. But because they've dismissed and refused to investigate my mesh, I could potentially get new hips and then still be struggling to walk and function because of mesh erosion. I'm trying to continue to work through the pain, but I'm totally and utterly worn out with the pain and the fight. Moira said 20 years ago, prior to the insertion of mesh, I had suffered with demobilising deep pelvic floor pain whenever I stood or walked, plus a degree of incontinence, which was manageable. But the constant pain was debilitating, to say the least,

and any kind of everyday normal life was a huge struggle. Eventually, it was found that the vault of my pelvis was prolapsing, and internal organs with it. My point is that, to put things right, I had mesh inserted extensively, which immediately improved my symptoms. My quality of life improved hugely, and for several years, thanks to mesh, I regained a normal life. I was pain-free. Only now is it beginning to surface and give some problems. Would I have it again, in the same circumstances, without hesitation? Even knowing the potential risks, there was nothing else that could be done.

It was a last resort and it has worked for me. Someone who didn't want to be named said, just listen to your item on vaginal mesh. I had one fitted about 15 years ago in London and it's been a great success. It changed my sports and everyday life beyond recognition. Your item has made me very nervous despite having absolutely no adverse symptoms. Maybe it's more to do with the surgeon than the process. I chose a specialist on the NHS who'd carried out numerous of these procedures. Perhaps you could address those who are well, but now worried.

Thank you. And Jane said, I had a mesh implant for a rectal prolapse in 2011 when I was 57. It was done privately and the only caution I remember receiving from the surgeon was on leaving his consulting room after my three-month checkupup, he said in a very casual manner, oh, by the way, you may get some erosion into the vagina if you get any bleeding, dot, dot, dot, and no actual advice on what to do. Well, earlier this year, I became aware of some internal discomfort and discovered the mesh had indeed eroded into my vagina. I saw my GP early in March and was referred to the colorectal department at the QE in Birmingham. Of course, due to the COVID pandemic, I'm still waiting for an appointment.

On motherless daughters, Lorraine said, as another woman who lost my mother very young, huge respect and sympathy for Emma. Like her, it took me many years to face. My online groups have been wonderful. We can all support one another. It's a lifelong wound. And someone else who didn't want us to use a name said, My father had difficulties when

mum died he couldn't cope although later on in life our relationship with him was one of lowing concern but now that I'm 72 it seems to have loomed up again in fairness to my husband and son I know I must overcome this deep sadness but sometimes it's extremely difficult. And then on school leaving, Christine wrote, I am aghast. Proms and dress to impress. Primary. Secondary is bad enough. Materialism imported from the USA. What good training for a selfie generation. Most of us listening managed perfectly signing shirts without a thought of a dress to impress. Now do join me tomorrow when I'll be talking to

a Canadian academic, Lesley Kern, who has written a book called Feminist City. She is interested in what an inclusive city might look like, one that puts friendship, pushchairs and more public toilets above skyscrapers and statues.

Join me tomorrow, usual time. Bye-bye. BBC Sounds. Music, radio, podcasts. 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.