Woman's Hour - Saskia Reeves in 'Us', a new BBC1 drama

Episode Date: September 16, 2020

Julia Gillard, once Prime Minister of Australia, and Dr Ngozi Okonjo-Iweala, economist and international development expert from Nigeria and also a woman with experience at the top of the Nigerian pol...itics, have come together to explore women and leadership. They’ve written a book together and interviewed high profile global leaders who are women: women like Jacinda Ardern, Hillary Rodham Clinton, Christine Lagarde and Theresa May. Saskia Reeves is best known for the films Close My Eyes and I.D. and her numerous roles in dramas like Spooks, Luther, Wallander, Page Eight and Wolf Hall. On Sunday you can watch her in the first of a four part comedy drama for BBC 1 called 'Us'. Based on the novel by David Nicholls, she is Connie who wants to end her 24 year relationship with her husband Douglas – played by Tom Hollander. But he’s meticulously planned and booked a European tour with their teenage son Albie – and so they decide to go ahead with it. Jenni talks to Saskia about how relationships change as children leave and you grow older, and the joys of filming in cities like Paris, Amsterdam and Barcelona. Multiple sclerosis is an autoimmune disease that currently affects over 130,000 people in the UK. It’s three times more common in women than in men, with many of those women being diagnosed in their 20s and 30s. It’s been known for some time that pregnancy can lessen the symptoms and reduce the chance of relapse for those who already have MS. But now a new study from Monash University in Australia shows that pregnancy can help women before symptoms begin – by delaying the onset of MS by more than three years. Lead researcher Dr Vilija Jokubaitis joins Jenni to talk about the findings and what it might mean for women at higher risk of developing the condition. Presenter: Jenni Murray Producer: Kirsty StarkeyInterviewed Guest: Julia Gillard Interviewed Guest: Dr Ngozi Okonjo-Iweala Interviewed Guest: Saskia Reeves Interviewed Guest: Dr Vilija Jokubaitis

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Starting point is 00:00:00 This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.
Starting point is 00:00:42 BBC Sounds. Music, radio, podcasts. Hello, Jenny Murray welcoming you to the Woman's Hour podcast. Good morning. In today's programme, Saskia Reeves, who stars in a new Sunday night serial on BBC One, It's Us by David Nicholls, where she and Tom Holland are a player couple trying to work out their marriage
Starting point is 00:01:03 as their son prepares to leave home. Multiple sclerosis is more common among women than men, but new research has found that pregnancy can delay the onset of symptoms by more than three years. Why? And the serial, the third episode of Lifelines. Across the world, less than 10% of national leaders are women. A new book, Women and Leadership in Conversation with Some of the World's Most Powerful Women, sets out to ask what obstacles continue to hold women back from becoming leaders
Starting point is 00:01:39 and offers advice on how to overcome them. The writers who collaborated to create this book are Dr Ngozi Okonjo-Iweala, who served as Nigeria's first female finance and then foreign minister, and Julia Gillard, the first woman to become Prime Minister of Australia. She's still renowned for what's known as the misogyny speech she directed in Parliament in 2012 at the then leader of the opposition, Tony Abbott. And then, of course, I was offended too by the sexism, by the misogyny of the leader of the opposition catcalling across this table at me as I sit here as Prime Minister.
Starting point is 00:02:23 If the Prime Minister wants to, politically speaking, make an honest woman of herself, something that would never have been said to any man sitting in this chair. I was offended when the Leader of the Opposition went outside in the front of Parliament and stood next to a sign that said, Ditch the Witch. I was offended when the Leader of the Opposition stood next to a sign that said ditch the witch. I was offended when the leader of the opposition stood next to a sign that described me as a man's bitch. I was offended by those things. Misogyny, sexism, every day from this leader of the opposition, every day in every way across the time the leader of the opposition has sat in that chair and I've sat in this
Starting point is 00:03:04 chair. that is all we have heard from him. Well I spoke to Ngozi and Julia earlier. In her introduction to the book Julia describes herself as a feminist. Why? I describe myself as a feminist meaning that I'm someone who's believed throughout my adult life in, even for portions of my life as a child, that men and women are inherently equal and should be able to do all things in equal numbers. That's what I mean by feminism, though I know that word has come to have a lot of baggage associated with it.
