Woman's Hour - Elizabeth Siddal and Pre-Raphaelite women, SNP Conference 2019, Faecal incontinence after childbirth

Episode Date: October 14, 2019

Picture: Ophelia by John Everett Millais, 1865-66. Private CollectionThe Scottish National Party brings the autumn political conference season to a close this week. The leader of the SNP has made her party’s position clear – she wants the Conservative government out, a Brexit extension secured and a General Election as soon as possible. Last week the First Minister told the Scottish Parliament: "We need to get powers out of the hands of Boris Johnson and his ilk and into the hands of this Parliament so that we don't have to put up with Tory welfare cuts anymore because we can take the right decisions here in the first place to lift people out of poverty." Jane is joined by Shirley Anne Somerville, MSP for Dunfermline and West Fife and Scottish Government Cabinet Secretary for Social Security and Older People to discuss the SNP’s offer to women voters on Brexit, Scottish Independence and other pressing policy issues ahead of a much anticipated General Election.The “Pre-Raphaelite Sisters” exhibition opens at the National Portrait Gallery this week to show just how engaged and central women were to the production of the art. Over the next few days Woman's Hour features some of these overlooked models, artists, makers, partners and poets. Dr. Jan Marsh curated the exhibition and wrote The Pre-Raphaelite Sisterhood in 1985 and Dr. Alison Smith curated Tate's major Burne-Jones exhibition last year. Today Elizabeth Siddal. Faecal Incontinence: "It’s like a dirty secret,” one listener told us. Why is faecal incontinence after childbirth so hard to talk about, even to your GP? While conversations around many of the effects of childbirth – from postnatal depression to pelvic floor problems – have become more common in recent years, bowel problems, less so. It’s thought that sphincter injuries can affect 1 in 10 mothers who’ve had vaginal births - with a higher risk to those having their first baby. So why don’t we talk about it more? Jane speaks to two Woman's Hour listeners living with faecal incontinence and to Dr Sara Webb, Research Midwife at the Institute of Applied Health Research, Birmingham University. Sarah Phelps, award-winning British screenwriter, joins Jane to talk about her latest TV crime thriller Dublin Murders which starts tonight on BBC1. It's drawn from Tana French’s internationally bestselling Dublin Murder Squad books and stars Killian Scott and Sarah Greene as the two ambitious detectives investigating two murders in Ireland around the turn of the millennium.Presenter: Jane Garvey Producer: Caroline Donne Interviewed guest: Shirley Anne Somerville MSP Interviewed guest: Jan Marsh Interviewed guest: Alison Smith Interviewed guest: Dr. Sara Webb Interviewed guest: Sarah Phelps

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. This is the Woman's Hour podcast. Good morning, welcome to the programme. Now today, amongst other things, we're talking about faecal incontinence. This is something that can happen to women, certainly not all women, but can happen to some women after vaginal childbirth. And to put it mildly, it can really have an impact on your life and how you live it we've got some really interesting contributors to that conversation this morning

if it's something that you think you'd benefit from listening to or perhaps you have a friend who wouldn't listen to radio 4 doesn't listen to this program but does have this issue let them know that we've talked about it this morning they can always catch up via the podcast on bbc sounds so we joke don't we about urinary incontinence there aren't that many jokes about needing to They can always catch up via the podcast on BBC Sounds. So we joke, don't we, about urinary incontinence. There aren't that many jokes about needing to poo really urgently. That's because it's still a bit of a taboo. We will bust that on Women's Hour today.

I'll also discuss pre-Raphaelite women. Who were they? What did they contribute to that important movement? And we'll chat to screenwriter Sarah Phelps, who's responsible for the Dublin murders, which starts tonight, BBC One, at nine o'clock. First, let's head to Aberdeen. The SNP conference is taking place there at the moment. And Scotland's First Minister, Nicola Sturgeon,

was on today, here on Radio 4 this morning, explaining why she continued to push for another referendum on Scottish independence when both the Tories and Labour parties were opposed to it. Let's allow the power of public opinion to have a say here. It is highly likely we're going to be in a general election in the pretty near future. I'll put that question centre of my campaign and we'll let people have their say on that because we see support for independence

rising we see support for a second independence referendum rising and you know westminster governments it is not sustainable for them to stand in the way of what the people of scotland want in that regard nicola sturgeon talking on today this morning well shirley ann somerville is the msp for dunfermline and west Fife, and she's also Scottish Government Cabinet Secretary for Social Security and Older People. Shirley-Anne, good morning to you. Good morning. Let's start with new polling at the weekend, suggesting that support for independence is increasing. Why do you think that is? Well, I think it's the fact that when the people of Scotland look around at the states of the current debate within

British politics at the moment, they are looking to see whether we have another alternative. And thankfully, we do in Scotland. I think that's why people are looking at the issue of independence, because issues have materially moved on since the last time this question was asked and that's why we see both an increase in support for independence and also an increase in support for Scotland to be able to choose to have it say as well. Well that poll over the weekend I happened to see it in the Sunday Times suggested that support for independence was at 50 percent when you actually think about it you might actually have expected a bigger increase mightn't't you? Well, I think one poll is good to see that it's at 50%, but we take absolutely nothing for granted. These are very, very difficult times, and I think it's rather obvious that people will be looking for alternatives, but also looking to see how things settle and how best to settle them.

