Woman's Hour - Surviving in Scrubs, Male Contraception, Little Women Opera, Caps for England Women's Team

Episode Date: July 19, 2022

It’s being called medicine’s Me Too moment. Two female doctors have launched an online campaign gathering testimony about sexual harassment and a culture of sexism in the world of health care. Dr Becky Cox and Dr Chelcie Jewitt join Krupa to explain why they launched Surviving in Scrubs. Last week we looked at radical solutions to the ageing population and slowing birth rate, including a tax on the childfree. One country which has taken a unique approach is Hungary which introduced tax breaks and loans to encourage women to have more children in 2019. The BBC’s Nick Thorpe’s joins Krupa to discuss how successful the policy has been. Back in 1972, the very first England Women's Football Team beat Scotland in their first international victory, but unlike the men’s team, the Lionesses were not awarded official caps. Pressure has been mounting for the Football Association to recognise the 1972 team with caps. The reserve goalkeeper, Sue Wyhatt, joins us as the FA announce they will award the caps. The male contraceptive pill has been talked about for decades but so far has never got past the research stages. There is a current clinical trial though that is already yielding good results – however it’s not a pill, it’s a gel. It’s also had positive feedback from the couples who tried it. Krupa is joined by Dr Diana Blithe, who leads the Contraceptive Development Program at the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the US.The UK premiere of Little Women opens at Opera Holland Park later this week. The award winning director Ella Marchment, joins Krupa Padhy, along with Charlotte Padham, who makes her professional debut as Jo.Presenter: Krupa Padhy Producer: Emma Pearce

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, this is Krupal Bharti and you're listening to the Woman's Hour podcast. Hello, welcome to the programme. Summer is here and weddings are back. A timely announcement then that wedding laws are having their biggest shake-up since the 19th century. A government commission report is recommending a major overhaul which would shift the owners from getting married at registered locations to ceremonies taking place at, I quote,

any safe and dignified site. And this could mean beaches, forests, gardens. They could all be on the cards. We want to hear from you on this. What's the most unusual wedding location you've been to? Looking back, where would you like to have been married? And if you're planning a wedding, what's the ideal location? You can text Women's Hour on 84844.

Over on social media, you'll find us on the handle at BBC Women's Hour. Or you can, of course, email us through our website. We're also going to talk about Surviving in Scrubs. It's the name of a new campaign trying to bring to light the extent of sexual harassment and sexism in healthcare. The doctors behind the campaign will join us. The latest developments on male contraception. The gel has reached clinical trials.

An expert in the field will tell us more. And for over 150 years, Little Women has captured the imagination of the audience through the tales of the March sisters from childhood to womanhood. The opera version is in London now. The director Ella Marchmont joins us, as does Charlotte Badham, who plays Jo. We do have a treat in store for you as Charlotte will be singing live for us. But first, let's start with some good news on the programme. The Women's Euro tournament is currently underway in cities across England,

with all eyes on the Lionesses, who are amongst the favourites to win the Golden Trophy. At the start of the month, the reserve goalkeeper of the very first England women's football team, Sue Wyatt, got in touch with us. And Sue pointed out that after the Lionesses beat Scotland in 1972

in their first international victory, her team were not recognised for their accomplishments with official caps. Now, a cap is granted to players for each game they play for their country.

And this was Sue's plea. I want those girls who went on to coach and play for England for a long time, they should be getting a cap each, even if it's just for that very first match, an official FA cap. Well, Barbara Keeley, Labour's Shadow Minister for the Arts and Civil Society, heard Sue on Women's Hour and raised the subject in Parliament later that week. And in a win for Women's Hour and the women's team, on Friday last week, the Football Association made an announcement

that it will be awarding the caps. I'm delighted to say Sue Wyatt joins us again. Great news, Sue. Last week you said, for goodness sake, just give us the caps. I'm delighted to say Sue Wyatt joins us again. Great news, Sue. Last week you said, for goodness sake, just give us the caps. And now you have them. I can't believe it. I'm so grateful to all Women's Hour, Emma Barnett. It's been wonderful. Barbara Keeley, Anselm Cunningham from the iNewspaper, who also, his mum picked up the thing on Women's Hour as well so he ran it as well so he's been interviewing some of the other

females and we're all so delighted and the fact that we're all going to get the caps for all of our games I would have been happy as long as that first team got the caps but now we're all going to get one which means I'll get one as well.