Starting point is 00:03:41 Ngozi, you call yourself in the book a womanist. Why? Well, you know, womanist, first of all, is a word invented by the writer Alice Walker. And interestingly enough, used by my own aunt, who is a writer herself and a critic, Professor Gunyemi. And I use it because I think it really describes what I feel about women, the enduring respect and admiration, as I said in the book, my belief in gender equality and what women can do and the ability to manage so much. So, you know, the notion that boys and girls should have an equal opportunity in life and that girls can manage so much as they turn into women makes me a woman it's that respect for what we can do now Julia what made the two of you decide to collaborate on this book we increasingly got
Starting point is 00:04:44 to know each other in my years post-politics. We did meet when I was Prime Minister when Ngozi came to Australia as part of the Nigerian delegation to the Commonwealth Heads of Government meeting. But we actually got to know each other serving on an international commission looking at how we get education to every child around the world, including in the poorest communities. And we would be at all of these international events and struck up a conversation about women and what was happening to women leaders
Starting point is 00:05:14 that in many ways we're still having. But when we started having that conversation, we increasingly said, look, we need to get something out into the world about this. So many women leaders are being treated so differently to men. We need to examine this. We need to explain it. And more than anything else, we need to put some ideas out there about how to fix it.
Starting point is 00:05:36 And Gozi, how did you choose the women you were going to concentrate on? Because not all of them have served as prime minister or president. Yes, thank you. You know, initially, when we started talking, as Julia said, we thought the two of us have had very rich experiences that we could draw on. But as we talked, we then said, perhaps we need to look at other women. And we thought women in politics, because they have to face an audience, they have to go through so much to get elected. And so we started looking
Starting point is 00:06:14 at women in political life, mostly serving on former presidents and prime ministers. But there were some women with that same stature, like Hillary. So it's not that she's been a president, but she's the first woman in the United States to be nominated by her party to run for the post of president. And she's acquired that stature. And her experience is so important also to integrate into what we want to wanted to tell people and then we have Christine Lagarde who's been a politician in France meant former
Starting point is 00:06:56 Minister of Finance but headed the IMF which in terms of stature is also regarded as a presidential level position. So with this mix, we thought we had a good set from which we could draw experiences. Juliet, you've come up with a number of hypotheses in the book about what hinders and on the other hand, what encourages women to become leaders. Now, I remember Hillary Clinton telling me when I interviewed her, oh, it's all about the hair. And she thought of giving her book the title, It's All About the Scrunchie. How much does judgment of appearance hinder women, no matter how big and powerful they are? Unfortunately, from our women leaders, it seems far too much because whilst we were
Starting point is 00:07:46 speaking to women from right around the world, for example, to Ellen Johnson Sirleaf, who was the first woman to lead a nation in Africa, she led Liberia, to Joyce Bander, who led Malawi, to my region of the world with Jacinda Ardern in New Zealand, we were talking to women in different cultures and contexts. But each of them was aware that they would be judged on appearance. And in many ways, they tried to minimise that discussion by getting a style of look, the way that they would look every day. And the choices they made were quite different. For example, Ellen and Joyce wear African style dress, but they decided that if they effectively looked not too different day after day, ultimately people would get bored talking about their appearance. And so it's a bit like men get the advantage of having a uniform, a suit. We expect to see a politician in a suit and tie. They were trying to close down discussion of their appearance.
Starting point is 00:08:53 The one who was a little bit different was Theresa May, who's always enjoyed fashion. She's someone who cares about clothes and she was known to have that interest in clothing and so she continued to wear fashionable items which she liked but I guess people came to expect that of her too. And Gozi, you quote research which shows that men tend to fit better with people's idea of what a leader is supposed to look like. How have the women you've spoken to overcome that problem, looking as if they have a right to be there? Well, when you look at the experiences of these women, there's no one way that we can describe. They've used various approaches. For instance, when you look at
Starting point is 00:09:47 Christine Lagarde, she got into a job as head of the IMF where she's a trained lawyer. She had been a finance minister, so that gave her an advantage, but she was not an economist. And to lead, she tells us she had to work twice as hard. She really studied her briefs. She really prepared so that by the time she came on, she had all the confidence that she could handle any situation and any questions. So that's one approach. Overdo the homework in order to make sure that as a leader, you not only know as much, but probably are ahead on the information.