And I think the more they see of the chaos that is ongoing at Westminster and with Boris Johnson's government, then they'll look for that alternative more and more within Scotland itself and within independence. So I wouldn't be surprised to see that momentum growing and that's certainly how we feel within the buoyant mood of our conference

is that the momentum is with the cause for independence and the strong showing of the SNP government. You mentioned what you referred to as the chaotic situation. Of course, that is connected to Brexit and all sorts of activity, of course, on that front this week. Essentially, leaving with no deal is actually the best bet for the SNP, isn't it? That would suit you. Well, leaving with no deal would be absolutely catastrophic for the Scottish economy. Not in terms of support for another referendum and for Scottish independence, it wouldn't, would it? Well, I think that's why the leadership that Nicola Sturgeon has shown as First Minister really, really comes into stark contrast with what we've seen from the rest of the leaders from the UK parties.

Yes, a general election would absolutely be in our interest at this moment in time. But the First Minister has made absolutely clear that our absolute priority is to stop a no-deal Brexit because it would be catastrophic for the Scottish economy and indeed for the rest of the UK economy. And that's why the First Minister has attempted throughout the years since the Brexit referendum

to show compromise, to try and seek out an alternative way forward that wasn't our first option, but something that we could hopefully agree with some of the other political parties on at a UK level. Now, that hasn't came into being, and that's not for the lack of trying from the SNP's point of view, but our absolute priority must be stopping a no-deal Brexit because the catastrophic implications for Scotland are too grave to really consider.

We know that what Nicola Sturgeon wants, I mean, she's been very clear about it, is an extension and then a general election. So what would that offer women in Scotland? Well, I think the election would offer everybody in Scotland, including the women, the choice to say once again about the importance for Scotland a new Scottish child payment you know there are many things going on in Scotland that demonstrate what we do with the powers that we have but more importantly they're a great example of the types of things we could do

if we had more powers and if we had independence. We know that the economy in Scotland, it's not without its problems to put it mildly. Your deficit is what, seven percent? Now the deficit is the gap between effectively what you get in taxes coming in and what you then spend on both public services and on paying down the debt. Seven percent is a very high figure. Well the deficit that is measured through the GERS figures, which I presume is the ones that you're referring to, is the state of the Scottish economy under the union. So if the figures are not looking great, it actually shows how the union doesn't work for Scotland. So this is solely the fault of Westminster? No, it's the responsibility of Scotland to be able to take powers

here in Scotland to be able to make decisions that are better for the Scottish economy. It's a simple fact that again in an area that I'm responsible for we have 16% of the social security powers. We could do so much more if we actually had all of them. So it's very very important that we look at what we can do in Scotland but we're obviously frank about what we are unable to do because we do not have the powers up here. You mentioned social security and you're actually you're, you're taking over an increasing number of benefits, aren't you, in Scotland? That's right. But your Auditor General has already warned of the need to control. There are some big

administrative costs that you're taking on here. Are you content that you're actually doing this because the costs appear to be rising? No, we're absolutely determined to have a system that is humane because one of the things that strikes me as a social security... As you're discovering, I think, I know you've in the past criticised what you describe as the inhumanity of the system administered from

Westminster, but you're coming up against the same problems in Scotland, aren't you? It isn't easy, this. No, it's not easy, but how you run a social security system is a matter of political choice. The fact that people in Scotland, and I'm sure in the rest of the UK, call the disability assessments inhumane and degrading is a choice about how you run social security. Now, we will be able to deliver a system up here in Scotland that does so in a way that supports people through

that process so they get the money that they're entitled to. Social security should be, and is within Scotland, a human right. Now that doesn't make it an expensive system, it makes a fair system, it makes a humane system, and that's what the people of Scotland deserve in a public service. What about women with caring responsibilities? We know that women do have rather more of those than the average man. What are you doing to make sure that they're able to continue their lives reasonably? Well, today actually is the qualification date for a carers allowance supplement. That was the very, very first act that we brought in when we had social security powers to give more money to carers with a carers allowance,

more money within Scotland than they do within the rest of the UK. So there's one absolute demonstration of today's qualification date where more money will be actually received by carers in Scotland than anywhere in the UK. Okay, on the face of it, that sounds wonderful. But going back to the 7% deficit, how are you able to afford it? Well, the 7% deficit is one particular way of measuring the figures which doesn't actually take into account many of the public services which are in Scotland but are

already run by UK departments so the the fact that we always within Scotland have to have a balanced budget as we run the Scottish government is exactly how we'll take this forward so our finance secretary will bring forward a budget in December and that will absolutely once again be a balanced budget where we make choices in Scotland about how we want to spend our money and we're investing it in carers, we're investing it in low-income families through the Scottish Child Payment and we're investing it for example in a doubling of early learning. That balanced budget that Derek Mackay will bring forward is how we deliver the policies which have been very, very popular within Scotland. Early learning, three in 10 children are leaving primary school, not meeting their literacy targets. Why is that?