So it's just wonderful. But Sue, it's taken 50 years. Did you ever imagine that this day would come? I didn't, to be quite honest. And I have to say that it's thanks to today's Lionesses, who've been playing so brilliantly. They've given us a platform to ask for us to be recognised as well. So I think it's women acting together has brought this about in the end.

And I'm so, so pleased. I think it's shown how powerful women can get these things done. As long as we're not divided and we support each other. Yes, absolutely. Have you been on the phone to and we support each other yes absolutely have you been on the phone to one another messaging each other what's been the conversation we have yes yes it was because we kept getting trickles of information through um so there was emails flying backwards and forwards uh oh it's going in commons and whatever then we heard oh they're going to recognize the first team um the 1972 team and we were absolutely delighted about that um and then to hear when that came through there was just a

flurry of emails facebooks and and as i said we've all well a lot of us have got facebook pages as well and that's been going wild with everybody congratulating us, male, female, everybody has been sending their best wishes and saying about time too. Absolutely. An FA spokesperson said, it's always been our intention to invite all former internationals to attend an England women's fixture in the autumn where they will be honoured.

We are also committed to awarding them with bespoke caps. Sue, have you heard from the FA as yet? No, we've heard nothing at all from the FA. And I think we have to realise that those from my era are all pensioners now. Some of them gave up careers to play football and will not be on a great pension. If they do, like they did last time

when they invited them to Wembley, leave it till the last minute, I don't think that many of them will be able to afford to even come down. So, I mean, that's another point. And I don't think the FA did intend to award us the caps. And I do think it's thanks to Woman's Hour that we are being awarded them. I don't think that that was on the cards at all. There's never been any contact with us about this. Well, if you do get that invite, please do let us know and we would love to follow up with you. Back to the actual cap, what's it going to look like?

Is it a normal one? Is there something special on it? I'm assuming it's going to be, as for the caps that the Lionesses get today, I'm assuming that that is what is going to happen. I'm not even sure whether they have the dates on them or the year that they were won, but it doesn't matter. It's happened now.

We've been officially recognised. The only thing I am a little worried about is one of our teammates, and I hope you'll forgive me, but Jeannie Allitt who scored that winning goal against Scotland we have been unable to trace her

and if there's anybody out there who could possibly get hold of her we know she went playing football in the Netherlands so if anybody knows where she is or could get her to contact us because it's important she was a great player and she should have that cap too.

So, yes, a shout out for Jeannie Allard, please. Well, the power of radio. I really do hope that we can connect with Jeannie. And if we do, we'll be right back on the phone to you, Sue, to let you know. I've been having a look on Twitter for some reaction on this. And interestingly, I spotted a tweet from Zambia, from one person who writes,

our Zambian women are playing very beautiful football, but no cap. They deserve $10,000 per game. So do you think this development could have a global impact at all? I'm hoping so. I'm hoping so. I think, as I said before, I think if all women stand together in this, if all female footballers stand together and it's like the get a cap wherever they're from. And really, they at least need expenses to keep going. Because as I said, a lot of those in my era gave up their careers to play football without any pay, without any expenses.

They carried on playing and coaching and helping young players. And that's why the game is where it is now. Just for the love of the game. Just before I let you go, Sue, the Lionesses, still lots of hopes for them to get to the end of this tournament. What are your thoughts?

