Woman's Hour - Jilly Cooper, Rachel Goldberg – mother of hostage Hersh Goldberg-Polin, Women & binge drinking, Perinatal pelvic health service.

Episode Date: November 8, 2023

Jilly Cooper began her career as a journalist, wrote columns on marriage, sex and housework for the Sunday Times, and numerous works of non-fiction before turning to romance novels - to great success. She has sold more than two million copies of her books including: Riders, Rivals, and Polo - taking us into the glamorous worlds of show jumping and classical music. Her latest novel Tackle! takes us to the football pitch and features her legendary hero Rupert Campbell-Black. Jilly joins Emma to talk about football, why there is less sex in her novels now, and her view on Prime Minister Rishi Sunak reading her books. Yesterday marked a month since Hamas launched its unprecedented attack on Israel in which 1,400 people were killed and more than 200 men, women and children taken hostage. One of those seized and kidnapped was Hersh Goldberg-Polin - a 23-year-old dual Israeli American citizen who was attending the Supernova music festival - the site of which became a massacre of a majority of young people - more than 250 people at the hands of Hamas. Hersh lost an arm during that attack but is still believed to be alive. Since then more than 10,300 people have been killed in Gaza according to the Hamas-run health ministry in retaliatory air strikes by Israeli forces demanding the return of its citizens. Emma speaks to Hersh's mother Rachel Goldberg.A new report by the Organisation for Economic Co-Operation and Development, which compared alcohol consumption across 38 countries, British women top the list as the heaviest binge drinkers alongside Denmark. The OECD found that 26% of British women reported binge drinking at least once a month - defined as having at least six drinks in a single session. Emma discusses the issues with Dr Helen Garr, GP and Medical Director of NHS Practitioner Health, a mental health and addiction service for healthcare professionals; and Catherine Gray, the author of The Unexpected Joy of Being Sober.The government has announced £11 million in funding for the NHS in England to roll out a dedicated perinatal pelvic health service across all trusts. The aim of these new perinatal pelvic health services will be to help educate and assess women during pregnancy and after a traumatic birth – but how will it work? And is it enough? Emma speaks to Jacqui Barrett, who had a traumatic birth and was incontinent for a year, Professor Swati Jha, consultant gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists, and the Conservative MP Maria Caulfield, who is the Women’s Health Minister. Presented by Emma Barnett Producer: Louise Corley Studio engineer: Gayl Gordon

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BBC Sounds. Music, radio, podcasts. Hello, I'm Emma Barnett and welcome to Woman's Hour from BBC Radio 4. Good morning and welcome to the programme. How's your head today? I'm asking because we hear that women in the UK are some of the heaviest binge drinkers in the world. This is new research and for this purpose, just in case you want to know exactly what that means,

it means six drinks in one session. Once a month. Why do you think that is? You might not think it's that bad. Men are heavy drinkers too, I should say. But what is driving women's relationship with booze? What's yours like? Where are you with it this morning?

Perhaps it's quite fresh in your mind. The number's 84844. That's the number you need to text on social media at BBC Woman's Hour or email me through the Woman's Hour website or you can send a WhatsApp message or voice note using the number 03700 100 444. Those numbers, you can get in touch with Jilly Cooper today. Well, via us, that is, because she's going to be here. She of Bonkbuster fame has written a new book this time,

Less Sex, More Football. But are we having enough? Sex, that is, because she's going to be here. She of Bonkbuster fame has written a new book this time, Less Sex, More Football. But are we having enough? Sex, that is, not football. Jilly Cooper will be here. And we also will be hearing from the Women's Health Minister today as women's pelvic health centres are rolled out across England. We talk about macho attitudes at the top of governments and whether she agrees with the most senior woman in the Cabinet

that for some, being homeless is a lifestyle choice. Those words not belonging to the health minister Maria Caulfield but of course to Suella Braverman the Home Secretary. All that to come and more. Do get in touch on anything you wish to have your say on with those contact details I just read out. But first yesterday did mark a month since Hamas launched its unprecedented attack on Israel, in which 1,400 people were killed and more than 200 men, women and children taken hostage. One of those seized and kidnapped was Hirsch Goldberg-Polin, a 23-year-old dual Israeli-American citizen who was attending the Supernova Music Festival, the site of which became a massacre of a majority of young people, more than 250 people killed, the site of which became a massacre of a majority of young

people, more than 250 people killed at the hands of Hamas. Hirsch lost an arm during that attack, but is still believed to be alive. Since then, more than 10,300 people have been killed in Gaza, that's according to the Hamas-run health ministry, in retaliatory airstrikes by Israeli forces demanding the return of its citizens. And the Israeli government has said there will be no pause in the fighting until the hostages are returned. Hersh mother Rachel Goldberg joins me now on the line from Israel. But before I speak to her, we can play for you a part of a speech she recently gave at the United Nations. Let's hear a clip of it. So here I live in a different universe than all of you.

You are right there. We seem like we live in the same place, but I, like all of the mothers and all of the fathers and wives and husbands and children and brothers and sisters and loved ones of the stolen, we all actually live on a different planet. And the very cruelest of questions each of us is asked every single day without intended malice is, how are you? Well, picture your own mother.

And then picture her being told there are only two options. You are either dead or you had your arm blown off and were kidnapped by gunpoint into Gaza and no one knows where you are. Or if you bled to death in that pickup truck 18 days ago. Or if you died yesterday. Or if you died five minutes ago. Rachel Goldberg, good morning. Welcome to Woman's Hour. Thank you for having me. I can see you on a video, Lincoln.