Well, that's why we're absolutely determined to ensure that we increase the available hours of childcare within Scotland. We're doubling that to 1140 hours. It's very, very important that that's for vulnerable two-year-olds, three- and four-year-olds to ensure... So you would expect your literacy rates to improve? Well, we are seeing attainment within Scottish schools improve. Now, that's one of the areas where we're absolutely determined to take very, very early intervention. But we do that right from birth.

That's why we have the baby box in Scotland to ensure everyone has the same start in life. It's why we've increased the Best Start grant within my social security responsibilities to give low-income families another additional support at times of need. And that's why we're supporting them through the doubling of free childcare.

Can I just ask you a question too? This is an interesting one, actually. It's something that was discussed at conference over the weekend about the decriminalisation of drugs, because here's a genuine example of Scotland, or the SNP in particular, thinking of doing things rather differently. This contrasts to the plans that the Prime Minister is expected to set out in the Queen's speech today. We know that Priti Patel, the Home Secretary, is very tough on crime, or that's her claim at least. Why are you doing things rather differently, bearing in mind as well that Scotland does have the highest drug death

rate in the EU? Well, it's exactly because of the shocking figures that we are seeing that we are looking to have a policy that works, that's evidence-based, looking to see what's happening within the rest of the EU, Portugal being one example, to see what else can be done. So we're not frightened to back away from what might be radical and different policies if the evidence shows that that will make a genuine difference. So just briefly, if you can, when do you hope that drugs will be decriminalised in Scotland?

Well, many of these aspects actually depend on Scotland having the powers to be able to do that. So I'm afraid there's not a specific time scale that we can deliver that. But an independent Scotland governed by the SNP would aim to do that? Well, that's exactly why the party was looking at that today and that's how we'll then develop the details of that policy to see how we can take that forward and what we can do under devolution because we're not going to wait until independence.

If there's things we can do just now, we'll absolutely do that. But then there are, honestly and frankly, some areas where we do not have the powers, whether it's in drugs or social security, to take the actions that we want, and people will be able to see the implications of that because we're being prevented from doing things, and it's yet another reason why independence is an alternative

which more and more people are looking to. Interesting to talk to you. Thank you very much for your time. Thank you. Shirley-Anne Somerville, MSP for Dunfermline and West Fife. And the SMP conference continues in Aberdeen. You've got coverage, of course, across the BBC. And we've covered all the other cut party conferences and had conversations about Plaid Cymru. I think it was this time last week in the Green Party and everybody else.

We're still waiting, I think, for our leading Conservative to appear on the programme, but I'm sure any time soon they'll make that date with us. Now, faecal incontinence. I mentioned earlier that the whole leaking a bit of wee after childbirth is something that is sort of part of the general backdrop to conversations about life post-childbirth. Fecal incontinence, a really urgent need to go for a poo, is not. So let's talk about it now. It is thought that sphincter injuries can affect one in ten mothers who've had a vaginal birth, with a higher risk to women having their first

baby. Why don't we talk about it more? Why don't we feel equipped to have these conversations? Dr Sarah Webb is in our studio in Birmingham she is a specialist midwife in perineal trauma at Birmingham Women's Hospital. Sarah good morning to you. Good morning. And in our studio at Exeter is Kirsty. Kirsty is a midwife. Welcome to the program Kirsty how are you? Morning Jane good thank you. You have an eight month old don't you? I do. Great and Sophie is in the studio with me in London. And your son, Sophie, is 22 months old. Yeah, 22 months. You coincidentally, and it is a coincidence, are also a midwife.

Yes. Now, we put out an appeal on our Insta feed, I think, asking for women willing to take part in what is basically quite a difficult conversation. And midwives happen to be the people to contact us. So these are the women we're talking to this morning. But I know I can rely on all three of you to be absolutely frank and clear about this. So Kirsty, if you don't mind, just tell us what happened.

Because your baby is eight months old and you had just a small tear, I gather. I did. So interestingly, I think there is an assumption that only women who have sustained significant injury to the perineum, so that muscle between the vagina and rectum, are people that suffer postnatally with these issues. But what's interesting about my story is that I had what was a really positive, empowering birth.

I had a very small tear to the perineum, which didn't require stitches. And I was actually, you know, fitting well in the postnatal period until about six weeks. And then that's when my issues started to arise so initially it was struggling to open my bowels and when I say that what happened was that every time I tried to open my bowels I was just unable to unless I was able to physically position my fingers in my vagina and push back against my rectum which going to my GP at six weeks they were very clear with me that that was something called a rectocele so essentially

what happened was during childbirth sustained an injury so the connective tissue between my rectum and my vagina had weakened to the point where there was a big bulge so every time my rectum was full it would push into my vagina so every time I needed to open my bowels, I would have to position my fingers in and manually push that in order to have my bowels open. You're a midwife. I am. Did you know this could happen? I had no idea, Jane. And I think, you know, when I talk about the kind of assumption that only women that sustain injuries really, you know, there's this assumption that if you don't walk on any stitches and you don't have a deep tear that your perineum will heal and everything will be fine

and as a midwife I had no idea and I had no follow-up in regards to that so the gap in knowledge in terms of the kind of research and the awareness of these issues I think is really really lacking in midwifery education but also in our dialogue in women's health issues generally and can i just ask sophie what happened to you so you well tell me about initially life after birth immediately um so yeah i had a normal vaginal birth and i had an episiotomy which is the cut which is the cut in the perineum i just had quite a long labour and he was in a bit of a funny position. And yeah, after giving birth to him, I bled a lot from my rectum for about four months. And I just had really sudden urgency and I had to get to the toilet really quickly. And it just never really went away.

