Woman's Hour - Nicola Bulley, tearing during childbirth, black women swim, tweakments gone mad?

Episode Date: February 21, 2023

We discuss the statement released by Nicola Bulley's family following the sad news that that the body found in river Wyre had been formally identified as Nicola Bulley who had been missing for over 3 weeks. They expressed their pain on how their loved ones were treated throughout this ordeal. They called for accountability, and for another family not to go through what they had gone through. Joining Nuala is Zoe Billingham, former head of the inspectorate of Constabulary, Ellen Milazzo from Victim Support and Baroness Helen Newlove, former victim's commissioner for England and Wales. Up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear. So, it’s no wonder that tearing is a big worry for expectant mums. Marie Louise, also known as The Modern Midwife, explains to Nuala why tears happen, and what to really expect. Plus, midwife turned inventor, Malene Hegenberger, explains how she created a retractor to help her see tears better when suturing. Why are women from diverse background much less likely to be able to swim than white women? And what can be done about it? Team GB’s first black female swimmer Alice Dearing helped to found the Black Swimming Association along with journalist Seren Jones – they join Nuala to discuss. As London Fashion Week draws to a close today, the Times fashion director, 51-year-old Anna Murphy, reflects on feeling like the only woman of her age in the front row who has not had work done on her face. What she calls the normalisation of ‘tweakments’ is one of the topics explored in her new book Destination Fabulous. She tells Nuala about the changing trends in tweakments, why she finds the term problematic and how to embrace ageing naturallyPresenter: Nuala McGovern Producer: Lucinda Montefiore

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BBC Sounds. Music, radio, podcasts. Hello, this is Nuala McGovern and you're listening to the Woman's Hour podcast. Hello, good morning. Welcome to Woman's Hour. We will begin with the sad news that the body found in the River Wire has been formally identified as Nicola Bully, who has been missing for over three weeks. You may have heard the statement released by the family who expressed their pain on how their loved ones were treated throughout this ordeal. They're calling for accountability and for another family

not to go through what they have gone through. We've also seen the criticism of the police and their actions including the disclosure of Nicola Bulley's private medical information. The press and members of the public were accused by Bulley's family of vilifying friends and family. And we've also seen the speculation about what happened to Nicola Bully rife online across social media platforms

and in particular TikTok. So how can families like that of Nicola Bully be protected and supported? What's in place at the moment? And why didn't it work for this victim's family this time? We're asking what needs to change to prevent it from happening again.

My guests have been thinking about it deeply. We'll hear their views. I also want to hear yours. Particularly if you have personal experience. To text the programme, the number is 84844. Also on social media, we're at BBC Woman's Hour, or you can email us through our website

and if you'd like to leave us a voice note or a WhatsApp message that number is 03700 100 444 Also this hour we will be speaking about childbirth If you've had a baby there is a high chance that you had a tear during that birth We're going to speak to two midwives about the medical advances and the lack of them when it comes to helping women heal. And we'll ask, why are women from diverse backgrounds so much less likely to be able to swim than white women?

The first black female swimmer to represent Team GB at the Olympics, Alice Dearing, she's going to be with us. And she is one of our guests who is working to change the Olympics. Alice Dearing, she's going to be with us and she is one of our guests who is working to change the statistics. You can text the programme, as I mentioned, 84844 on any of those stories. But I do want to start with first that our thoughts are with the family of Nicola Bully. This is after three heartbreaking weeks and that it was confirmed, as I mentioned, that the body found in the river wire on Sunday was indeed their loved one. In a statement that was read by the police her family had this to say. Our family liaison officers have had to confirm our worst fears today. We will never be able to

comprehend what Nicky had gone through in her last moments and that will never leave us. Ni fyddwn ni ddim yn gallu deall beth roedd Nikki wedi mynd drwy ar y cyfnod diwethaf, ac mae hynny ddim yn gadael ni. Ni fyddwn ni ddim yn gofio Nikki. Sut allwn ni? Roedd hi'n ganolbwyntiau ein byd. Roedd hi'n yr un sy'n gwneud ein bywydau'n arbennig iawn. Ac mae'n ddim yn gwneud unrhyw beth yn ystod hynny. Bydd ein gyrsion yn cael y cefnogaeth y maen nhw'n ei angen gan y bobl sy'n eu hoffi'r mwyaf. Ac mae'n ddifrifol i ni feddwl y byddwn ni'n rhaid i ni ddangos i nhw bod y prws a chymdeithasau'r cyhoedd yn cyfrifo'r dad eu bod wedi'u gwneud o'i wneud o'i wneud, of wrongdoing, misquoted and vilified friends and family. This is absolutely appalling. They have to be held accountable. This cannot happen to another family.

They then went on to criticise Sky News and ITV News for not respecting their privacy. The statement brought up so many issues that victims' families have to deal with when they're going through what is most likely the most traumatic event of their lives and it raises questions about what may need to change well to speak about those issues

we have with us Zoe Billingham former head of the Inspectorate of Constabulary and Ella Malazzo will also join us from Victim Support an independent charity dedicated to supporting victims of crime and also traumatic incidents in England and also Wales. Zoe, good to have you back with us on Woman's Hour. What is the legislation that is in place at the moment to protect and support victims? Morning, Nuala. And as you said at the top, all of our thoughts are with the family of Nicola and the heartbreaking news over the last two days. And this is about, isn't it, looking forward, what lessons can be drawn.