Starting point is 00:10:26 I think other leaders, I think believing in yourself and self-confidence. So even if you walk into a room or you're giving a speech and people are not looking at you the way they'd look at a man sooner or later if what you're saying makes uh sense and and um is on point so to speak that begins to show people to get away from the gender aspect of it and indeed look at what you're saying and the leadership in it so i i think women have used their personality and their style, their belief in themselves to be able to be that leader women than it is for men. How have the women leaders you've spoken to dealt with that balance? Jacinda Ardern is probably the leader with the biggest story to tell that we interviewed, given she's the second woman in the world to have a baby while in office as a national leader.
Starting point is 00:11:43 The first, of course, was Benazir Bhutto in Pakistan. And Jacinda was very clear in her discussions with us that there's no right way, there's no wrong way, there's not even a question of balance. She ends up saying that she doesn't think she balances things, she just gets through, She makes it work. And her partner, Clark, has become the primary caregiver for their daughter, Niamh, so she has that kind of support.
Starting point is 00:12:14 Other women talked about some of the sacrifices that they needed to make, some of the concerns that they had about what it would do ultimately in terms of their relationship with their children, but came through their leadership saying, look, they managed it and got through. We also examined my experience, Theresa May's experience. Neither of us have children. And of course, people do look at women who haven't had children and try and make some assessment about what that says about their character.
Starting point is 00:12:48 So we walked away from all of this thinking that there's still so much that we need to do, whether it's in politics or business or beyond, to try and make the current structures more flexible, more inclusive and better for work and family life. And ultimately, that's not just an agenda for women. It's for everyone, because, you know, many men today, many fathers would also thrive if there was a way of putting work and family life together better than some of the current stresses and strains that people bear. And Gozi, how important have you found the idea of the role model is? Well, with ourselves and looking at the women, certainly we searched for whether there was a
Starting point is 00:13:41 mentor, a role model, someone they looked up to, to help them shape their lives. And indeed, in several cases, yes, people they looked up to, I think of Ellen Johnson Sirleaf, who looked up to her mother after her father died, and her mother had to bring up the family single-handedly. And she saw a strong woman trying to make a go for her children, and that shaped the way she wanted to be a strong woman, a Christian woman, a leader. And so, yes, throughout our leaders have looked up to sometimes their fathers, their mothers or others outside. But there was no systematic role model or mentor for everyone. Julia, you conclude with a number of lessons for aspiring leaders.
Starting point is 00:14:44 What would be your favourite one? Well, I think our overall message is if you've got a passion for leadership, whether it's in politics or some other walk of life, go for it. We end up using the terminology, it's not about beware. We're not trying to tell you, you know, don't do this, but we are trying to say be aware, be ready that there will be times when there are moments when you are treated differently because you're a woman.
Starting point is 00:15:19 Think about that in advance so that you're not blindsided in those moments, so that you've got a game plan. I think that in some ways is the biggest message we can give women because we've had a number of female leaders now. In some ways, women coming up through leadership now have seen this movie before. They've seen women go through it. So let's learn the lessons so that the next generation of women can be there already empowered to knock over any of this stereotyping,
Starting point is 00:15:54 any of this gendered treatment that gets in their way. So Julia, I'm sorry to bring this up, but you knew I would have to at some point. Had you prepared in advance to make something like your misogyny speech or did it just come off the bat in fury? Oh, it just came. I didn't even know I would be giving a speech. So I had no notice to prepare a speech at all. I walked into the parliament that day for what I thought was going to be parliamentary question time. And I knew because of the circumstances of the day that there would be issues about gender and sexism raised. So I'd taken in some quotes from the leader of the opposition, things that he'd said, which I thought was sexist. I had them with me to use in question
Starting point is 00:16:42 time. But we didn't have question time. Instead, the leader of the opposition jumped to his feet and moved a motion. And what's come to be known as the misogyny speech is my immediate case in reply. So there was certainly no opportunity to write it. And Gozi, of these lessons for aspiring leaders, what would be your favourite? I think my favourite really has to do with men. You know, so for aspiring leaders, we also say that don't only look to the women. If you're looking for mentorship or guidance, men can also play a role. And we have a message for men. You are part of the solution.