And I went to my GP several times who just gave me suppositories and just said, oh, this is kind of normal. And I thought, is this normal? I've seen a lot of postnatal women. and just said oh this is kind of normal and I thought is this normal I've seen a lot of postnatal women I don't think this is normal and then I eventually saw a physio privately when I was about he was about 10 11 months old and not much has changed to be honest I'm getting better with my pelvic floor exercises but I think the sort of underlying message was if you want to do anything about it like surgery, it impacts having

future children and I want other children Yes, you are you actually said to me earlier, you'd like three more kids, bearing in mind what you've been through, are you sure this is a serious question, are you sure about it? Yes, to be honest he's so wonderful.

No, I'm sure. I can't imagine. That's a fantastic thing to hear. But the urgency, you have a slightly different experience to Kirsty. You do get that urgency thing. You have to go. Yeah, really urgent. How urgent?

I mean, sometimes, yeah, it's like I have about a minute's warning, if that. And that is, I mean, now it's easier because he's a toddler. He's nearly two. He's walking. But when you have a new baby, do you just leave them where they are and run to the toilet and run upstairs? Or do you take them with you? In which case, you've got to have places in the bathroom where you take them. If you're out at a baby group, do you go in immediately

and map out where is the toilet in case this happens? This is the reason why I've set up postnatal support where it's, you know, it's open and we can talk about these things. And if people do need to urgently go to the toilet, they're close. You can just drop a baby. You can go. Would wearing any kind of a pad or, you know, a sanitary towel thing, would that help? Sanitary towel thing. I don't know why I said that. I just don't want it to get to that. I get that said that. I just don't want it to get to that. No, OK, I get that.

I get why you don't want it to get to that. Sarah, why is this still happening? Still happening to women? Yeah. Or the stigma attached to it and the lack of care? Well, we'll move on to this. I've established there isn't a stigma because we're talking about it really honestly.

We're not going to let there be a stigma. But why are women still reluctant to get help is really what I should have asked. OK, I think it's because it's an issue that's always been hidden and i definitely think and i agree with kirsty about the midwifery education awareness about pelvic floor and the implications is still there and it doesn't seem to be being addressed in education so midwives aren't aware of the long-term implications we're therefore not informing women what to do and this whole thing just carries on being hidden. Sophie did your GP actually offer any practical help? Not at the beginning on the after I saw a private physio she said no he really should have and so I went back and then got a

referral for NHS physio because my private physio said I needed to go see sort of a urogynecologist and you have to see a NHS physio before you get referred to that and have a whole course of that but that's obviously quite tricky I'm a single parent do I get child care for all these physio appointments how does that work practically? Sarah what should happen what's best practice here? Best practice would be for hospitals to have specialists midwives like me that are links to the maternity that can then refer into urogyne. There will be people listening, women listening, in their 60s and 70s who I suspect strongly are still suffering as the result of childbirth many decades ago.

Can they have anything done, Sarah? Yes, they can. There are definitely services out there for them to be seen. One of the trickiest things is getting those women on the right care pathway and getting GPs aware of the right pathway and how to refer those women. So those older women will be reluctant to go to the GPs. If they do, do the GPs know where to refer the women to and what language is required to let your GP know exactly what you're

going through Kirsty do you want to answer that yeah well I think maybe that's also maybe quite telling as to why we have three midwives in the studio discussing these issues is that you have to know and understand your own anatomy to be able to recognize that there's a problem and on top of that you have to kind of have an understanding of what a normal postnatal body is to know that yours isn't normal and without that knowledge and understanding amongst women how are they able to describe you know what what they're feeling and what they're experiencing and one of my experiences in talking to my peers about this is when I'm able to open up with them so many people have

come forward and said oh do you know I've experienced similar to that or oh really I didn't realize you know I thought that was normal after having a baby so I think there is an issue around language and an issue around feeling isolated in your symptoms or maybe not even knowing that your symptoms are symptoms that are worthy of being discussed with a doctor well that's the problem isn't it sarah can i ask what should you expect what would you count as normal post-childbirth should you in fact have any problems with pooing at all you are within the first six we always say it takes nine months to make a baby it takes nine months to get over a baby.