You have a sticker on your chest this morning. What is it? Every day I have a sticker on my chest of what day it is since these 240 souls have been buried alive under Gaza with the world allowing that to continue to happen. So today is day 33. So I have a 33 on my chest. It also happens to be the number of nations that are represented in the hostages that are underneath Gaza. There are

people from 33 different countries. The age range is from nine months old to 85 years old. The religions that are underneath Gaza who are kidnapped are among Jewish people, Christian people, Muslim people, Hindus and Buddhists. And it's really breathtaking to think that the world is actually allowing that to continue. Let me come to that because I want to make sure that we hear about your son. We hear about Hirsch and who he is. Tell us about him. music lover and has had wanderlust and been obsessed with geography and travel since he was a little boy in first grade. And he was attending the music festival on October 7th with one of his best friends. And that music festival, as you mentioned, came under attack and a massive massacre happened. They're actually still finding bodies and people.

So the number is somewhere around 270, I'm told. And Hirsch and his friends managed to escape to a roadside bomb shelter where they came under attack. These are barefoot, crunchy granola hippies who were at a music festival. And Hamas came down on the bomb shelter, threw in hand grenades, fired an RPG into this small windowless room of 29 young people, and then sprayed the room with machine gun fire. So most of them were dead. A lot of them were critically wounded and in the process of dying. And a few of the lucky ones were trapped under the dead bodies. And it was from them that we heard that Hamas came in afterwards and ordered by gunpoint three young men who were wounded wounded but clearly alive to

stand up and walk outside. And when Hirsch stood up, that's when all the witnesses told us his left arm from the elbow down had been blown off. But he walked with the other two. And we actually, subsequently from Anderson Cooper from CNN, he came across a video of Hirsch and those two other boys being put on a Hamas pickup truck. And you can see as he turns to sit down, he climbs on himself using his right arm. He's left handed, but he used his non-dominant hand, got on. And as he turns to sit down, that's when you can see the stump where his arm was previously. And that was on October 7th. His last cell phone signal was at 10.25 in the morning from inside of Gaza. And that was 33 days ago. And we have not heard anything

since. Even to find out that information was extremely difficult. And the journey to find that information, and thank you for presenting it how you have, was, I imagine, you know, traumatic to say the least, and terrifying each step of finding that, and then nothing since? Correct. The Israeli government, are they in regular contact with you? How does it work at the moment with that number of hostages? So initially, there wasn't a lot that we were hearing from the government in those first couple of days because it was actually war. running around different kibbutzes and different communities in the South, you know, killing these families and elderly and babies and children. And so we knew that we couldn't wait for the government to come and help us because we knew that, you know, when you walk into a hospital, when there's been a massive, you know, disaster, there's triage. And we knew that really what they needed to focus on

was the actual fact that people were still being attacked. So, but since then, the government has assigned two people to each family who check in with us daily. You know, someone from the army checks in and someone who's from, you know, a different branch checks in. But there's nothing to tell us because, you know, the International Red Cross, which normally will go into situations like this just to tell people, oh, you know, these people were treated or, oh, unfortunately, they're dead. But we know that they're there, you know, there's some sort of proof of life. But they have not done that. There's no international aid organization that has done that for these 240 souls. So they are just buried alive underneath Gaza. And the world is just pretty silent about it. I know that there are British citizens as well who are there.

You did talk to Joe Biden, I believe. Yes. On the phone, which I imagine, you know, you talk about living in this on this different planet and part of living on that planet means, you know, have situations like that. Yes. The truth is that the Biden administration and Congress in America has been wonderfully supportive to us. On that Saturday when this happened, one of our first phone calls was to the U.S. embassy since we and Hirsch are American citizens and also Israeli. We moved here when my husband and I were almost 40 when we moved here. So we're very much, you know, entrenched. And all three of our children were born in America and Hirsch was raised till he was almost eight years old in America. So I called the U.S. embassy and they jumped right on. And we have been very much supported by the American administration. And President Biden, yes, as you mentioned, called, there were 12 American hostages, two of them have since been released. So there were,

I think there were 11 or 10 families total, because some families have multiple people taken. And he was on a call with us that he was supposed to be on for a few minutes, I think, perfunctorily. And he very he insisted on staying. His aide came on and said, Mr. President, you know, we have another call. And he said, no way I'm staying with these people. I want to hear from every single person. lent us some firsthand empathy because he has lost two children. He has lost a wife, both in very traumatic situations. So that was helpful to us. You talk about your son being buried alive. Your belief or understanding is that he is in a tunnel somewhere in Gaza. Is that what you're working from at the moment? That's what we're being told. understanding is that he is in a tunnel somewhere in Gaza. Is that what you're working from at the moment?

That's what we're being told. But again, I mean, we have no idea. No one of the 240 has any idea. And yet at the same time, you're in, again, just to use your phrase here on this different planet that you now exist on while the rest of the world continues, as it were before, the rest of the world continues as it were before. The rest of the world I suppose in Gaza isn't continuing in the sense of you are seeing your government strike saying there will be no pause until hostages or any break until hostages, its citizens

are returned and yet the same time while the world talks about how that's for Palestinians and aid and what's available, you are also aware, you don't quite know where, of course, but that your child is in there as well. It's a very particular situation. Right. And, you know, one of the things that I mentioned at the UN is that war always harms innocent people. Always. There's no such thing as a war where, oh, just the bad guys get hurt.

There's never been in the history of the world a war where there aren't innocent people who get hurt. And that's what's so devastating about it. And that's why we should, as human beings who have been blessed with intellect and insight and creativity, figure out different ways of solving any crisis we have all over the world without resorting to this. And yet somehow we always do because it's very familiar and it's very easy. So I am, of course, concerned for innocent Gazan civilians the same way I am concerned for my son and the other 239 people who are with him who are also innocent and in a very scary situation.