Oh, I just can't believe how wonderful. And then again, to beat Northern Ireland 5-0, Beth Mead again and Alicia Rosso. It's wonderful to see the football they're playing is superb. And if they could win the Euros, that would cap my year off completely. Getting a cap and England winning the Euros.

How wonderful would that be? Well, all the very best to you and the team. Do keep in touch. Do send us a picture when you've got the hat as well. We'd love to share it with our listeners as well. And I'm sure they'd love to take a look at that as well. Thank you so much, Sue White, for coming back on Women's Hour and for persisting with that battle to get the cap. Right. It's being called medicine's Me Too moment.

Two female doctors have launched an online campaign gathering testimony about sexual harassment and a culture of sexism in the world of healthcare. The campaign called Surviving in Scrubs was launched last month and has gathered more than 100 anonymous stories so far. I can speak now to Dr Becky Cox, a GP specialist in community gynaecology based in Bristol, and to Dr Chelsea Jewett, a specialist trainee in emergency medicine at Merseyside Hospitals. Welcome to both of you. Thank you. Thanks for having us. Dr Becky Cox, let me start with you first. Why did you set up Surviving in Scrubs? So it started off as a collaborative project between the two of us.

We've known each other for a couple of years now. Unfortunately, both of us have lived experience of the kind of behaviours we're reporting on the website. So for myself personally, I've been unfortunately subject to various different sexist remarks, sexual harassment in the workplace and unfortunately sexual assault. And we got together through Chelsea's work on the BMA Sexism in Medicine project. We linked up and started thinking about what we could do in this area, because it felt like it wasn't something that was really talked about. And so we decided to go independent and set up our own website where we can share these

stories anonymously to raise awareness about this problem. So this really has come about through lived experiences. Dr. Chelsea Jewett, tell us about the testimonies that you've been hearing. We're completely overwhelmed by the number that we've had in. There's been a great, great response. And there's obviously a thirst for people to want to talk about their experiences, because as Becky said, this is something that isn't really mentioned and we're not surprised by what we're seeing in these stories we're horrified by what we're reading but we're not surprised because as again as Becky said this is we've lived this experience we we know about these stories we talk to our friends this is a very real state of affairs of what's going on right now in healthcare.

Are there the numbers to back this up through research? So going back to the report that I did with the British Medical Association last year that was published in August, that was pretty groundbreaking in that it was probably one of the first reports of its kind. And through that, we found that 91% of female respondents had experienced sexism within the two years prior to that survey coming out. And that's very up-to-date data. So we know that this is a huge, huge problem. And those numbers speak for themselves. Becky, talk us through the process in terms of reporting incidences like this.

So in terms of what happens in hospitals, or if you're in a general practice at the moment, there isn't a set reporting system. So if you experienced a sexist incident or harassment at work, as a medic, your main route would be to speak to your clinical or educational supervisor. It's usually somebody you work with as a consultant on your team. Unfortunately, quite often the harassment you may be facing is within very close within your work environment. So it might be the consultant's friend or their colleague, the person they go and play golf with. And so you end up caught in this situation where you're trying to report to someone who probably knows the perpetrator very well. And unfortunately,

what we're seeing through many of the stories is that people, when they report these things, they might get humiliated by the person they're reporting to. They might not get believed. It might not get investigated. It sort of feels like there's a crisis in the system where it's not working. People aren't getting the justice that they need for this. You mentioned in your first answer that you have, unfortunately, also experienced this firsthand. And if you are comfortable sharing, did you go about reporting this formally?

Did you feel comfortable enough to do so? No. So one of the instances I remember very clearly, and unfortunately I came back and sat at home thinking, oh my goodness, what do I do about this? At the time I was wanting to go into surgical training and I thought, well, the person who did this was a surgical consultant. If I want to further my career, I might not get anywhere if I raise this.