OK, your pelvic floor is very badly designed. It's very weak. And having a baby through it means that it's going to get tired. But within the first six weeks, you're going to have disruption to, you're not going to be able to hold things for as long as you used to. But you shouldn't be having frank incontinence. You will have an element of urgency but that should be bearable wind control will be very variable but over the six week period it

should start to improve right okay so that's that's what we need to know that you shouldn't expect to be having the sorts of problems encountered by sophie and kirsty as a matter of routine absolutely and the other thing is that a lot of midwives and women expect everything to be back to normal, fantastic, within two to six weeks. OK, and that shouldn't be... OK, I get that. Now I'm pretty clear about this.

I just wonder, though, whether we need to... I don't know. Women, before they have babies... I mean, you're in this position, Sophie, you're working with women. What do you now say to women that you wouldn't have said before you had your son? I mean, we do discuss it. So I run antenatal courses and we do, I discuss it about the postnatal period.

But I think the big thing is that you also don't want to scare women. We have a massive culture of fear around giving birth. And I don't necessarily think we need to add to it. I think we could mention these things but that's why I've set up a postnatal course where we have a physio come in and discuss it but yeah I think the answer is creating a sort of community where we can all discuss these things so this is why I've set up the village midwife because I think we need an open and honest community where we all can talk about these things and not be scared.

And the danger, Sarah, of being fobbed off by your GP, what do you say about that? Is unfortunately, and I have surveyed a lot of GPs and work with a lot of trainee GPs, there is a tendency for GPs to not understand a lot about the postnatal period. For women that feel that they are getting fobbed off they need to just keep going back really keep going back and diet can diet change anything diet is it is very important your bowel function your bladder function doesn't just evolve or function on your anatomy and physiology it also functions on what you eat and how healthy you are so yes it does does matter so you could actually change your diet? You could help yourself by changing your diet post-birth?

I guess it's just a case of making sure you have a healthy diet. What have you been told about that, Sophie? Yeah, I've been told to up my fibre, but I think it's also really tricky because you also have a new baby. And so cooking one-handed is fairly difficult anyway. And also a lot of people haven't got great maternity pay or great support. And so you've got to really think about what is easiest to cook that isn't really expensive. You see a lot of people on Instagram and Facebook discussing sort of the ideal postnatal diet.

And it includes really expensive things. Which are not easily achieved. Okay, I get that completely. Sarahah i gather there has been an impact your work has had an impact on midwives training well what we've done is the nmc currently are looking at the standards of training for midwifery and myself and some colleagues have done a survey of students and midwives about how they felt their education and training on the pelvic floor was and unfortunately that's revealed that we think it's not good enough not good enough in what way in the fact that the midwives and the student midwives don't feel they're getting it i think it's a pretty much under 50 percent of midwives and student midwives that completed the survey felt that they weren't

getting enough education in bowel bladder rectocelecele, cystocele, long-term impact, all elements of pelvic floor. Right. Well, thank you all very much. Just a very quick question, Sarah, if you don't mind. What are your chances, if you've had a bad tear in your first pregnancy, what are your chances of getting an elective caesarean the second time round if you are going to have another child? You should be able to. Every hospital should

offer any woman who had a bad tear the option of a c-section. They should, okay. They should be offering the choice with the knowledge, yes. Right, interesting. I wonder whether that does happen. You can let us know depending on your own experience. Thank you all very much. Really appreciate your frankness. Kirsty, thank you. Thank you to Sophie and thank you to Dr Sarah Webb who is the specialist midwife in perineal trauma at the Birmingham Women's Hospital. And I'm really keen to get your emails on this subject. So you can email the programme whenever you like via the website bbc.co.uk slash Women's Hour. It's about a year and a half, apparently, since Viagra became

available in the UK over the counter without prescription. So what impact has that had? We have heard on Women's Hour from some women who feel that there is now additional pressure to have sex more often with male partners who have got hold of Viagra. Maybe that isn't your experience. Maybe you're both having an absolutely wonderful time. Either way, we would love to hear from you in Yes, we can keep you anonymous. Again, use the website bbc.co.uk slash womanshour. That's something we hope to be talking about tomorrow on the programme. And the podcast, of course, is available every day.

So if you miss an edition of Women's Hour, you can always catch up via BBC Sounds. The Dublin Murders starts tonight, BBC One. It's a kind of chilling winter. Well, it is winter, isn't it? Autumnal delight. And the screenwriter, Sarah Phel tonight, BBC One. It's a kind of chilling winter. Well, it is winter, isn't it? Autumnal delight. And the screenwriter, Sarah Phelps, is here. Good morning, Sarah.

How are you? I'm all right, thank you. How are you? Good, very well, thank you. Now, this series, it's eight episodes, isn't it? That's right. Shown on consecutive nights, so tonight and then tomorrow. And then Tuesday, yeah, for four weeks.

Right, OK. And it's about two detectives, of course it is, and they are investigating some creepy murders in Ireland. It's set when, 2000 and... It's set in 2006, which is the very height of the Celtic Tiger of the boom where everybody was incredibly optimistic and roads were being built and houses were being thrown up

and flats were being thrown up. And there's just, yeah, the body of a girl is found in the middle of some woods which are in the process of being flattened for one of the motorways and that brings our detectives into the woods and it starts a chain of events which leads into some very, very heartbroken places. Right, well, let's play a short clip. It's the two ambitious, they're described here as ambitious detectives. They are.