Do you feel that all is being done to get your son back? How do you feel about that at the moment? I've interviewed people who have been related to hostages before, that their relationships with the official channels, with state, can be very strained. Right. It's hard to really know. First of all, I'm not a military strategist and I'm really not, you know, a diplomat or politician. No, no. I'm asking on a human level. Right, exactly. So, like, as a mother,

I feel, like, terribly concerned. Very hopeful that the people who are in charge are actually thinking about what is the price? What is the price that everyone's willing to pay to see this end in a way that could be a good ending? I mean, we have been living through, this is what 32 nights of not sleeping looks like. I went to New York and I was going on a news show and they said, can we put makeup on you? And I said, no, I haven't put makeup on in however many days it had been. And they said, but it's a little bit distracting because you just look so drawn in these black circles under your eyes.

And I said, yeah, that's my war paint. Like, I want to be distracting. You know, my, there are 240 people buried alive underneath a war zone. They were stolen out of their, out of, you know, where they lived. And I do think that it's strange that both're saying, give us back these people and we will stop what's going on. And the answer from that side is no. And that's a problem for both sides. It just ends up hurting innocent people on both sides. Do you sleep, Rachel? What we generally do is we work about 18 hours a day.

Sometimes my husband works even longer. I kind of just turn into a zombie. But we can't sleep because it's terrifying and we can't fall asleep. So our family doctor gave us these tranquil you know, tranquilizers basically that knock us out for a few hours so that we have, you know, three or four hours of nightmare filled sleep. And then we get up the next day and we have to start all over because obviously we failed, even though we worked 20 hours the day before, because they're still not home. Hirsch isn't home. Those other 239 people are still not home.

And then we just start all over again. So it's really the myth of Sisyphus for us. When you say work, part of that work is talking like you are now and giving interviews to keep this. I'm also aware as we speak that three Israeli mothers have come to the UK, have come to London asking for the return of their children who have also been stolen, who have also been taken hostage by Hamas. Right. Right. So, yes, there's a lot of, you know, we have this incredible team of people who showed up on Saturday, October 7th and have not left our side. Some of them were friends, but they realized we didn't need people to hug and pet us

and make us feel better. We needed people who can help us get these people back. So people with a lot of talent showed up and said, you know, I'm a PR person. Let me help you. I'm a political strategist. Let me help you. I know about social media. Let me help you. and that's all been very helpful because i'm a teacher my husband works you know in business development like we this we don't know i mean this is a crash course in uh in diplomacy and politics and in uh catastrophes um and uh you know that's uh that's what we've been focused on. And at the heart of it, you, of course, are just thinking of Hirsch. Oh, my gosh.

At the middle of all of that. At all times, at all times. And thinking of him without his arm, his dominant arm. Like, is he in pain? Did he get the surgery he needed? Did he get the surgery he needed? Did he get the antibiotics he needed? Also, we know of so many others. We know of, you know, a little girl who has type A diabetes, you know, childhood diabetes.

Like, if she didn't get her insulin, that girl's dead. And the grandmother, who is 85, who we know needs certain, she has a heart condition that needed certain medications. Did she get that? Because I'm friends now with her granddaughter who said, the cardiologist said, if she didn't get that, she's dead. You know, there's just, it runs the gamut. And there's so many people who were wounded in the process of being kidnapped. And we just don't know anything. Rachel Goldberg, thank you very much for your time this morning.

Thank you. Your message is coming in, talking to us this morning about everything you're hearing on the programme as always, but also I should say at this point bringing things much, much closer to home. A lot of you getting in touch about health and women's health and binge drinking because a new report by the Organisation for Economic Co-operation and Development, which compared alcohol consumption

across 38 countries, showed British women top the list as the heaviest binge drinkers alongside Denmark. The OECD found 26% of British women reported binge drinking at least once a month, which is defined as having at least six drinks in a single session.

Dr Helen Garr, GP and Medical Director of NHS Practitioner Health, a mental health and addiction service for healthcare professionals, is here, as is Catherine Gray, the author of The Unexpected Joy of Being Sober. Helen, are you surprised by these findings with British women? Actually, no, I'm not. So as a GP, as a medical director of a service that I run for healthcare staff with mental health and addiction problems, and as a woman and as a mother, absolutely not. And I think Catherine will agree with me.

What we have in England now is a culture where we've normalised drinking. We hear it everywhere. wine o'clock, we see it on merchandise, we see it in TV shows, we see it on social media. And it's become completely normal for women to cope with the stresses of modern day life by turning to drinking. And actually, I don't think as women, we always recognise the dangers of drinking or even how much we're drinking, because it's become completely normal. And on that, the medical risks associated with it in that normalisation, you know, some may listen, binge drinking, six drinks in a single session, at least once a month. How bad is that for you? Well, I think often we don't realise just how much we're drinking or how bad things are. So for binge drinking particularly, it's actually terrifying, the statistics.

So drinking alcohol, any amount of alcohol, but the more you drink, the bigger your risk of all cancers. That's terrifying. But for women, there's unique risks to women. So breast cancer, we know that around one risks to women so breast cancer we know that around one in ten cases of breast cancer are caused by alcohol liver cancers throat cancer bowel cancer particularly all related to drinking it's not just cancer we increase our risk of osteoporosis thinning of our bones heart disease hypertension depression I know as a GP, around 70% of all mood disorders that I see have some substance misuse, alcohol particularly in the background, memory loss, death. Most alcohol-related deaths are not independent drinkers. And if you have a healthy lifestyle

other than your booze, what about the risks there there can you mitigate it through that well of course um having a healthy lifestyle is really important and the the more you lower your um extra risks the better but we know that any alcohol at all increases your risk so the less you drink the lower your risk of these cancers and chronic diseases it's not just the cancers and the physical things. I just want to say it's actually, it's the short-term things. You're more likely to have an accident. You're more vulnerable if you're drinking. Your ability to work and care for your children.