Starting point is 00:17:29 You cannot be a bystander. If you see the kind of behavior going on that is clearly against women, whether in public life or in the workplace you need to call it out and on your own part try to also reach out mentor women make space so that they can climb up so that they can lead so that's my favorite that we can't do it without men julian what do you reckon the world would look like if we had around 50-50 male, female leaders? I know people tend to answer these questions suggesting that the world would be more collaborative, more nurturing, more empathetic. And I'm always a little bit hesitant about saying that because it seems to me it's kind of baking the sexism in that we stereotype women one way and say therefore a world with more women leaders would necessarily be like
Starting point is 00:18:34 that. What I think I can certainly say is a world where women came through for leadership in equal numbers as men would be a world with a better calibre of leadership. Because if you believe, as I do, that merit is equally distributed between the sexes, if we are not seeing women coming through for leadership in reasonable numbers, that means that there are women of merit who aren't making it. And why wouldn't we want the most meritorious people to be leading us as a global community? And Dunguzi, finally, how hopeful are you that we may get there sooner rather than later? I'm an optimist. The numbers, when you look at them, don't tell a very good story. If you look at the number of women who are presidents and prime ministers in the world today, even in the workplace, CEOs, and within parliaments even, in many countries, this is not the case. So the numbers say that if we continue at this pace, it will take us years and years and years to get there.
Starting point is 00:19:50 But I remain hopeful that the changes are coming on. I remain hopeful because the younger generation is more impatient. And I think that with the way things are going now, we may be able to make faster progress. Men are also changing. We are bringing up our boys differently. Certainly, my three boys were brought up in a household and a world where they were told that nobody, they have to be an equal partner to any woman they marry in the future. So if we can change these attitudes of boys and young women coming up, I'm hopeful that we'll make faster progress. I was talking to Dr Ngozi Okonjo-Iweala and Julie Gillard.
Starting point is 00:20:34 Still to come in today's programme, multiple sclerosis. Why is it more common among women? And new research shows that pregnancy can delay the onset of symptoms. Why? And the serial, the third episode of Lifelines. Now, next week, we'll be launching the Women's Hour Power List 2020. The first Power List was in 2013. And since then, we've been celebrating inspiring women who not only wield power and influence, but have made a difference.
Starting point is 00:21:02 On Tuesday's programme next week, Jane will reveal the theme of this year's list and introduce two of our judges, as well as asking for your suggestions of women you think deserve to be considered. You can look back to see who made it onto previous power lists by looking at the Woman's Hour website. And earlier this week, you may have missed Bridget McCrum discussing her career as a sculptor
Starting point is 00:21:26 which continues at the age of 86 and Mandy Cassidy who began working in the London Ambulance Service after her son became the victim of knife crime. If you missed the live programme all you have to do is go to BBC Sounds and you can catch up. Now Saskia Reeves' face may well be very familiar to you. She's appeared in a huge range of films, plays in the theatre and numerous TV dramas including
Starting point is 00:21:54 Luther, Wallander and Wolf Hall. On Sunday evening you can see her in the new serial at nine o'clock on BBC One. It's called Us. It's based on the novel by David Nicholls and we see Saskia as Connie struggling with what her future might be after her son Albie leaves home to go to university. She's been with her husband, Douglas,
Starting point is 00:22:18 played by Tom Hollander, for 24 years. I think our marriage might be over. When you say leaving... Starting again. 24 years. Separation? Except not a trial. I mean, breaking up. Don't say breaking up. 16-year-olds break up. What you're saying is you'd rather be alone. We're going to be alone, Connie.