And what's fairly clear from the media melee and the kind of free for all that we've seen in respect of this case, the invasions of privacy and the unconstrained comments and remarks across social media. Clearly, the law as it stands right now is not sufficient to protect victims' families moving forward. And that's perhaps one of the most disturbing issues that we need to learn lessons from here is we're talking about human beings. We're talking about feelings. We're not talking about protocols and relationships between police and the media. We're talking about the feelings of the family. And that has to come at the fore of any redefinition of the relationship between the police and the media. And I think we need to move on, don't we? We do need to learn these

lessons. We need to allow the police the freedom and flexibility, I think, to give off-the-record, behind-the-scenes briefings so they can understand the context and not report it. And I think we need to be very clear that the victim and the family must be the first and foremost consideration in cases like this. But shouldn't that have always been the case? It should, shouldn't it? But what we've seen, haven't we, Nuala, in this case, is this extraordinary vacuum that seems to have opened up into which has stepped every single armchair detective,

TikToker, enthusiast for promoting themselves into that domain in the most appalling, appalling circumstances. The idea that someone would think it was right to go on a day trip to the bench to take a selfie of themselves when Nicola was last seen is obscene. And so I think we just need to look at the reframing of the relationships. The police really need the media, don't they? They need the media because they need to engender the goodwill of the public to step forward, to check their dash cams, to look on their ring doorbell, to check whether they may have been in the area. So it's vital that we maintain that. But I do think the police have a responsibility without any doubt to consider their media strategy, be very clear about it from the outset,

and to set some clear boundaries. On occasions, I think the police need to say no. That's a question too far. That's an intrusion too far. And it will damage our ability to bring this investigation to the conclusion that we all want to see. Well, let me turn to Alan, because you are supporting victims of crime and traumatic incidences. What do you think went wrong here? Sorry Ellen I think we're having a problem just hearing you at the moment. Can you hear me now? Yes we can hear you go ahead. Yeah I you know, I really do echo what Zoe said, that, you know, police and media do need to have a useful and productive relationship.

But I think the families absolutely have to be at the heart of that. And protecting families in those situations is absolutely crucial. And I think, you know, if the families don't want press intrusion, that should be listened to. And journalists and others who are not regulated should take that on board and listen to the needs of the family. The real challenge is once information is out there in the public domain, you can't take it back. It's there and people can keep going back to it. And it really slows a family's ability to move on from an incident such as this family's because to move on from an incident such as this family's, because, you know,

this information keeps resurfacing. So if there's an inquest, it will resurface. And that's really incredibly challenging for families. And as has been said, you know, by the family, this information is going to be available for the children and other loved ones. And that is incredibly traumatic into the future as well. And I think that was a part that struck many people in the statement that was released by the Bully family. It says it saddens them to think that they will have to explain to the children that the press and members of the public accused their dad of wrongdoing, misquoted and vilified friends and family. We also have with us Baroness Helen Newlove, a former Victims Commissioner for England and Wales. Welcome. Good to have you with us this morning.

I'd be curious for your thoughts on what needs to change because we are living in a social media age. And as Zoe was bringing up, there's a vacuum that sometimes arises that then gets filled with speculation and out there theories. Yes, good morning. Yes, listening to I completely agree with the previous speakers in all of this. But my thoughts have been with the family from day one, the way it's been handled, way um stories are absolutely uh put out there and you know it brings me back to when i lost gary in 2007 where there's a lot of press intrusion a lot of police but the one thing i think um we need to look at is how the communication with the police their comms person has organized all this because I have a really good relationship with the comms person who ensured that the family were protected. When they were ready to speak, she would know. And I think it's about relationships.

But my heart goes out to the family because they've been put through every emotion going. And it's easy to judge from the outside because in the inside, everything's going to be a blur to them. And they've now got an added anger that shouldn't have been there because they are absolutely. When you come back to all of this, it's like being in a nightmare where everything's going around you and you have no control. And there's two young daughters here. We live in an age of social media that's 24-7. It happens when you're in the courtroom. It happened to us when the conviction, when we had the trial. Everything was out there before I could talk to my children. And so they're looking at different dynamics of this. So I think it's been handled not so great, shall I say. I think there should be better support and understanding.

And the main thing that I think also we presume that these families know exactly what system's in place and actually it isn't you don't know the system you know you think there's a system there to protect you but they're asked lots of questions they're not given time to digest it and come back so they're answering on the hoof and actually they're not at the right space to answer them questions. And then it's out there. So I think we need to look at better support packages that the police deliver. If you know, I had a family liaison officer because obviously Gary's was a murder trial. But I have to say, you know, she was excellent. And there's some excellent officers who we need to now look at the quality of how they deliver this system to the victims' families, because it's gone from a missing person. And then there was a gap of,

you know, everybody was that, you know, the sleuth of the year, Miss Marples and Puro and everybody. And then sadly, we've now learned that, you know, they found Nicola. And now there's another level of emotion going through that family. And I just, my heart just feels for that family because it's all going to be a blur. And now you've scarred them on top of everything else

that we've got to handle. A lot of people are commenting. There is one that says, there is as yet no indication that Nicola Bulley was a victim of any crime. Her family, meanwhile, were victims of a horrendous harassment campaign by the media.

They should be held to account. But coming back to you, Baroness Helen Newlove, could you tell our listeners a little of what happened? I know you mentioned, Gary, and that it was a murder trial, but for people that are not familiar with your story. Yes, 2007, my husband, Gary Newlove, was kicked to death by a gang of youths. And 48 hours later, I had to turn his life support

machine and my three daughters witnessed every kick and punch and had to do life support on his body on the ground so that was a very high profile murder and that's 2007 and I would have hoped that you know the support that we got and i still remember it now being a blur you know that and through the roles you know as victims commissioner and through anything within the criminal justice system and agencies i've spoke to victims do not absorb what you're asking them and i think i heard on the media where you know when they gave details personal details about nicola um and that you can say well we told the the family of this. They will not absorb it.