And actually, it sounds really superficial, but looks, I've seen women who have been drinking heavily. They've come to me for support as a doctor. They've managed to stop. And I've seen them just six weeks later, they've cut down on their drinking, they've stopped, and they look 20 years younger. Catherine Gray, the unexpected joys of being sober.

What do you want to say this morning? I'm not surprised either, because the Institute of Alcohol Studies found that during lockdown, it was 28% that people were doing this. So that's actually a fall of 2%. But it's still a lot worse than it was 28% that people were doing this. So that's actually a fall of 2%. But it's still a lot worse than it was pre lockdown. So I think lockdown launched a lot of problematic drinking, and that is lingering still among British women.

And what have you found? And why were you driven to give it up? I was incredibly depressed. I was researching suicide. This was 10 years ago. And the curious thing about it was that most people around me, other than my parents and my best friend, really thought that I should quit. Everyone else said, why don't you just cut down, you know, take six months off, that kind of thing, do a dry January. So it's very easy to hide this in plain sight because binge drinking is so normalised. And the normalisation of it and particularly how women are attached to it, what did you find out about that when you were researching your writing? Well, if you look at the marketing of alcohol, it's the biggest stroke of genius ever. I mean, it's marketed to every woman and it's the top drug of choice because

it is a drug unfortunately um for everyone from the millennial who's like swilling a whiskey sour and equating it with feminist rebellion to mums on playdates and middle england with their keep calm and drink wine sign it's still incredibly accepted to be visibly and ridiculously drunk in this country and in the Nordic countries like Denmark. But that is beginning to shift. I do want to emphasise that there is hope on the horizon and all the research that's coming out is just helping that and tons of women are quitting. One in four don't drink now. Well, yeah, and I'm seeing that on some of the messages coming in. Some of them have read your book as well, Catherine.

But what would you say has been the top benefit for you not having alcohol now in your life? Because some people feel they need it to take the edge off, even if they aren't in the binge drinking category. Yeah, see, that's the funny thing. And whenever I quit drinking, my anxiety spiked sharply. I'm not going to sugarcoat that. And I was drinking because I was very anxious. But now my anxiety is practically non exacerbates it. It messes with our brain and makes us less able to create serotonin and dopamine and all sorts of things. So the only way that you really get over anxiety is to remove it and learn how to have confidence. Well, Catherine Gray, thank you very much to you and to Dr. Helen Garr there. Let me read a few of your messages. Claire says, who's in Devon, good morning, five months alcohol free, never felt

better. Mood, money, relationship, self all so much better. I drank 30 to 40 units a week at worst. Minimum of 20 since the age of 18. I read Sober on a Drunk Planet. Also The Unexpected Joy of Being Sober. We were just hearing from the author and Sober Curious. Others have been inspired too. I love it. Still go out, not as

often. Happy to be the sober driver. Guinness Zero is a winner. Another one here. I started I love it. sleep much better and losing the belly fat slowly, it can be done. And someone says here, peer pressure could be one of the reasons. I gave it up decades ago and I was never really interested in it. And yet others saying you do enjoy it and about moderation. Thank you for those messages. Keep them coming in. Let me take you to something else entirely, though, but it is still linked to women's health. The government has announced £11 million in funding for the NHS in England to roll out a dedicated perinatal pelvic health service across all trusts. According to the

Department of Health and Social Care, one in three women experience urinary incontinence three months after pregnancy and one in seven experience anal incontinence six months after birth. Both of these conditions can affect women's relationships, mental health, their ability to work and pretty much everything you could argue. The aim of these new perinatal pelvic health services will be to help educate and assess women during pregnancy and after a traumatic birth. But how will it work? Is it enough? Earlier, I spoke to Jackie Barrett, who did have a traumatic birth and was incontinent for nearly a year, and Professor Swati Jha, a consultant gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists. I began by asking Swati what the service is for

and who it's for. The perinatal pelvic health service is basically aimed at improving care pathways for women needing support after birth. The newly published um perinatal pelvic health service implementation recommends that the oase care bundle developed by the rcog is also rolled across and rolled out across all the maternity units um so that's the royal college of obstetricians for people who don't know carry on yes so the rcog initially conducted a survey just to give you a sense of the enormity of the problem we're dealing with and 60 percent of all women have described one or the other pelvic floor problem whether that's urinary incontinence or prolapse or bowel dysfunction so that's how common this problem is. And yet one in four women have never

done pelvic floor exercises. And just to top that up, 69% of women have never spoken to anybody about their pelvic floor health. Let me bring in who I'm about to talk to here in the studio, who's just joined me as well to talk of your experience. Because Jackie, I know we could talk about your birth in some detail, but I actually want to really get to what happened because of your birth. And that brings us to pelvic health. Very, very front and centre for you. But you go in for your birth and you have a very difficult birth.

It lasts some days, I understand. And you are left in a position, I mean, you tell me, you now look at it and think you should have had a C-section, but you are left in a position where you are having to get towels out of the cupboard to mop up what's going on with you for many, many days and weeks afterwards. That's right. Yes, that's right. Yeah, so my birth was episiotomy and forceps, and there's a whole backstory to that, but for context of this conversation, yeah, so the damage from that delivery

caused significant bladder incontinence. And I appreciate the point that we, as women, we need to prepare ourselves but I really thought I was girl guide prepared and well informed. I can be a bit of a swot so I did all my NCT classes, I read that big chunky what to expect book, I exercised loads, I did yoga swimming, my bladder incontinence was really bad and those chunky towels were not fit for purpose. I had to go to the laundry cupboard and help myself to bath towels and roll them up, put them between my legs and then waddle to the floor below to feed and change my baby who was in neonatal special care.