And will anyone even believe me? A question that so many women who have experiences would be asking themselves as well. Chelsea, what about your personal experience of this? I have attempted to raise things in the past, but haven't really gotten anywhere with it because of healthcare being such as it's such a small world everyone knows everyone and you are worried about your career you know we both love being doctors we want to be successful um and it's only through

doing surviving in scrubs that we feel as though we're able to try and make a difference and try and change this culture and that's very much where we're focusing our energy now is on this campaign because we want other people who don't feel empowered to speak up to have a voice and we want to push forward with this so that eventually there is a safe, a psychologically safe environment where people can report these instances and where perpetrators are held to account. I'm interested to hear about how your male colleagues have responded to this campaign. Honestly, quite positively.

In terms of my day-to-day working um the team that I work in that they're very positive about it they ask lots of questions and they want to know what they can do to to help really um so what are your answers when they say what can we do to to actually help practically speaking I'd say talking about these things within male circles, being an ally and trying to support women who are going through these experiences, asking questions about what experiences people have experienced. They need to realise how much of a problem this is.

This isn't just a woman's problem. It isn't just a doctor's problem. This is the whole of healthcare. We're aware that we're two female doctors here speaking, but we want to encourage anyone in health care to speak up about this culture. and it's calling for women, notably female patients, to be taken more seriously when it comes to matters of healthcare, that their data talks about female patients feeling like they're up against this wall of misogyny. Becky, does this surprise you at all when you're hearing female patients talk like this?

No, unfortunately it doesn't. So in my day job in gynaecology, we see lots of women coming through with various different issues related to their menstrual cycles their periods pelvic pain in particular is one where women just do not feel they get taken seriously they repeatedly present to their GP or to healthcare professionals and don't feel like they get the referrals that they need or the care that they want. And you also talked when you were mentioning your personal experience about surgery specifically being a field that you wanted to venture into.

A headline in the Daily Mail this morning reads, Britain's most sexist surgeons. I mean, is this happening across medicine? Are there some fields of medicine, in your opinion, that are worse than others? So looking at the reports that we're getting in from our stories a lot of the medical ones do focus on surgery um so we've seen from um groups such as women in surgery that they feel that their area of specific specialty in medicine is an area where this is of high frequency so i think we don't have exact data on this but we do think that surgery is one particularly problematic area.

Why might that be, though? Well, I think traditionally surgery has always been a male-dominated profession. So if you look at it originally, it was always men that were doing this job. More women are coming into the field now that they face the problem of sexism and sexual harassment, but also the fact that there's a glass ceiling in surgery. Yeah. Chelsea, let me bring you back in here. Going forward, if there's, you know, a young woman thinking about going into medicine, thinking about going into healthcare, and listening to this thinking, well, maybe I don't feel as secure as I might have felt

going into this sector, what would you say to them? I would tell them that being a doctor is the best job in the world. It's very hard and there are a lot of challenges, not only in the job but around the culture around it. I don't think sexism in health and sexism in the workplace is just a healthcare problem. I think this is a large societal problem. I think the fact that we're now having these conversations,

highlighting these problems and trying to make changes proves that things are going to get better. I'm extremely hopeful that things are going to get better. And through talking to universities and med schools, I can see that there is a culture coming from the bottom up that is changing. And the people at the top are trying to change things as well so I'm very positive for the future and I'd encourage I'd encourage them to to pursue that

career. I'm sure this is taking up a lot of your personal energy both of your personal energy there how do you how do you manage that alongside a very full-on job, Becky? So I try to compartmentalise as much as I can, but for me, my outlet is wild swimming. So that's the thing that kind of helps me to relax and switch off. I can't check my phone. So it's about finding ways that suit you to get through it. Well, thank you to you both for raising this issue, Dr Becky Cox and Dr Chelsea Jewett there, who are behind a new campaign called Surviving in Scrubs.