They think they're helping the police to understand why they're concerned for, you know, Nicola. And I just think miscommunication is the most painful for victims as it goes on because it's out there. You know, my daughters knew about everything before I could actually get to them in the court trial because there was a 10 week court trial. And even through education, you know, when them girls, you know, Google things, their mum's name's going to be up there with people commenting about Nicola and the family that they don't even know them personally. So we have got to handle this very, very sensitively for the children and for the family.

But do you think you're in the House of Lords? We're in a social media age. I think with this particular case, I haven't seen before that TikTok sleuths, for want of a better term, that people that were speculating, getting involved and really at times even going to the scene, which was pointed out earlier, which would have been unfathomable then for that to be reported on their various accounts. Is the law fit for purpose? It is, and I think this is where, you know, we're in the House of Lords at the moment, which is the online safety bills going through the House of Lords.

But I think it's another layer we need to look at. I'm quite surprised they were allowed to go anywhere near the scene. I'm surprised police let them go there. And that's the problem. I'm trying to really understand why you would allow that, knowing that you are going to get these type of people going to have a look. I thought it was very, very shameful to do that because we're talking about human lives here. I do see Zoe you want to come in on that. Yeah no Helen lovely to hear you again and good to see you and thank you for sharing that

story again about Gary it's so harrowing to hear but you're absolutely spot on there needs to be a redefinition of roles doesn't there the the family must be at the heart it's really interesting you describing the the time that you experienced as being a blur so there needs to be some parameters and boundaries set with the family at the heart it's really hard to take those decisions in the moment. I think the learning that we'll see come out, Nuala, from this terrible set of events is the police need to be very clear on what their role is. They probably need to be a lot firmer from the outset and from the get-go. I think they need to put their media strategy in the public domain. And can I just say one last thing, because there's broader issues relating to this case. My worst fear is that women will see all of the publicity around this case and wonder if their loved one goes missing, whether or not they should report it for fear that all of this type of information will be on the front page of the newspapers. this is a hugely unusual situation and police leaders really do need to step forward now and explain to the public how that's not going to be allowed to happen again.

Well, can I just say as well, I know I'm not time, but I've worked with Zoe and I really love her work and everything. I'm really, really brilliant inspector when she was that inspector. But I think also, and I hope Zoe understands when I say this, can we not hear lessons learned? I am tired of telling agencies to stop using empty words because actually they're trained. We shouldn't be even having this discussion. There should be a system in place that should have protected the family from the outset, but please don't come back, chief constables, commanders, and say we've learned lessons because they're too painful words.

Zoe? Yes, spot on, Helen. Always absolutely on the point. We don't want to hear about what they've learned. We want to hear, don't we, what they're going to do in the future to stop it from happening again. I wonder if this is a particular point in time, though, because there is the social media aspect, which obviously has exploded during this particular case. But we're also coming at a point post Sarah Everhard, for example, that there has been questions of trust in the police. Is that part of the problem? Let me turn back to you, Ellen Malazzo. I think there are some really complex issues in in all of this

and the you know there is obviously as a result of the Sarah Everard and incidents like this it is incredibly challenging for the public to have trust and faith in the police but I think also you know the journalism profession also has to take some responsibility here and journalists should be printing facts based on evidence and you know and they should be held responsible for the act you know for their actions and the information that they put into the press and put out there to the public and you know they too should listen to the needs of the families and if families are saying please do not publish this information then they should listen to that and

respect that you know families do have a right to respect to dignity to privacy these things are in the victims code of practice and they should be they should be upheld by all of those who are involved um in in the case of of each individual and as we keep saying this isn't you know the case of Nicola Bulley that isn't a crime so we need to be really clear about that but the media circus that has has um has circled all of this you know they should they should be people held to account for the information that they've put out there. So, and it's really, I suppose, so many actors within this particular story as well. And I know the Buddy family did point the fingers towards some. But let me go back to you, Helen, on that issue, particularly being in the House of Lords, on trust in the police.

Yes, I mean, it's very, very low on trust on the police. And that's why when I mentioned about the head of comms at Cheshire Police who was looking after our family, she was very spot on in how she handled it. And it's about ensuring that, again, you've got an adequate, qualified, confident officer who will say whatever information and sensitive information we're giving out, we want you to fully understand and direct it and say, if we can get that, then we can work with the press.

There's lots of things that has gone wrong. Yes, it isn't. You know, this isn't a crime. Sadly, it's ended up really horrific anyway. But I do think, you know, the trust in the police has been shot because to be perfectly honest the work that I've carried out these years police are marking their own homework you know it's the same lines it's the same word and actually you know we heard the press conference from the I don't know who the lady was I think she was seen investigating officer she spoke in a language that you know it's waffle to people And so we need to understand and get trust in our police by, you know, saying sorry, being accountable

for what you've delivered, and ensuring that whatever you put forward, you know, even with the TikTok, there's got to be accountability. And nobody's accountable these days. I did see that TikTok responded because it was very much that social media platform that was criticised when it came to how members of the public were acting.

They said their thoughts are with Miss Buddy's family and friends. They said they do not tolerate bullying or harassment on their platform, that they remove content that violates our policies. They also say they're deploying additional resources to reduce the potential spread of conspiratorial content about unfolding events by making it ineligible for recommendations for the For You feed, which is one feed within the platform. But do you think, Helen, that TikTok, for example, will be held accountable? You've talked about what you would like to happen with the police force, but let's talk about that aspect of social media. Well, that sounds like a copy and paste answer, doesn't it really? We can all copy and paste that.