A week later, I was sent home and me and my baby had all the usual checkups. I was diligent with that little red book. In fact, I've brought it because it was a real Bible. But in terms of checkups on my baby, but nobody asked me about incontinence ever. I suppose your point there is nothing that you had done in advance could help you with then what you were trying to live with? Absolutely not. No, absolutely not. I mean, I was above and beyond prepared in terms of what I did pre-birth. I had a beautiful pregnancy. It was serene. It was all the trauma from the birth. And your experience then, ideally, you'd tell this to a doctor and you'd be referred to a gynaecologist, perhaps also to a physio, you know, whatever level this was at at a certain point. And you'd be looked after in a timely fashion. What was the reality?

Well, the reality was nobody asked me about it. And I was so utterly broken and exhausted for various reasons. And I felt like my bladder was way down the pecking order in what I could even discuss I was convinced this was so much more um there was so much more damage here the the exercises were just not going to fix it were you offered any physiotherapy so eventually I was given some physio and I'm not a defeatist type of person, but I knew that this physio, these exercises were almost futile. In some respect, I couldn't believe that this physio couldn't tell that this damage could not be fixed. That's what we should say at this point.

So this was, what what did happen what have you had to have so i had to have surgery um and but i finally persisted i saw a consultant about 10 months later and after a very quick simple examination that consultant told me it's cases like mine that make him advise his wife to have a C-section when the time comes. And rather than being shocked, I was so relieved. This was professional confirmation that this was bad. It was validation. It was acknowledgement that it's not my fault and it's not because I'm not doing enough.

And the surgery was to do what? And the surgery is called a colpo suspension. And it was a very simple surgery and I got my life back. I got my bladder back. I got my life back. I got married a few months later. Let me just bring in Swati at this point. I believe she's been listening to what you have to say. What is your response? Because doing the exercises, just talking about that, the idea of pre your birth, being prepared, in this, you can hear is to no avail. So, first of all, I'm very sorry to hear of your experiences, Jackie.

No woman should ever have to face what you had to go through. And I think the other thing to emphasise is something you've touched on. Well, several things. The mother and baby are a team and so they need to be managed as a team and that is one of the objectives of this service because we recognize that we have been focusing purely on babies who obviously need most attention but we also need to focus on the mothers but we mustn't undermine the importance of physiotherapy because 70% of women will improve with physiotherapy and I'm so sorry to hear that you didn't but that doesn't mean to say we shouldn't try to at least I'm a surgeon at the end of the day I always say to my patients you can't go back

to do physiotherapy once you've had surgery give it a good go and if it doesn't work we're here but what we have to remember is one of the other things or one of the other objectives of this service specification is exactly what you've highlighted Jackie which is improving the rate of identification of these problems when they happen and ensuring timely access to services access to a urogynecologist I hope, I hope that going forwards, women will not be in a situation where they have to go through what Jackie has been through. I hope that we are in a position to provide access to services antenatally to all women and easy access to those women who need it postnatally and going forwards. Postnatally extends to the rest of our lives.

Problems with our pelvic floor can happen at any point in a woman's life. What do you want to say in response, Jackie? I feel, yeah, I agree in that we should, there should be more help. I feel that when we're talking about the funding, I feel, you know, is that enough? Because we shouldn't just look at the whole how many women give birth this year. There's a whole backlog of women. I mean, I've got friends who had babies 10 years ago and they're still struggling. And like you say, this is a lifetime issue.

When the lactating has stopped, when the stitches have healed, when the babies have gone to uni, we're still dealing with our issues. And there isn't enough, there aren't enough touch points for us to talk about this. Jackie Barrett and Professor Swati Jha there. Listening to that was the Conservative MP Maria Caulfield, the Women's Health Minister. I started in our conversation before coming on air this morning to ask her why it's taken so long for these services to come about. Well, I think this is symptomatic of women's health in general, whether it's the menopause or whether it's things like endometriosis. Very often there's been a culture that things that women do naturally,

such as giving birth, there doesn't need to be intervention and support. And actually, that is absolutely changing. And our rollout of perinatal pelvic health services now is actually taking a step back in terms of Jackie's experience and looking at those women who are at risk of maybe tears during labour, because there are some risk factors. And where we've been rolling this out in some parts of the country, we've seen a reduction of around 20 percent. But that also then, you know, we can't eliminate the risks of tear and birth trauma completely. And so, as Jackie pointed out, when it does happen, there needs to be help and support from others,

both at the time, but also for longer term as well. And so the rollout of perinatal health services, which will be across England, obviously health is a devolved matter. We're doing this just in England. All areas of England by March will have some of them up and are running already, but will have started those services being available and changing that culture of having these discussions both before labour and giving women choices. Jackie touched on it, that some women would have a C-section if that was available. But these discussions are not being had with women and then they're left picking up the pieces afterwards.

£11 million of funding works out to around £19 per woman in England in terms of the number of women who gave birth for the latest data. Is that enough? It's not just about funding, it's about how we organise services. And so the perinatal pilots that we've been doing in 28 areas of the country are the ones that have seen a reduction of 20% of injuries. So we know that with the existing services, by delivering them in a slightly different way, is able to have an effect. So the funding is one part of it, but it's about changing the culture. I get that, and prevention is really important,

but you aren't going to prevent it all. 20% is still quite low, and you are then going to need serious support afterwards if you've got certain issues. Postnatal care has never been where it's meant to be in this country. Everyone actually can agree on that. I'm sure you would as well. So the issue is, can you then get the support of, for instance, if you don't need surgery, women's health physios for long enough and quick enough? Yeah, well, and this funding is, you know, one piece of maternity funding. We've got £168 million a year going into workforce funding specifically for maternity services.