I wish somebody would write a series about two unambitious detectives. I know. It's one of those things where people say, this is really going to be thrilling. And I said, well, we're not going to say it's, you know, it's not. Of course, people are ambitious. Well, it was just as well, really. Here are Detective Rob Riley, played by Cillian Scott, and Detective Cassie Maddox, played by Sarah Green.

They're discussing taking on the case of a new child homicide. This isn't for us. We can't do this. Not this one. You know what O'Kelly does to people who pass on cases. You've seen how he treats quickly. I don't care. We're passing on it. How?

We tell him my head is wrecked from working dead kids. You back me up. I'm drinking too much. My concentration shot. I'm not sleeping. That's not true, Cass. You think I can't play psych report? There we are. are detectives Cassie and Killian and interestingly they are friends they're not lovers

at least not yet in the two episodes I've watched they're friends they share something and they have they've kind of recognised each other as outsiders and they have a relationship and a friendship very much built on that

and it's rather exclusive and intense and it's not sexual, but it is dangerous. Now, these are interesting because they're based on the books by Tana French. That's right. And there are how many books? They're all about separate murders, aren't they? There's six books and they're all um they're they're all based on like different detectives all of whom have a very kind of like a connection to um an individual murder murder case which is why it's called the dublin murder squad novels um but that those cases also connect to something else back in the past like a case. And it just, they're very intense interior examinations

of who these people are, who these detectives are and how they came to be this way. The things that they've done that have made them who they are and whether or not they can unpack that or whether it's going to damn them forever in a way. Now you, I know, are quite keen to avoid Irish clichés. Yeah, very much so. You've got Irish heritage, I think, haven't you?

Yeah, my mum, yeah. Yeah, and there are some, aren't there? There are dramas where you really do get... Oh, you think, oh, God. I mean, it all happens. It's still out there. Oh, yeah, very much so. But when I took this on, I was very keen for it to be... Like, when we're going to be seeing Ireland, we're going to be perhaps seeing the island that isn't familiar to us, like aspects of Dublin that isn't familiar to us, aspects of the countryside that isn't familiar to us. without having this kind of here we come with our baran and everything else like that.

Back to dance the jig. We are just here trying to live our lives like anybody else is trying to live our lives with all the compulsions and the shames and the hopes and the optimisms and the lies that we've told to try and keep ourselves safe. Your work in the past is really interesting because you have done things with Agatha Christie. I've done things with Agatha Christie.

That's one way of putting it. You certainly have. Well, Witness for the Prosecution was one of them. And then There Were None was the other. And then There Were None was the first. Witness for the Prosecution was the second. Then Ordeal by Innocence. And then the ABC murders.

And then The Pale Horse will come next. The Pale Horse? The Pale Horse, yeah. I haven't heard of The Pale Horse. What's that about? The Pale Horse is one of her last novels. And it was set in, she wrote it wrote it in 19 well she published it in 1961 and um because when i first sort of got involved with this or really after um and then

there were none i thought you could tell you could tell a kind of a story about the 20th century, 50 years of blood soaked tumour via the medium of murder mystery from a woman who had one of the long, who had this extraordinary writing career, which is 50, 60 years nearly. And she starts writing in the mid, you know, she starts getting published mid 1920s after she's been a vad all of the the whole expanse of the first world war so she was out there yeah no no she was a dispensing chemist right which is a really interesting way of how looking at the way she looks at murder but so i thought i want to see if i can write a quintet which spans five decades or five periods of english history via murder mystery and you have really got people talking because that your fantastic agatha christie's five decades or five periods of English history via murder mystery. And you have really got people talking because your fantastic Agatha Christie's are shown sort of over the Christmas period, aren't they? Usually in that wonderful lull between Christmas and New Year.

They're a terrible lull when you sit there going, oh, my God, I can barely move. You're sweating Stilton through your pores. Yeah, yeah. But they are very disturbing. And you have taken Agatha Christie to a new place, I think. I think she is quite disturbing. Oh, yeah. No, I'm not suggesting she was. I think that, yeah, I just think that because I didn't have any kind of familiarity with her before, I'd never read them as a young person.

And so that when I picked them up and read them, I was generally quite shocked because they didn't have that sort of familiarity of, you know, sometimes you read books when you're ill from school and the rain's on the windows and it's just like... And it feels like you're being shown a glimpse into an adult world because it's a grown-up novel. And I didn't have any of that with her, so I found her really shocking and surprising and tricksy, actually. I think she's tricksy. I think there's a tension between the book she wants to write

and the book she knows people wants to read. And I think she leaves tricksy. I think there's a tension between the book she wants to write and the book she knows people wants to read. And I think she leaves little clues in her books, which are sudden little images or references or details, which suddenly shock you and go, what? Based on this, I'm going to reread an Agatha Christie. I haven't read one for years. Maybe I should read it. Just go and have a little look.