There's no accountability. TikTok, you know, has these rules, but do they actually see this through? You know, and I think all media platforms have just got no moral compass in a sense. These keyboard warriors, whatever people do, how would they like that intrusion in their lives because it's fact you know people who live in glass houses shouldn't throw stones and I don't

think it's I think the moral compass and the way people unpick things it's not ever about you it's about the family in the background I had it personally with stories when I lost Gary in the press every week it could have been my father and I still remember them and it hurt my daughters as well so for me I think these social media platforms have to be accountable themselves not just pass the book and say we stopped bullying this wasn't bullying this was going intrusive into a you know a crime scene and I say crime scene I don't mean it was a crime I meant this was an investigating scene that any aspect needed still to be investigated. And that's where the police should have blocked this off, no matter what, whether they saw it as a missing person or whatever. This was a human being who deserved respect and never got that.

And the family have now got to pick up all that damage and protect them young lives because it's a life sentence for that family. No matter what, this is a heavy duty and responsibility to protect their children. Pairness Helen Nuala former Victims Commissioner for England and Wales thanks to you also to Zoe Billingham and Ellen Malazzo from Victims Support. I want to turn to childbirth next and tears in childbirth they very common, but not that commonly talked about, perhaps. Maybe you had one. I'd love to hear about your experience. 84844. This is what the Royal College of Obstetricians and Gynaecologists say. They say

up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze, or epistiotomy. And for most women, these tears are minor and that they heal quickly. But they are still one of the biggest worries for expectant mothers. They can lead to lifelong complications in some cases,

such as pain during sex or incontinence. With me now is Marie-Louise, known as the modern midwife and the Dutch midwife, Malene Heggenberger, who's invented a horseshoe-shaped retractor to help with suturing. And if that raises some questions, we'll be able to answer them with Malene. But before I get into what she has created, I want to start with Marie.

Some say there's a fine line between preparing and scaring expectant mums. But you are keen, Marie, to get more people talking and thinking about tears. Why? Yeah, exactly. I think there are many ways to have difficult conversations with women. And I think you've just read the statistics out there. It's a significant amount of women every single year that do sustain some sort of tear during birth. So it's really important that ahead of the birth, we actually provide them with as much education as possible to prevent tearing. And we also empower them with information about what might happen should they sustain a tear, because this is really important. After you've had a baby, you've got so much going on. You've

got this newborn baby on you. If you're planning on breastfeeding, you're looking to breastfeed this baby. You've got a whole host of hormones flowing through your body. It's, you know, one of the biggest transformations life has to offer becoming a mother. So if we're going to relay very important information to women at that time, it's very unlikely that they take it in fully, which is why I really campaign for antenatal education, specifically around tearing during birth, because there's a lot you can do to prevent it. A lot you can do. So Malene, let me turn to you. There's a lot you can do to prevent it,

but let's say it is happening, which it does for, I think I read 85% of women. There are different degrees of tears. What are we talking about? Well, there is. Oh, thank you for having me. I'm actually from Denmark. I'm not from Holland. There are four degrees of tears. There's the first degree tear, which is very minor, that needs a few sutures. And then there's a second degree tear that involves either one or two of the muscles that are surrounding the vulva. And then you have the third degree tear, which involves the sphincter, that means the muscles around the anus.

And then there's the fourth degree, which is very rare, which includes all three muscles, but also including the lining of the bowel. So those are the degrees of tears that we have. So obviously a different approach is needed with each of those tears. But if I turn as well to episiotomies, that I always have to think how to say that word, there's about one in seven deliveries in England involves one. What is that exactly for the uninitiated?

An episiotomy, that is a surgical incision where you make the outlet of the vulva, the vagina, a little bit bigger. And you can do that to prevent some severe tearing towards the rectum, the sphincter injury. You can do that either to protect the mother, but you can also do that in case you're afraid of the baby's well-being. So let me turn back to you, Marie-Louise. Very different situations that we're talking about. What does it require, depending on whether

it's a few stitches or something like an episdiotomy? Yeah, exactly. So as mentioned, there are different grades of tears. So a first degree tear won't always need suturing. Sometimes they come back together beautifully and they're not actually bleeding. So sometimes the mother's body will heal really well. And there's a really good blood supply as well to the vagina and to the perineum. If you have a second degree tear,

it's likely that you will require some sort of suturing alongside a third and fourth degree tear. And an episiotomy will always need suturing as well. So that is the practice where we hand stitch the perineum back together and we bring back those muscles back together. It can either be done in the birth room, depending on the severity of the tear, or sometimes mums are taken to theatre for this reason, and that procedure is performed by an obstetrician. But of course, there can be issues that arise in some of these cases. Malene, you've been thinking about this, you are a midwife turned businesswoman, and you have invented what we're calling a sort of horseshoe shaped retractor.