And that will include midwives, but it will also include kind of maternity physios as well. So there is a greater effort. I don't think maternity has had the focus it's getting right now in terms of trying to turn around services for women. It's always been seen as something wrong, isn't it? It's going really, really badly, Minister. Under your care, may I just remind our listeners of the latest annual state of care report by the NHS Watchdog. I'm sure this will have astonished you. 65% of maternity services are now regarded as inadequate or require improvement for safety, up from 54% last year.

Do you know how bad it is? And do you know which direction it's going? Absolutely. And it's going in the right direction. It's going in the wrong direction. Sorry, I've got the data in front of me. Emma, if I can just set the scene for you. We have got inquiry after inquiry, the Donna Ockenden inquiry, the Bill Kirkup inquiry into East Kent. There have been problems to maternity services for decades. And when they've been assessed, if you look at the ratings of those hospitals traditionally, they've been assessed as good. That clearly hasn't been the case. So we have got a much more robust inspection system, which will record units as not performing well, because we actually want to know the state of

the problem, rather than doing inspections that just gloss over some of the problems these have been fundamental problems for decades not just in in recent years and we have set up programs for those that come in are rated as inadequate or require improvement we've got 32 of those units now going through programs to transform them and they are coming out at the other end and starting to get big ratings. This is about fundamentally changing maternity. Which is very important. And I'm talking about safety only because I've just heard from a woman who didn't feel like what happened to her was okay. And it's important to get a clear picture of that. But you talk about decades and decades,

we've had the Conservative Party for more than a decade. So it feels for some, why only now? Yes, okay, you can make the point that the reports are being more thorough so you get a better picture. But if it's going in the wrong direction, there's also detail in this report talking about a staff under great pressure and not being able to look after women. If you want to help women's postnatal care, it's about them having safe births in the first place and having a good experience with those around them. If you look at the work we're doing to transform the East Kent Trust, which, you know, we had Bill Kirkup report some tragedies that happened there, you know, decades ago, as well as in more recent times, we are seeing a transformation of that unit where women are now saying that they feel better listened to by their teams and having a better experience. If you look at the work, you know, in Cornwall, for example, we've now got a waiting list of a student midwives waiting to train in trusts there. So we are starting to turn the corner. But the way to do that is actually to admit that there's

been problems for years. And, you know, we hear that in the women's health strategy all the time that women haven't felt listened to when they've tried to access care, when they've raised concerns or tried to get help. It's not been available. We are transforming that. And yes, acknowledging that there are fundamental problems, but we're putting the funding and resources in to turn that around. And this isn't about who's in government, that we've got exactly the same problems in the devolved nations in Scotland and Wales. So to change this, it's about changing the culture, listening to women, and the perinatal services, the pelvic services that we're setting up, it's absolutely for too long, it's just been seen as acceptable that one in three women experience urinary incontinence

three months after giving birth. That's not acceptable when we know that can be prevented in many cases, and if it starts to happen can be managed and we are the first government to actually try to tackle this and try and deliver an improvement in women's health across the board possibly at the end of your term well that that may be i mean you know you're someone who's worked as a nurse you know the nhs you care about it why has it taken so long we have set up the women's health strategy just two years ago just two years ago you've had 10 years before that. I'm interested why you think, is it the macho culture that we've heard so much about in the COVID inquiry?

Well, if you look in Wales where Labour run the health service there, they've only got the Women's Health Strategy. Don't do that. You're saying to me. Come on, talk to me about what you can talk about, which is your government, the party of government. Come on. It's so good to have you on the programme. I'm genuinely trying to get an answer from you. Why has it taken the Conservatives so

long? You've been telling me in the last two years, you've had 10 before that. We didn't. The first five years we were in coalition with the Lib Dem, I wasn't even an MP during some of those years. I'm not saying you, I'm just saying, OK, your party has still had power in the coalition. You know it's a bad day when you're having to blame Nick Clegg. Well, no, it's not a bad day. I'm really proud that we are the first government ever to have a women's health strategy, to put maternity as a priority area, to put perinatal pelvic health services.

That is great. That women don't even want to talk about because it's embarrassing, it's difficult. You know, it affects their self-esteem. Honestly, we know this. We're women's are. We know. You know, we know. I'm just trying to understand why it's taken so long. And if you've really got the long term commitment, which is what we were hearing from our doctor, the funding that's needed from those at the very top of the table, because hearing about WhatsApp messages that we weren't meant to get access to, but we're now hearing about that the macho culture around health, around COVID,

led to decision making being done in a way that some of the key women didn't feel comfortable about. I wonder how comfortable you feel about it and the long term commitment. I'm very encouraged that for the first time ever, you've got government ministers talking about organ prolapses, urinary incontinence, anal incontinence and driving that forward as the top of the agenda. And that by March next year, every part of England will have set up perinatal pelvic health services. You know, I think, you know, we shouldn't be afraid to say that that is actually quite radical because it's never happened before. We are changing the way that we view women's health. And yes, it's maybe taken us a while to get there,

but we are the first government to drive this change forward. And we should be proud of that, that we want to change it. It's taken a while. Yeah, I mean, that's definitely one way of putting it. But I accept you're trying to look forward and you're trying to look at what we're doing. Just while I do have you, very briefly, if I may, you are in charge of women's health and you are somebody who works in the health, has worked in the health service.

Maybe you'll be going back to it. You don't know. We don't know yet what the election holds. But do you think homelessness is a lifestyle choice? No, I don't. You know, I'm someone who grew up in a very poor... I'm quoting Suella Braverman, the most senior woman in your party, the Home Secretary. Yeah, I'm someone who grew up in a very poor working class area and struggled financially. I'm not someone who's, you know, come from a privileged background to talk about nursing. I still do nursing shifts. I did a night shift last weekend. Oh, I'm sorry. I didn't realise you still did it. But there you go.