Starting point is 00:22:54 Yes, I know. Well, tell me, tell me clearly. I just feel that things between us might have run their course. I don't agree. Oh, well, if you don't agree, we don't talk. We talk? About the boiler, about holidays and insurance. We don't have conversations. So what do you want to tell me?
Starting point is 00:23:16 It's not you. Oh, don't say it's not you, it's me. It's not me either, it's us. No, it's not us, because I don't want to leave. I just feel... Don't say I just feel, I just feel. Say what you want. I want change.
Starting point is 00:23:31 Saskia, that's how the new series opens. What do you suppose motivates Connie suddenly to announce she thinks her marriage is over? Um, well, I don't think it's suddenly actually i think in my
Starting point is 00:23:47 imagination the younger connie who we see they they flash back to them as a younger couple and how they meet and that younger chaotic artist is still very much inside her and i think after all these years of marriage and teenage son about to fly the nest she's looking at the rest of her life and and has been I think for a while thinking what am I going to do here in this house with Douglas is this is this it and I think um she's scared. Now, Douglas is shocked and surprised and hurt. Why do you reckon he hasn't seen it coming? Oh, I don't know. She's...
Starting point is 00:24:33 Yeah, good question. I think she probably hasn't communicated enough. I think she has a very private life. And this is based on David Nicholl's book. And the book is very much from Douglas's point of view. And I had the chance, doing the screenplay, which he also wrote, to flesh her out, to give her a complete three-dimensional experience. And I think she has quite a private life.
Starting point is 00:25:02 And he's very particular, obsessed, difficult to talk to maybe about personal things, he's insecure about... They go on this artistic tour of Europe, they go to lots of galleries and he's very insecure about what to do when he looks at a painting and I think they just struggle to have those intimate
Starting point is 00:25:28 conversations and it's easy to avoid them isn't it when you can talk about domestic stuff at one point she says she has a dread of the box set yeah what does she mean there oh the routine of you know working, coming home sitting on the sofa watching something going to bed, starting again that sort of I think she
Starting point is 00:25:53 as a personality just is frightened of getting stale, she says that later on in the programme, I don't want us to get stale, she says as a younger woman, I don't want us to get stale, she says as a younger woman. I don't want us to get stuck. And, yeah, I think she's struggling with what to do. She also says she has a nap in the afternoon and that terrifies her.
Starting point is 00:26:19 As you said, they go on a European holiday with their son Albie, which Douglas has planned and she agrees that she will go. He is completely incapable of spontaneity, isn't he? Yes. Why is that? Well, he was a scientist, well he still works in a science world but he was a practitioner so everything was very meticulous I imagine and well organised and I think the idea of just seeing what the wind blows in is a bit scary for him.
Starting point is 00:27:03 I think one of my favourite lines in the whole piece is when Albie says, Dad, are we going to do anything spontaneous on this holiday? And Douglas says, I hadn't planned to. I think that's such a brilliant, neat way of explaining the differences. I think Douglas likes things to be organized you know I like to know what's happening yeah I've only seen that the first part of this there are three more to come
Starting point is 00:27:34 and I can't wait to see what happens I mean I laughed all the way through and also thought oh my goodness this must be very familiar to a lot of people. Yeah. What was it like to travel to Paris, Amsterdam, all the great European cities before lockdown? Oh, it was, well, obviously we didn't know lockdown was coming, but it was a dream job for me, Jenny. It was such a lovely part. And to go to some of my favourite cities
Starting point is 00:28:04 and have the privilege of walking around art galleries when the public weren't there. So, I mean, it was a fantastic job. I think you got access to the Louvre when there was nobody else there, didn't you? And the Rijksmuseum and Miro's gallery up in Barcelona. And it was absolutely fantastic. Well-organised, tight production.