And there'll be little things, there'll be tiny little details you go what is where does this come from and that's and that's what i tend to pursue that those are the things not the endless policemen wandering around and wondering to themselves you know what's going on and what happened to that fingerprint it's a weird little details there's a detail in um or deal by innocence about um somebody uh imagining it well remembering his mother's death in a in a road accident it's a detail of or deal by innocence about somebody imagining, well, remembering his mother's death in a road accident. It's a detail of her peroxide hair lying in a rainbow pool of oil on the Great North Road. Now, that's an extraordinary little detail

and there's something in it. That's what I pursue. I don't pursue the pages and pages and pages. I pursue the little details that give me the electric shocks. And so, yeah. So I do a lot of murders don't i when you do all the christies and now and now the another dublin ones as well you're currently a free woman but who knows a free woman yeah yeah oh what you mean in terms of you did say you've done a lot of murders it was anyway don't worry uh it's um the dublin murders is i've seen the first two episodes and well, it's nine o'clock tonight and tomorrow night and it's perfect for this time of year. Thank you.

It's great. Really good entertainment and chilling. You're right. Thank you very much. Good to talk to you, Sarah. Thank you. The Pre-Raphaelite Sisters is an exhibition opens at the National Portrait Gallery later on this week. Now you'll know those images of women with all the gorgeous hair often clutching pomegranates generally being all sort of languorous and beautiful the Lady of Charlotte, Ophelia the Hiling Shepherd. You'll know names

like Rossetti, Waterhouse, Holman Hunt Over the next couple of days and weeks we're going to feature some of these overlooked models and artists and makers and poets and we're starting with Elizabeth Siddle. Dr Jan Marsh is here. Jan, good morning to you. Good morning. You curated the exhibition and wrote the Pre-Raphaelite

Sisterhood in 1985. Welcome. And Dr. Alison Smith curated the Tate's Major Burne-Jones Exhibition, which was last year. Welcome to you too, Alison. So why should we care about Elizabeth Siddle, very briefly, Jan? Because she's been entirely overlooked and misrepresented, I think. She's represented as this frail victim of the Pre-Raphaelite Brotherhood, when she was actually a very energetic and ambitious young woman who got into modelling not through being discovered in a bonnet shop which I was about to ask, how was she discovered? but by her own efforts of showing her own drawings

to the director of the School of Design and then apparently it would seem offering to model for his son Walter Deverall who was a good friend of the PRBs, the Pre-Raphaelite Brotherhood. And that was Siddle's way into the art world, because she had ambitions to be an artist herself. Right. But the story about her being discovered in a hat shop is everywhere you look. You Google her and that's the story that crops up. So it's frustrating.

Can I just tell people a little bit more about her? She was the model for Ophelia, we know that. The muse and wife of Rossetti. And she died of a laudanum overdose. And Rossetti buried a collection of his poems with her. But after seven years, he was persuaded to dig up her grave and recover the book of poetry so he could publish them. And now that exhumation was 150 years ago this month and the

BBC loves an anniversary. So last night on Radio 3, Elizabeth Siddle, played here by Lily Cole, climbed out of her coffin to tell her own story. October 1869. It takes a long time for attitudes to change, but maybe people are willing to listen now. To really see me for who I am. The first woman to exhibit with the Pre-Raphaelite Brotherhood. People forget that. First woman in a brotherhood. I don't need men to dig me out this time. I can do it myself. I can bloody well do it myself. And I don't give a damn if that upsets you, if I'm not your tight pin-up anymore.

But this time, I'm going to make you look. Don't turn away. And plot 5779, Unearthing, Elizabeth Siddle, is available now on BBC Sounds. Alison, this muse idea, what is a muse? A muse is someone who inspires an artist, who sort of embodies the spirit of their creativity. But a muse can also be a catalyst for creativity itself.

So rather than being passive, a muse can also be active. It does sound passive, doesn't it? I think in this exhibition, we're trying to show the muse in a more positive way, in the sense that the women who pose for the male artists play a key role in fashioning their own identity, selecting their costume, their jewellery, their pose, and they do strike these wonderful poses.

I think it's this element which gives these images their incredible attraction and appeal. Well, the key pose, Jan, I guess, is the Elizabeth Siddle as Ophelia. Everybody will know that, even if they don't know it's her posing. Just describe that image, which I think is one of the... Is it the best-selling postcard at the Tate still? It's the most popular of the works in the Tate Gallery. Happily, in this exhibition,

although we weren't able to borrow the Tate version, we have got a small autograph replica. So this is very exciting. We have another view, a copy of Baimile, of his Ophelia. And Lizzie posed for this lying fully clothed in an antique dress in one of those long tin baths that the Victorians had. So to look like she was drowning in the river. She is Ophelia who falls into the river and drowns in Shakespeare's Hamlet

It can't have been much fun doing that to put it mildly that must have been quite an ordeal posing in a bath for hours on end Yes and it's a tribute I think to Lizzie's commitment to the art world that she wasn't deterred by those experiences Well we're perhaps falling into the trap of ignoring her own artistic abilities. Alison, was she a good painter? She was, and I think her works are coming to light,

and people were saying not only was she good, particularly for someone who was untrained, but she was very original and innovative as well. And she might have influenced Rossetti and artists in his circle with some of her ideas. What's unique about her works is that she sees things from a female point of view. Her works concern female protagonists, not being seen as objects of the male gaze, but they're often women in these psychologically, they tense, demanding situations. You say her work is coming to light. Where might people find it?