Sorry. It's interesting to hear. And I don't believe homelessness is a lifestyle choice. I do know of constituents where we offer them housing. Why on earth is she saying that then? on the ground and I don't believe homelessness is a lifestyle choice. I do know of constituents where we offer them housing. Why on earth is she saying that then? Well I do know of constituents that I support that we offer them accommodation and they don't want to take it. I wouldn't class that as a lifestyle

choice. I would say they have other issues that mean that housing and accessing housing is difficult. And I don't think it helps the discussion. Why is she doing it then? You would have to ask Suella that. We'd love to get her on the programme.

But from your point of view, if you are trying to relate to people and talk about change and difference, is it unhelpful? I don't know if it's unhelpful, but it's certainly not something that I've experienced either personally growing up in quite a tough area or as a constituency MP, you know, part of my bread and butter is helping people who are homeless and accessing... It sounds like it's rather unhelpful for your conversations

because you don't relate to it, you don't agree with it, and yet she's one of the most senior members of the government and she's saying it. And there are others speaking this morning to the papers saying this is just not what we believe and this isn't right yeah well you know my focus really is uh on trying to you know i've focused on my portfolio area but also but you care about health and um if we're talking about health and ill health homelessness is a is a key thing there and obviously women are particularly affected by it in some unique ways which we've talked about on the program so i wanted to give

you the chance to respond. We always appreciate your time and talking to us and I hope you'll come back soon. Thank you. Maria Caulfield, the Women's Health Minister and Conservative MP. Let me tell you who's just walked in. My next guest began her career as a journalist, wrote columns on marriage, sex and housework for the Sunday Times

and then numerous works of non-fiction before turning to romance novels to great success. Who am I talking about? Of course, it's Jilly Cooper. She's sold more than two million copies of her books. You'll know the title. Some of them, Riders, Rivals and Polo, taking us into the glamorous worlds of show jumping and classical music and giving many out there an unofficial sex education en route.

Her latest novel, Tackle, takes us to the football pitch and features her legendary hero, Rupert Campbell Black. Jilly, good morning. Hello. Football. Why are we doing football? Well, I think football's exciting. And it's the most, I mean, more people watch football. It cheers the world up.

I mean, it's something that cheers people up more than sex because, you know, people watch football. It cheers the world up. I mean, sometimes it cheered people up more than sex because people watch it and if their team wins, they're terribly excited for a week and they're happy and then they get a bit sad the next week. And I think we all need cheering up at the moment. It's a brilliant game. I believe you sat with Alex Ferguson and heard from him a bit about this world.

I sat next to him at lunch and he was a bit scared because I thought he might be too important to sit next to me. But he was so sweet and so funny. And we giggled so much. And I told him a few naughty stories and he told me some. And I just fell in love with him and just thought, why not write a book about football? What naughty stories do you tell Alex Ferguson at lunch? Not sure that it's... No, it's about a lot of naughty mice in Scotland. I don't think I want to tell you to do it. You can't blame a girl for trying. OK, so there's a lot of football, there's a lot of intrigue,

there's a lot of characters and plots, as there always are in your books, and slightly less sex than normal? Well, slightly less sex because I think I'm 86 now and I always, in my life, I always like to write about things that describe things as I go along because my darling husband died 10 years ago I haven't really got an example

I think there is a bit less sex but there's quite a lot of sex but not as much as there was I mean and you know it's an important point to sort of write as you find the world and as you are but it is something that people do associate with your books. And remember fondly perhaps sneaking their mum's copy and having a look and learning a lot. Lovely.

How do you feel about that? No, I love it. You've been an unofficial sex educator. I think it's wonderful. I mean, I've always thought sex was heaven if you enjoyed it. And I think people should enjoy it. And it brings an enormous amount of pleasure in life like football is so I think it's it's lovely if I've encouraged people to have more

sex I'm very pleased well it's it's also just something I was thinking right at the start of the week uh there was this interview with Barbara Streisand who doesn't give many interviews uh she's written a book uh of her of her life trying to sort of talk about things and I'll come back to your writing in a moment. But it was really striking that she said she doesn't think she's had enough fun in her life. And I thought, my gosh, if Barbara Streisand's not had enough fun in her life, what are we all going to hope for? And I wonder, what do you think that says? And do you think there sort of is less opportunity or fewer opportunities for people to have fun and think of the lighthearted things.

I hope that when they tackle, it will cheer people up, because I do think, we're all terribly depressed about the world and everything and climate change and all these awful things happening, it never stops raining in Gloucestershire. And I think people need cheering up. So I'm terribly sorry, I ought to ask you out to a party, wouldn't I?

Yeah, you should. You might have to cheer Barbara Streisand up. Tell us, in terms of your story then, this particular story, you have tackled the fact that, for instance, one of the characters has breast cancer. There's a very good description of her side effects during treatment and you're trying to show those difficulties but also within relationships as well.

Yeah, I am. I think it's terrifying about cancer. And I think so many people are so brave. And so my lovely Taggy, my heroine, she has it. But she's so kind, Taggy. If a new dog comes to stay in the house, she puts flowers in its basket. So she's a real sweetheart.

I love her. So I hope dealing with her cancer will encourage people to look after themselves and comfort them. You also worry about the emasculation of men. You have a character called Iron Man. Iron Man. Isn't that awful? Yes. Poor man. I love Iron Man. He's one of my heroes. And he's called Iron Man because Iron Man means very strong, masculine. But he's called Iron Man because he's terribly henpecked.