Starting point is 00:28:26 There wasn't a lot of room for maneuver but everyone was very on it and we managed to film on trains we managed to film in streets in art galleries it was it was great fun now I got to ride on the bike in Amsterdam. Had you never done that before? Because I know it's your mother who's Dutch, isn't it? So Amsterdam must be a very familiar city to you. Yes, yes. My mum and I got married there, actually. No, I can't remember the last time I cycled in Amsterdam. I must have done when I was younger but Amsterdam was always this amazing naughty place because we weren't allowed to tell my my grandmother we've been there or we were going to go back that way as we visited them in the north because she
Starting point is 00:29:15 was a very religious woman and full-time why would anyone want to go to Amsterdam it was a den of iniquity you know um so I love Amsterdam and yes it was joyous joyous experience filming there now I know at the moment you're looking after your father Peter Reeves who's an accomplished actor how much did he influence your choice of career? I don't know. I think he didn't necessarily push me into it because he knew how difficult it was for women. I remember he said to me once, OK, if you want to do drama, he said, just think of this. He said there was twice as many actresses as actors
Starting point is 00:30:04 and half as much work for actresses as actors, so you do the maths. So I always knew how tough it was and I never had any expectations. But I saw drama school as a fantastic way to spend three years rather than go to university. ffordd wych i ddiweddru 3 flwyddyn yn hytrach na mynd i'r brifysgol. Ac nid wyf yn gwybod, roedd yn bob amser yn hynod o ddiddorol ac roedd yn hoffi dod i weld fy ngwaith. Ac rwy'n credu pan roeddwn i'n llawer yn ifanc, roedd fy mab yn hynod o gyngorol. Roedd hi'n dod i'r grwpiau drama i mi a fy mab. Roedd hi'n yr un sydd wedi helpu i fynd i'r brifysgol ac, chi'n gwbod, yr holl hynny. the drama groups for me and my sister she was the one who who helped me get to them and you know all that dad was you know dad was always very not negative but he was like look it's not easy cautious i suppose yeah i know you've worked with some of the most amazing directors stephen
Starting point is 00:31:00 burckhoff mike lee nicholas heitner How true is it that you do absolutely meticulous research for every part you play? People like to ask me this. Yeah, I do, because I find it really interesting. And every script, every piece of work demands a different approach. So I won't do, it's not like one approach fits all. And as I've got older and more experienced, I try to simplify things.
Starting point is 00:31:35 But I love delving into my characters' lives and, you know, I can't think at the top of my head but like yeah just working in a shop I remember for Ireland at war I went to my local deli and said can I hang out with you for a morning and just anything to grab a piece of something like one of my favorite actresses and books on acting is utah hargan and she says she writes you know do 10 hours of thinking or research or however you want to do it for one moment's inspiration it's worth it and i love i love that idea that you have a wealth of feeling and experience for your character whether it's you've done a lot of thinking or you've i don't know exercised if
Starting point is 00:32:35 you're going to be running or do you know what i mean so you you you are full of ideas before you start thank you very much indeed for being with us this morning and just to repeat that us will be on BBC One on Sunday night at nine o'clock. Thank you very much. Now, multiple sclerosis is an autoimmune disease which at the moment affects more than 130,000 people in the United Kingdom. It's three times more common in women than in men, and a significant proportion of them are diagnosed in their 20s and 30s.