There's still some in private collections. Quite a few are in public museums. But they're not often shown. And I think in this particular exhibition at the National Portrait Gallery, we have a whole room devoted to Elizabeth Siddle. And there are about five, six works, drawings, watercolours by her. And some of them actually anticipate later developments in art. For example, the beautiful drawing, Lovers Listening to Music.

Rather than showing the lover and his mistress, it's the lover and her boyfriend, or whatever it is, listening. And the two musicians are two dark-skinned women playing an exotic instrument. Now that anticipates the ascetic movement

which happened a decade after, in the 1860s. So she's actually rather ahead of her time, and also being untrained, that allowed her to sort of heighten her imagination, and people in Rosetti's circle really surprised the idea of the amateur, or the artist who worked from their own inspiration alone, and Siddle really epitomises that tendency in producing these jewel-like works, which show her great knowledge of poetry and English literature, but seen from her own unique perspective.

Alison Smith and Jan Marsh. Now, to your emails. First of all, on the topic of the interview about the SNP, if the SNP hadn't pressed for independence in a referendum, we might never have had an EU referendum and never been in this Brexit hell. They started the idea of breaking away, says a listener called Jane. Ben says we're moving to Scotland from the southwest of England because Scotland seems to be the only part of the UK where decisive, compassionate, thoughtful politics are undertaken.

So there you go. Different side of the story there from Ben. Now I thought there would be a reaction to the conversation about faecal incontinence and we have had a lot of emails so let me read them out or some of them. I did not know that faecal incontinence even had a name. Just saying it on air is actually a huge step in debunking it. It is horrendously debilitating, not only physically, but socially and emotionally, all at a time of huge change in life post childbirth. It's so sad that a listener feels that just by hearing it mentioned, they feel a little better. I'm so sorry that it sounds like you're going through a really tough time. Another listener.

I had faecal incontinence with my daughter six years ago. After years and years of asking for help, last year I finally got a spinal implant that helps my bowel recognise when I need a poo. It was a long, drawn-out process and I felt there were many barriers to help, but I would really recommend keeping going if you need help. It isn't perfect, but it's so much better than before. Now our focus in that conversation was unashamedly on childbirth. I did say we were talking about incontinence after childbirth

but of course it can be associated with all sorts of other conditions and Sue wrote to point out, I've had one third of my colon removed because of bowel cancer which means I also need to use the loo more often and sometimes at short notice. It does impact on your life and means a lot more organisation if you're away from home even just a day out. I can never be far from a loo so no more long country walks for me. It's also a hidden disability with the prospect of having to explain if you need to use somebody's toilet really urgently it can be very embarrassing

from Sinead I had a wonderful birth but sustained a third degree tear I was scared by the incontinence I experienced I cannot say enough how important it was to see a physio straight away at the hospital who gave me exercises I started from

day one. Thankfully I have recovered fully but I think without this information and help from the first day it would have been so much harder. From Lisa, I agree midwives need to educate women about pelvic floor exercises pre-birth and also what to expect continence-wise when the babies arrived. I worked as a gynae nurse for 20 years, and I knew about the possible effects. An anonymous listener says, I still have a bowel problem nearly 40 years after giving birth, similar to the one mentioned. I cannot empty my bowel without pressing on the area behind my anus. Then I very often cannot fully empty it, leaves me feeling uncomfortable

and resulting sometimes in staining my underwear. I did see a bowel specialist about it 20 years ago who said there was nothing more to be done. I do feel now I just have to live with it. Well to that anonymous listener, I mean obviously if you listen to the programme regularly you know I'm not an expert on anything, but I just on anything. It just doesn't seem like something you should have to live with in the 21st century. So you're probably bored to tears by seeing doctors and trying to get help, but maybe it might be worth another go. You never know. It does seem a terrible way to feel that you've just got to keep on living your life like that. Now, tomorrow on the Woman's Hour podcast, we are going to be talking about the availability of Viagra.

It has been available without prescription over the counter for a year and a half. Has it changed your sex life for the better or is it actually something of a challenge if you have a partner who uses it and feels that they would like to have sex more regularly or for longer? What is that doing to you? Also tomorrow, there's no easy way. We can't connect the two. We're also talking about map reading. So that's tomorrow. That is why,

in a nutshell, I love my job. So Woman's Hour tomorrow, get the podcast because you're doing that already or you could always listen live if you want to be a bit retro. BBC Sounds,

music, radio, podcasts. Hello, I just wanted to tell you about my new podcast. It's called Classical Fix and it's basically me, Clemmie, podcasts. Hello, I just wanted to tell you about my new podcast. It's called Classical Fix and it's basically me, Clemmie Burton-Hill, each week talking to a massive music fan. I mix them a classical playlist. They have a listen, they come in and we just see where the conversation goes. If you like to give classical music a go but you haven't got a clue where to start, this is where you start. To subscribe, go to BBC Sounds and search for Classical Fix. Now then, as you were.

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.