To me, it kind of looked like a giant plastic wishbone. Does that make sense? I'm trying to kind of get it in the heads of my listeners. Oh, I'm sorry you have this picture in my mind. It's shaped for the female birth canal yes and it's very it's it's flexible um because up until now we've been using our fingers as retractors and if you look at any other procedure any other surgical procedure in the hospital you will have some kind of retractor to have a clear visibility to be able to see what you're doing but when it comes to uh suturing women we've been using our fingers and they are unpredictable. They move around, which causes a lot of pain and discomfort. And then I was sitting one night alone

myself and I couldn't actually see the top of the tear. So I thought if only I could have something that would actually hold aside for me, that would cause much less pain. And I could actually see clearly where the tear was. And that's how I came about the idea for the Higginburger. So it's a flexible shaped, a little plastic device that you place in the vagina, and then it holds the side gently and it sits still. And that means I have both hands free. I can actually suture better and I can see what I'm doing. I have both hands free, just like in any other surgical procedure. And I have an international background. I worked in different countries. And when it comes to female health,

and when it comes to labor, that is the same thing we do on a global level, no matter where we are. So I wanted to improve this procedure. So I want the women to come into the hospital, have a good labor delivery, come out with a healthy baby, but also leave with a pelvic floor and genitals, if you so to speak, that are well diagnosed, well sutured, because they're going to live with them for a lifetime. And it is three organs that we're dealing with. It is the bladder, the vagina and the anus. So it's three daily, very important functions that we human beings are using, we women, we use on a daily basis. So it is something that I want to prioritize. And I want the standard of care to remain high throughout pregnancy, labor, and also... Afterwards. Which I think is sometimes forgotten.

I do have a listener getting in touch. I had a severe tear 32 years ago at my first child. It wasn't spotted at first, leading to large blood loss. It impacted on me all my life with pelvic issues and scar tissue. My daughter is a midwife and has now explained it all to me and I realise how traumatic it actually

was. And I want to tell our listeners that you, Malene, are the second midwife, get this, in 200 years to create an obstetric device. The first was French midwife, Marie Boivin.

She invented the vaginal speculum, which many of us are familiar with, in the 1800s. And she has been called one of the most important women in medicine in the 19th century. I mean, can you believe those statistics and the place that you are now standing in history? No, I'm very honoured and scared at the same time,

because I would like to be a role model for other midwives, other nurses, other women, that if they have a brilliant idea, they should go ahead and take it on. You know, if I can do it, anyone can do it. But of course, I'm very honoured. And I hope that my story and the Higginburger is going to have a global impact, because I really want that part of labour delivery. This is my passion. I want that part of labour delivery to have the exact same prestige as the other things we do, because this is what we go home with. This is what we want to live with. And modern women, this is one of their fears. First, they want a really healthy baby. They want education.

But this is a fear that we as clinicians, we as hospitals need to go into and we need to improve the way we approach this procedure. Which is so interesting and more people getting in touch. This is Jennifer. I'm a midwife and so feel I should know better but I didn't. I had a tear in childbirth. I was told it was normal and it was able to heal well but

it didn't and on top of that I continued with pain and nerve pain and subsequently had a prolapse. We must stop normalising the issue and better educate women and health care providers. Let me turn back to you, Marie-Louise, because I was reading some of the work that both of you have been doing. And in the places that you work, if you go down the corridor or to another floor, there are robotic devices. I don't know, for a dodgy knee or for, I don't know, somebody's hip. But for some reason, this thing that so many people use to procreate isn't getting the same level of attention. It's somebody's knee, for example.

Marie-Louise? Yes, that's exactly it. And that's exactly what Malene and I talk about. The fact is women's healthcare, and in particular, maternity care has been left in the dark ages. Why are we left behind? You know, why has it taken Malene to bring this device to market, this revolutionising the suturing process? And it is just outstanding, as you say, in, you know, it's been nearly 200 years. That is a significant amount of time that everybody has just decided really willfully to say this procedure is good enough. Let's just use our hands. And, you know, all other procedures will get more attention, more funding.

And actually, it's time that we stop and we look particularly at new mothers. They are such a valuable and important part of our society and particularly vulnerable during this time. So educating women and also educating midwives and the general public. And because I'm wondering, Marie-Louise, say I were going in to have a baby, of course the thing you're thinking about

is the healthy baby and getting through it. What should they be saying in advance or their advocate? Because I'm sure after you've delivered that baby, the last thing you're thinking about is what sort of stitching or suturing will be taking place. That's it, exactly. And that's why I campaign for better education and to tackle this taboo.

So ahead of time, we're having these conversations with women. We're educating them about what type of tear may occur and what may happen during that. Because I think long gone are the times really where we're hush hush, oh, let's not talk about that in case we scare women. Actually, no, you know, women deserve to have access to this information. Women deserve to know and understand how their bodies work to ideally prevent tearing. But if it occurs as it does to hundreds of thousands of women every single year, they need to understand this procedure. And they also need to know how to support their body to heal,

how to support their stitches, how to go to the toilet afterwards. This is such a problem for mums. The amount of phone calls I've had from women saying, I'm absolutely terrified to go to the toilet. I've had stitches and I don't know what to do, you know, and now I'm terribly constipated. So I think, you know, these are basic bodily functions and women are suffering in huge, tremendous numbers. So, yeah, it's time that we really tackled the taboo and we bring these topics out of the dark ages and we really empower mothers with information and education so that they don't feel embarrassed about their bodies.

They understand what happened to them. You know, that case of that Jenny, I think her name was, who just wrote in saying that she had a tell, you know, 33 years later, it's only when her daughter's become a midwife, she's got answers. This should not be the norm and it is the norm.

And that's what we're trying to do. Change that today and really modernise female health care and in particular, maternal health care. It's so important. Good to get the conversation started. Marie-Louise, known as the modern midwife and our Danish midwife, Malene Hegenberger, who invented, as we mentioned, the device and putting her name, I think, in the history books. Thanks for joining us on Woman's Hour. Thank you.