And the team are jogging past his house and they look in the kitchen window and he's ironing his wife's dresses. So he's ironed like that. Yeah, so he's called Iron Man. But you also, coming back to the sex point, I've read before that you have some concerns that we're sort of having less of it or we're not enjoying it as much and we're perhaps not viewing each other in the most attractive lights anymore. Or the sexes. Yeah, and how women view men and how they see them. Well I think the sexes should cherish each other and I think I love masculine macho men, I love

them, gorgeous Clark Gable, do you remember people like that in my day and I just think one needs I just think and if you look at stallions, stallions are still macho aren't they and bulls and all those things and I just think one needs... I just think... And if you look at stallions, stallions are sort of still macho, aren't they? And bald and all those things. And I just think it's...

I don't like men to be put down all the time because they seem to be terribly belittled at the moment. You think that? I mean, obviously, it depends on where the power balance is, I suppose, between the particular woman and the particular man. But you can't do anything. A man cannot put his hand on a woman's shoulder without being accused of rape these days. Come on, that's not exactly true, is it? Well, not perhaps a bit lower than that, probably, but definitely. You do get accused of

all sorts of things, and it's very difficult for them. And also, if you put a hand on a girl's shoulder 20 years ago, she'll suddenly come out of the woodwork and say, this man tried to seduce me years ago. You like detail. You know that women, where there have been very serious accusations, it has to be documented, they come forward. And you yourself went through some of these moments. And surely you welcome in some way that there's a chance to redress the power imbalances where there are difficulties. Of course, of course, yes.

But I just think men are awfully a, I think men are awfully sort of a bit depressed at the moment. Is that men around you? Do you hear that? Well, I live in the country, so I don't see many. Mainly dogs and horses, it seems. Dogs and horses, yes. No, but it is interesting. I mean, there is a particular man who's apparently reading your work, Rishi Sunak. Isn't that lovely? Tell me about this, what's happened? He just said so. I just read it somewhere that he loved my books. And what was so lovely was he named them Riders, Rivals, Polo

and all that sort of thing. And he knew all the titles. I was so touched. I love that. So when you're talking about men who feel demasculated, depressed, are you talking about him as well, do you think, in this? No, no, I hope he gets cheered up by it. He does read them for a laugh, a cheer up. All I want really, I don't mean to be silly,

because I love women, I love both sexes, but I just want them to cherish each other and admire each other rather than sort of putting each other down all the time. We have another man now, a new man, in charge, as it were, in terms of the royal family, a king, and you've been close for years to now the Queen, to Camilla. I believe accepting an award on her behalf at the Oldie.

Was it the Oldie Awards? You collected something on her behalf? I mean, it's quite a thing. I'm just thinking with the spectacle of the King's speech yesterday and seeing the two of them, you know, taking on these roles that we've for so long seen with Her Majesty, with the late Queen. How do you think she's taking to that role? I think she's absolutely brilliant. She's looking gorgeous. She's really looking gorgeous at the moment. And she's fun. And I love the idea of wherever she goes, she's always cheered me up. And wherever she goes, she'll be cheering people up. And I think she's brilliant.

Yeah, I mean, it's quite a big job to have. I mean, it's her age, suddenly having to get up. I mean, she used to sort of like horses and reading. So she used to spend quite a lot of time on the sofa reading in the old days. But I shouldn't think she has any time for that now. But she has to get up and do three different appointments in a day and get up very, very early. And I mean, she's sort of in her 70s and it's not much fun there. Well, there is still a reading club, I believe.

Yes, brilliant reading club. There is all of that. And for you at the moment, I mean, I know you're also having a situation, you can't say all of it at this point, but you're having one of your books made into a television production, an extravaganza.

And as you were just coming on air, we were talking that you haven't been out and about and doing that much lately and now there's suddenly a Jilly Cooper explosion. It's wonderful. I have to say Rivals has been made by Disney and I've just seen the rushes and it's just fantastic.

It's so good. And they're taking it so seriously and I just think Disney being taken, taking me seriously, I'm so excited. What have you been doing in the intervening years? I know you still love to write. I've been writing, writing, writing football. Yes. Have you been

going to a lot of football? I have a local team, Forest Green, which is absolutely lovely and I've been going to them quite a lot and I watch Soccer Saturday and things like that and I watch Match of the Day from BBC and I watch it a lot. I've been writing a lot, working very hard on it.

So that's what I've done, really. Yes. Well, it's also, you know, it's interesting always to hear what people have been doing, you know, while they've not been necessarily in the spotlight. And you're a great diary keeper. Is that right?

Yes, yes, yes. But I keep, I've got diaries all across the house. I mean, all across my study, masses of them. But I keep saying to my children, they're quite naughty, these diaries. And I said to my children, darling, you want me to burn them so you won't be embarrassed? Would you like to be embarrassed and rich?

What have they gone for? I don't know, but I mean, they're quite a lot of goings on in the past, so they're quite interesting. I bet they are. And also, describing other people, being awful about some of the people I've met, too, which is quite embarrassing, too, because one always tells the truth in one's darlings, isn't one? Yes. Well, I feel we've

got a lot of time, we probably need to talk about this off air with some of these details that you're not going to share on air. I would definitely love a preview. But it's fascinating and it's lovely to have you apparently, I believe your first time here. Yes, never been on it before. So excited. It's lovely to have you on Woman's Hour.

It's epic Woman's Hour, isn't it? It's certainly been going a while. Wonderful. Gillian Cooper, thank you very much indeed. The novel is called Tackle and you're still writing. Even more to come. We will await. Gillian Cooper, thanks so much and thank you very much for your

company today. I'll be back with you tomorrow at 10. That's all for today's Woman's Hour. Thank you so much for your time. Join us again for the next one. Hi, Greg. I'm a long-time listener to the show and I'm not lying when I say it has changed my life. I'm Greg Foot and my podcast, Sliced Bread, from BBC Radio 4 is back to separate more science fact from marketing fiction. For me, they're the best things in sliced bread and they're not marketing BS. Each week, I investigate a new wonder product promising you the world.

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