Starting point is 00:33:11 It's been known for some time that pregnancy can lessen the symptoms and reduce the chances of relapse for those who already have the condition. A new study from Monash University in Australia shows that pregnancy can help women before their symptoms begin by delaying the onset of MS by more than three years. I'm joined by the lead researcher Dr. Vivier Jacobaitis. Vivier, why are women so much more likely to develop MS? Hi Jenny, that's a really interesting question and unfortunately we don't have a terribly good answer for it. We know that from an immunological perspective women tend to have a
Starting point is 00:33:52 slightly more active immune system than men do, which is why we're able to fight off colds and so forth perhaps a little more easily, but at the same time it means that women are also more prone to developing autoimmune diseases and so multiple sclerosis is just one such autoimmune disease where there is actually a disproportionate number of women that are affected by it than men. What do we already know about this question of pregnancy and MS? Sure. So historically, women with multiple sclerosis were actually discouraged from having children because it was thought or feared that it might actually make their disease worse. But there was this seminal study that was published about 20 years ago now with the lead authors in France. And they demonstrated that women who already had multiple sclerosis and were pregnant actually had a reduction in their
Starting point is 00:34:45 symptoms whilst they were pregnant. And so that really changed the way that clinical practice advised women with multiple sclerosis. And from then on, women were no longer discouraged from having children. And the question, of course, is why does that happen? What does the pregnancy do that holds the MS at bay? So that's the $64,000 question, really. So what we know is that obviously a fetus is only, you know, for want of a simplistic argument, 50% derived from the mother. And so it's 50% foreign. And so we know that the body has to change the way that the immune system recognizes this semi-foreign object in order not to attack it. So we know that autoimmune diseases mean that the immune system is more
Starting point is 00:35:39 active, and so the immune system has to become more tolerant whilst women are pregnant. And so there are a number of different fluctuations in terms of hormone levels that occur whilst women are pregnant. There are lots of different types of immune cells that are normally involved in our immune responses. And so we know that the different types of immune cells have their behaviours modulated really by that pregnancy. And so by being able to dampen down immune responses to tolerate the fetus, we think that really that's what's happening in terms of also alleviating symptoms when it comes to multiple sclerosis. What did you want to find out in this new research? Sure. So it was a bit of a sideways question that we had, really, because we had observed in that seminal French paper and a number of other studies that had come out subsequently that pregnancy did seem to act as if it was a treatment for women with multiple sclerosis. But then these studies are also, I guess, a little bit confounded because perhaps women who have a chronic condition choose to change their reproductive
Starting point is 00:36:47 behaviours. I mean, obviously not all women want to have children, but perhaps those with milder disease were the ones that were choosing to have children and therefore we were seeing this immune response and we were seeing dampening down of the immune system. So we really asked the question, can pregnancy act as almost a therapy for MS before women even know that they're destined to develop the disease? I guess the complexity with multiple sclerosis is that it can take a while to be diagnosed. And we now know that there are a number of underlying symptoms that can occur for a while before the diagnosis is made. And so we wanted to sort of get rid of that bias and have a look before women know that they have the disease and therefore are less likely to change their reproductive behaviours, what effect pregnancy had.
Starting point is 00:37:38 So how did you choose the women you were going to study if they didn't already have the MS? Sure. So I'm very lucky in that my group collaborates with a very large international register called the MS Base Registry. So it's the world's largest clinical outcomes register that follows people with multiple sclerosis, 72,000 people with multiple sclerosis from all over the world. And so we've been tracking all of their clinical outcomes for a number of different years, obviously with their permission. And so what we actually did is we identified a group of researchers that had a particular interest in pregnancy. And together, our teams interviewed over 3,600 women who ended up developing MS, but we asked them about their reproductive histories, dating all the way back to before they developed the condition. And it was an incredibly generous thing for these women to do because many of them told us very
Starting point is 00:38:41 private stories because we didn't only ask about childbirths, but we also asked about pregnancies that ended in the first trimester. And so then what we did was we took all of this information that they gave us and we identified two groups. We identified those women that had children before the onset of their first symptoms of MS and those that did not have children before their first symptom onset. And when we compared what age they ended up developing MS, that's when we discovered that
Starting point is 00:39:10 there was this 3.3 year lag in developing the disease in those women that had had children. So what do you think is actually happening to keep symptoms at bay for actually such a long time? It is a really long time. So my hypothesis here is that we think that obviously it's something that lasts beyond the pregnant period. And so that means that it must have something to do with perhaps modifications to our genetic code. So we know that DNA is immutable, it doesn't change, and we all have the same genetic code in every single cell of our body. And yet we also know that every single cell in our body is not identical. So we know that, for example, a hair cell is different to a liver cell, which is different to a brain cell, or an immune cell. And the reason why the cells are able to be different, even though the genetic code is the
Starting point is 00:40:09 same, is because of this modification that gets made to our DNA. And the modification is called epigenetics. The way that I think about epigenetics is much like punctuation in a sentence. So if you can imagine a page that's full of words with no punctuation, no paragraphs, no sentences, it's really hard to interpret how to read that page of words. But once we start including punctuation into it, we start to see sentence structure, paragraph structure, and so forth. And so the really cool thing about our DNA is that we have these epigenetic modifications that work much like punctuation and tells ourselves how to interpret that genetic information, which is what therefore allows different cell types to evolve.