Thank you. Thank you. Now, I'm sure many of you will be eager to hear who has made our Women in Sport power list, where we will be revealing it all at the end of March. But in the meantime, we are bringing you all these various stories featuring women in sport that we think you will want to hear about. Today, we're looking at diversity in swimming or the lack of it, perhaps is a better way of describing it. And also what two women are doing to help make the sport more inclusive.

So some statistics from a recent Sport England Active Live survey. They suggest in England only 2% of regular swimmers are from black communities. Another report found that women are more likely to be unable to swim 25 metres than men across all ethnicities. In a moment I'll be joined by journalist Saren Jones, who's produced an audio documentary called Black Girls

Don't Swim, investigating why so few black women appear to be involved in elite swimming and inspired to do something about it. Saren co-founded the Black Swimming Association to try and diversify the sport. But we're also going to speak to another co-founder, Alice Dearing, who last year became the first black female swimmer

to represent Team GB at an Olympics. Good morning, Alice. Hey, thanks for having me. You're so welcome. And congratulations the olympic games thank you yeah no it was um it was something that i never expected to happen so um just to be able to turn up and compete for britain was absolutely amazing yeah never expected it why i just honestly didn't think i had it in me to be quite honest when. When I was younger, I watched the 2008 Olympics. Becky Arlington winning those two golds in the four and eight throw.

And in my mind, I was like, oh, my gosh, this should be absolutely amazing if I could ever go to the Olympic Games. But you hear the stories about how hard it is, the difficulty, the sacrifices you have to make. And honestly, I just didn't think I was capable of it so I'm quite happy to have proved myself wrong. And what do you think was the catalyst? Oh wow um I'm just really stubborn if I'm being completely honest like I just um I just I just kept rolling with it and every opportunity that came my way, I just took it with open arms. And quite often there were opportunities which terrified me

and I didn't really want to do, but it put me out of my comfort zone. It made me a better athlete and to have achieved what I've achieved so far. I'm just really grateful. I'm just trying to get to the Paris games and just right my wrongs from Tokyo because I was really disappointed with my performance wasn't as good as I expected it to be so um I just want to get back to Paris and prove to myself that I've got it in me to do what I believe I can do good bit of stubborn will it will get you there um but but what about the diversity in the sport as you were growing up? So I'm from Birmingham originally, and I was quite fortunate, I suppose.

I'm going to use that word, coming from a very diverse area, loads of different cultures, mix of everybody, absolutely loved it. And every club that I went to, there was always another family of colour. However, when I went to open meets, this got dulled down quite quickly. And quite often there were times when it was just me, my mum and my brother who were the only non-white people at that competition. And I always say, like, I suppose with a bit of humour, it was really easy to pick my mum out in the audience. She's a black woman. She, like she like I suppose stood out in one sense and um it it was it was fine honestly it was fine I didn't notice that I was black and everybody else was white because I couldn't see myself like everybody else is in hats goggles swimming costumes and we're just racing we're just competing with children we're doing

that and I didn't notice it myself so I was quite happily sheltered and naive from the issues which black and Asian people face when getting in the water it wasn't until I was about 15 years old where I started kind of just doing a little bit of research into it and realizing that not a lot of black people swim that there are these stereotypes that we have dense bones, that we're just not better at swimming, that we stick to athletics and basketball and football. And I started to question it, obviously, as you naturally do, because I was excelling quite well at this stage. And there have been so many amazing black swimmers before that. So, yeah, we're just trying to challenge these ideas, basically. Well, let's bring in a fellow co-founder of the Black Swimming Association,

journalist and producer, Saren Jones. Saren, good to have you with us. Why did you decide to start up the BSA, the Black Swimming Association? Because it's not all about swimming, as I understand it. Exactly. The setting up of the BSA kind of came from a number of different things for me personally. Like Alice, I swam in the UK in age group swimming, but I was based in Cardiff. So it was, I had an experience of kind of much whiter environments. And actually when I

would advance up to the higher levels, that's when I saw more diversity because there were more swimmers who were black and brown coming from cities like Birmingham and London, et cetera. And for me, I wanted to set up the BSA because not only did I want a space that didn't exist when I was an age group swimmer that celebrated blackness and brown people in swimming and aquatics, but I also wanted to raise awareness of the importance of water safety amongst these communities.

A pattern I picked up on over recent years is we always have our two weeks of heat wave here in the UK, but we see people, you know, flock to different bodies of water, whether it's, you know, rivers or canals or the coastline. And something I noticed is that people who unfortunately were making it home happened to look like me and I started questioning kind of why is this why is it that it seems as though people who look like me don't realize or don't know about how to be safe in water and that's kind of the essence of our charity it's about water safety education and drowning prevention amongst these communities. I understand so even before getting to swimming I was seeing some of the swimming figures instead, Sarah. And according to Swim England, 95 percent of black adults and 80 percent of black children in England do not swim.