Starting point is 00:40:51 But we suspect that's also what's happening with pregnancy. We think that pregnancy is adding or subtracting different types of genetic punctuation to the genetic code and therefore changing the way that say immune cells respond. So whether or not they perhaps therefore have a slightly less inflammatory profile or something to that extent. So what we think is happening is or we know that these epigenetic modifications can last for quite a while. And so that's basically what we think is happening.
Starting point is 00:41:24 We think that there are these punctuations happening and therefore allowing that long delay in disease onset. So what do your findings mean for women now? Could it lead to new treatments for MS? Absolutely. So I think there are two things that it means. The first is I think it's a good news story for women that are contemplating having children. As I said, clearly having children is not for everybody. But I think that, you know, family planning decisions are really complicated and even more so when overlaid with a chronic health condition. So I think the first thing is that it's reassuring that if women do want to have children, they shouldn't be discouraged. But secondly, I think that it's reassuring that if women do want to have children, they shouldn't be discouraged.
Starting point is 00:42:08 But secondly, I think that it opens up a whole new avenue of research for us to look at to try to really work out the mechanism of how pregnancy is having this effect and therefore to see if we can identify more targeted therapeutic approaches. I was talking to Dr. Vilja Jakobaitis. We had lots of responses from you this morning, particularly to our discussion about women in leadership. Someone whose name I don't have said on Twitter, excellent guest this morning. Patriarchy allows women, even women in powerful positions, to constantly be undermined, not for their morals, their points, their positions on policy, but their appearance.
Starting point is 00:42:51 On Saskia Reeves, Rebecca sent an email and said, Please pass on my thanks to and admiration for Saskia Reeves as a performer. I first saw her on stage as Regan in King Lear at the Royal Court Theatre in 1993, in a production that remains one of the most electrifying experiences of my theatre-going life. I was studying the play as part of my A-levels and was completely captivated by the performance of Saskia. I loved it and will never forget how wonderful it was. I can't wait to see her in Us when it airs. And Philippa said on Twitter, Jenny asks about the breakup in Us. Why didn't you see it coming?
Starting point is 00:43:34 But so often men don't. I hear it all the time, actually from the men and women. And I encountered it myself. And then on MS, Ellen sent an email. I've had multiple sclerosis since the age of 16 when I had my first flare-up. It wasn't diagnosed until 2011 when I was aged 60. I'd been ill over the years.
Starting point is 00:44:00 I had a most terrible time when I was pregnant with my second baby in 1975, and I suffered a lot of very debilitating fatigue. I was told by the registrar on the maternity ward I'd been admitted to that I was bone idle and hospital wasn't a place to just come and sleep. Thank God times have changed. Well, thank you for all your responses to today's programme. Tomorrow I'll be joined by the children's author Jacqueline Wilson, which will delight any child who's listening.
Starting point is 00:44:32 She'll be talking about her new book, Love, Frankie, about a teenager falling in love for the first time. And then we'll talk about alcohol and how it's marketed when it comes to women. The glittery gins, the bottomless brunches, the whiner clock. Do you find it patronising or fun and does it work? Join me tomorrow, usual time, two minutes past 10. Until then, bye-bye. Have you ever wondered what teachers talk about when no one else is listening? Well, you're about to find out. I'm Maureen Bake and my brand new podcast,
Starting point is 00:45:13 The Secret Life of Teachers, goes behind the headlines to see what's really going on as teachers go back to school after the lockdown. I was a teacher for almost a decade, but I never witnessed a time like this. So I've created my own virtual secret staff room where each week some teacher friends and I will discuss everything from remote learning and mental health to offset inspections and teachers behaving badly. If you'd also like to overhear their uncensored staff room confessions then subscribe to my podcast The Secret Life of Teachers on BBC Sounds. 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?
Starting point is 00:46:10 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.

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