Ninety three percent of Asian adults and 78 percent of Asian children in England do not swim. Do you think and I'll throw this first to you, Alice, that can be turned around? Yes. Yeah. I mean, it has to be quite bluntly um the the work that we're doing at the BSA there's no way we're going to let these figures keep being what they are um we're working with aquatic government bodies which I'm sort of staring what we'll touch on in a second but we just want people to be safe we want everybody to understand that you don't have to go to the Olympics you don't have to be an amazing swimmer just swimming 25 meters or just having basic water safety is enough and is acceptable and that's what the minimum should be you don't have to love

swimming i completely get it's not for everybody but um we want everybody to be able to swim it is a basic life skill let's go back to that Sarah. What do you think standing in the way? What's the barriers? I mean, Nuala, every single time I hear these stats, and they've been out since 2020 now, so it's been a solid three years, it's still so difficult to just answer it in kind of one sentence,

because we know that there are factors that are to do with accessibility issues. There are factors to do with finance issues. There are factors to do with finance issues. There are factors to do with cultural issues as well. And, you know, geographical issues as to kind of where pools are located. And then in more recent years, post-pandemic, we have, you know, the closure of pools. We have a cost of living crisis, which isn't helping the situation and is currently exacerbating what's going on at the moment. And it's kind of all of these issues kind of married together,

as well as the stereotypes that these communities face, as well as the aquaphobia that exists in generations of Black communities in particular, that, you know, that's why we see such a disengagement between communities who are Black and brown in the UK and swimming. It's simply not a priority. And that's what we're trying to do. We're trying to make people in our communities understand that swimming can change your life for the better. It has mental benefits, it has physical benefits.

If you're a young person, you want to work for employment, it also has financial benefits. And, you know, it's something that can really enhance and enrich your life if you were to be aware and open to what it has to offer. I was seeing that you are pushing and many others about if there is a teacher or somebody to help somebody in the water, that they're in the water with them instead of on the side is the way I remember it when I was a kid. What about that, Alice? Yeah, it is that simple, honestly, especially for adults, think you know I've seen women who have had serious trauma with water women who were too scared to put their face in the shower let alone getting to a swimming pool and now we're talking about having a teacher stood on the side nice and dry and telling this person okay get in the water it's fine don't worry about it and it's it's understanding and having that empathy that um not everybody's had the amazing experiences

like i've had being able to access water and fall in love with it some people have had the complete opposite and if we can find ways to make sure they can access the water so it is something as simple as that getting in the water them, taking them through it slowly and just respecting that this might be quite a big deal for them and probably is, especially for adults. You know, you painted an image of when you were a kid, not really noticing, you said, the lack of diversity, everybody in their goggles and their swim caps. But the swimming cap actually has been part of this discussion as well. The Swimming World Governing Body, FINA, they initially banned the use of what they called oversized swimming caps so you could basically accommodate more hair at the Tokyo Olympics. They've gone back on that ban.

They've finally approved it for competitive use in September 2022. How significant is that? Oh, it's huge. It's one of those things, it shouldn't have been a problem in the first place being completely honest but the the fact that Fina recognized that they made a mistake that they've gone back on this and are looking to adapt and understand and learn is really important and it's honestly just about not policing black woman's hair not about policing anybody's hair just giving us the option to wear what we want to wear so if I want to turn up to world championships with I don't know 20 inch box braids I can I

probably wouldn't because it's not gonna be great for performance I was wondering would it slow you down exactly yeah there's a lot of weight in that but if I wanted to I could and it is that simple because and it's just showing people that our sport is for everybody it truly is for everybody and I don't want people to be pushed out of it because of something like a swimming cap stopping them from going swimming. Alice Dearing who last year became the first black female swimmer to represent Team GB at an Olympics and also Saren Jones who has co-founded the Black Swimming Association to try and help diversify the sport

and also get people over their fear of water. Now, London Fashion Week have you been following it? It is drawing to a close today. The Times fashion director 51 year old

Anna Murphy has reflected on feeling like the only woman of her age in the front row who has not had work done on her face. What she calls the normalisation of tweakments

is just one of the topics explored in her new book, Destination Fabulous. Let me get that right. Destination Fabulous, described as a toolkit for embracing your age and the beauty that comes with it. And in service of that, you may have seen some striking before and after photos

in The Times at the weekend. It shows what she might look like if indeed she decided to have her face cosmetically enhanced. And Anna and her lovely face is right opposite me in the studio

of the Women's Hour studio. Welcome. Hello. Yes, I'm here with my line and proud of them. Well, they're looking good this morning. Now, you say you are one of the only people on the front row that hasn't had anything done to their face. Do you think this is just the fashion world you're talking about?

And what is it that you're seeing in front of you or beside you as you sit at the fashion shows? I mean, the first thing I want to say is I have absolutely no judgment of any woman for what she does or doesn't do to her face. It's absolutely an individual's choice. But my concern with what I see in fashion, but I also see in other worlds, I spend a lot of time in yoga world and the same thing is happening there, is that increasingly for many women, they're not feeling it's a choice to do really quite invasive procedures with their face.

And I really don't think the industry is honest about what the journey is. The very word tweakments, you know, it all sounds very, very nice, doesn't it? You know, it sounds all sort of sweet and cuddly with a bow on it. Actually, these are really invasive procedures that involve injecting often toxins into your face. And they require hundreds of pounds of spend every few months for the rest of your life. And what I see a lot as well is I think often when people start, they're told, oh, you just have a little bit here, have a little bit there. But the problem is, if you keep on going, the bridge between what your face would naturally be at whatever age you are versus the sort of artificial creation just becomes too wide a gap to bridge. And you see an increasingly kind of other aesthetic.

And what I really feel strongly and what I write about in Destination Fabulous is we're losing sight of what ageing means. I want to see myself in the mirror at 70. I want to be the best possible 70 year old I can be, but I don't want to look like some aesthetic practitioner's version of me. Well, in the Times piece, you wrote increasing numbers want to look fake, that they actually want to appear almost bot-like. And I think we know the face you're talking about that's kind of puffed up on the cheeks and pulled back so it almost is shiny and of indeterminate age.

I would say perhaps not even younger looking at times. But is that a fashion? I mean, is that in just like big eyebrows were in? I think there's two things going on. I think for most women, they don't want that. They want to look natural. They want to look younger, quotes, unquotes. But yes, I would say quite an alarming development that I've seen is this desire to look slightly other, to look bot-like, as you say. What worries me is the people who don't want to look bot-like end up going that way. And I always quote something that the wonderful Iris Atfel once told me,

who's 101 and still looking fabulous, lines and all, which is she said that, you know, some of my friends have ended up looking like a Picasso. I don't want to end up looking like Picasso, thanks very much. And I think that is the risk. And I think this huge industry that is worth £3 billion a year in this country alone is not honest about it. Can people, like I've heard of Courtney Cox and that she dissolved her fillers. I mean, if you had the tweakments done, can you just revert back to baseline? It depends how far down the line you are.

It depends what you have or haven't had done. I think it's an incredibly brave thing to do to turn the clock back. I know certain women who work with clients who want to do that, who are sort of natural facialists. And it's really frightening. If you've been freezing your face or filling your face for 20 or 30 years, it's very, very frightening because you quite literally don't know what your face or filling your face for 20 or 30 years, it's very, very frightening because you quite literally don't know what your face is. There also are specific physical problems that if

you freeze a muscle, then over time, of course, that muscle atrophies. So you've lost the use of that muscle. Ditto, if you fill, you know, the clue is in the name, filler actually creates space in the dermis. So if you take the filler out, what often happens is people have indentations in strange places. So you can go back, but it can be quite a frightening path. And I think many women do reach the point of no return. And that just makes me very sad. No judgment, but judgment of our society for making women feel thating and lines are somehow something to be ashamed of. I sometimes wonder, is it akin, give me your thoughts, on the way we've gone with teeth in the sense of nowadays you wouldn't see that many people with very crooked or extra teeth, which would have been completely normal in the 70s and 80s. Yeah, completely. A brace would have been a very extravagant purchase for kids, you know, where now it's kind of the norm. And we don't really think twice if somebody has straight, whitish teeth,

whereas that would have been something extraordinary once upon a time. Yeah, I mean, I think there very much is this idea of perfectibility generally. You know, everything can be done everything can be changed and there are huge industries working off the back of that and and dentistry is another case in point but what I would say is that I don't think you lose sight of yourself unless you've had a particularly bad tooth job come on call it a tooth job I don't know we can we'll call it that

you heard it here first a tooth job uh you know that know. We can. We'll call it that. You heard it here first, a tooth job. You know, that's not changing sort of what your very identity is. And I think what troubles me with these faces is that that is what happens. And in fact, interestingly, with that piece that you mentioned in the Times magazine, so there was me on the left looking like me and me on the right, you know, the tweakment version. And I could see me in the tweakment version. But I looked like thousands of other people I've seen. You become this, even if you're not going for that bot-like aesthetic, you become this kind of manufactured aesthetic. You lose your individuality, essentially. What was your feeling when you looked at that? Because everybody in my

house that passed it had an opinion. What was yours? I was completely fascinated and completely horrified. Horrified. And actually felt vindicated in my own path because, of course, we're all under pressure, myself included. You know, I look in the mirror, I see lines that I didn't used to have. But actually, it is the right path for me and I think another point I would make and that I write about in Destination Fabulous is we anatomize our own faces very differently to how we perceive

another woman's or indeed man's face when I see friends of mine I don't look for their lines I look to see is their light switched on you know are they happy are they enthused are they living their best life and I really do think just from a sheer vanity perspective, we're looking the wrong direction in this regard. It's not about lines or lift. It's about that light. Is it switched on? Are you living the very best life you can, whether you're 20 or 80? 20 or 80. But some might say that maybe the picture on the front of The Times was more extreme, that you could have tweakments that wouldn't be as visible. As somebody once said to me, the good work you actually don't know it's been done. It was an extreme version, I would agree.

I think the issue, as I say, is where you start off in the journey tends not to be where you end up and actually what we're seeing now with with women in their 60s and 70s who had the the wealth and or the fame to be kind of outliers and take it taking on board these kind of treatments much earlier than the mainstream is again no judgment but they are they are looking odd you can be having the best quotes unquote work in the world and at some, if you're 60 or 70 or 80 or beyond, that gap, as I said, just can't be bridged. Is the odd subjective? Well, I don Madonna came under a lot of scrutiny, she called a misogyny and ageist, with her changing her looks that she sees as a way of empowering or disrupting.

I mean, I think that that was about ages and misogyny, but not actually in the way she means, you know, she's been forced to do things to her face that are symptomatic of the ages and misogyny that she and other women face. I think the response to that is not to annihilate how you look. It's to be true to who you are. Anna Murphy, we won't look at our faces in the mirror the same way. Comment coming in from Anonymous. Amen to everything that Anna is saying.

Thanks very much for listening to Woman's Hour. I'll be back with you again, same time, same place, tomorrow. That's all for today's Woman's Hour. Join us again next time. Introducing Gaslight. I think there's something peculiar about this house. A new drama from BBC Radio 4. The gaslight's over there above the fireplace. Yes. I wonder if mummy might be trying to get in touch. Is the light playing tricks on you? Or is it just your mind? What if we both sold this place and you got a job in one of those little colleges that would be pleased to have you?

You don't really believe that, do you? I'm trying to be kind. Like you were with the dog. How much do we really know about the person we love? Is there something I should know about, Jack? No. I didn't put a foot wrong. And how much can we rely...

Quite a bit younger than you appear to be on screen. ...on the kindness of strangers? And you look like you've been crying. Gaslight. You can't talk to me like that. I don't even know who you are. Available on BBC Sounds. I'm Sarah Trelevan 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.