We've had this message in from Shazia, who says, is it too much to expect men to behave like professionals in every industry? Thank you so much for sending in your messages. I'm going to get to a few more as well. But on the subject of messages, we do want to continue to hear from you as we prepare for our annual listener week starting on the 22nd of August we'll be dedicating a whole week to your ideas so if you've got an issue that you want to discuss or you want to tell us about something that you're doing or if there's someone you think we should be talking to please do let let us know. You can contact us via our website. That's bbc.co.uk forward slash women's hour. And at the start of the programme,

I did mention that wedding laws are going to have an overhaul and that means that you will likely be able to have your wedding at any, I quote, safe and dignified sites. This could mean beaches, forests, gardens. They could all be on the cards. And we've had a number of messages reacting to that.

This one from Elaine on email says, we had to postpone our wedding due to COVID, then change the venue to more COVID safe outdoor venues, a marquee. But we didn't have anywhere flat nearby to put the marquee. Well, there's more. And then she says, so we turned to our local community-owned estate on the Isle of Lewis who kindly allowed us to set up on a level ground that they had next to their wind turbine, which had lovely views across a lock out to the sea, across to our village, and which

was also the site of an ancient battle. It was a huge collaborative effort to pull it together and it turned out to be a wonderful day. So a team effort there to get Elaine's wedding off the ground, quite literally. And this one from Mary on email says, a lovely man and I travelled to New York and got married in Central Park at the age of 61. The most magical day of my life ever though, and I had been married before and at the time was a mother and a nana. Kate on email writes my partner and I are getting married

this October overlooking Clifton Suspension Bridge in Bristol on the terrace of a historic windmill called Clifton Observatory. She goes on to say the venue is a registered venue for marriages but it's only since the pandemic that people have been able to get married on the terrace

rather than inside the building. We're very grateful that the special measures have continued so we can look at the beautiful bridge while saying our vows. Well, good luck to Katie. I'll try and read a few more

of those messages as we go through the programme. On last week's programme, we looked at a radical idea from the demographer Paul Moreland. Writing in the Sunday Times, he proposed a tax on the child free as a way to deal with an ageing population and a slowing birth rate. As part of that item, we spoke to Professor Sarah Harper from Oxford University, who was against a tax on the child free, but did say that we need to

think creatively about this issue now. The only way it really works is by being supportive to parents so that women make the decision if they want to have children, they will have one or two children. And we will, I hope, across the 21st century move to a world where every child that is born has the opportunity to be well educated in good health and live a long life. But that does mean that we have to look far more creatively at how we're going to cope with our ageing population. And coming to terms with the fact that in most European countries, we are going to have by the second half of this century, over half our population is going to be over 50. And so we should be really looking at a life course set of policies

and not suggesting that women should be solving the problem by having more children. One country which has taken a different radical approach to the population challenge is Hungary. In 2019, Hungary's population was falling by 32,000 a year and Hungarian women were having fewer children than the EU average. The Prime Minister of Hungary introduced a raft of policies which include an interest-free loan of the equivalent of £30,000 which would be cancelled once the couple have three children. So has it worked? I've been speaking to the BBC's East and Central Europe correspondent

Nick Thorpe and I asked him to tell me more about the policy. Since it came to power in 2010, Viktor Orban's centre-right, some people would say right-wing, even nationalist government, has stressed protection of the family and encouraging couples to have more babies. So basically they've been introducing in the last 12 years because they've won four elections in a row now and a pretty popular part of their policy have been these different measures to encourage people to have babies so those include for example low interest loans there's one in particular brought in in 2019 called an expecting a baby loan that gives you the equivalent of thirty thousand pounds which is only repayable or

rather it's um it's not repayable at all if you have three or more children so in other words it is a loan it's a low interest loan um but as you have more children you pay less and less back and less interest on it until you get to the magic figure of three children and then you don't pay anything back at all there are also other tax incentive measures building of creches and more kindergartens, even a way of getting a larger car, a grant even to get a car, a larger car, if you have more children. Have they worked? It's interesting really looking at the figures. The government is very proud of the fact they say they have worked. If one looks at the rate of marriages in Hungary, for example, because these are all, this is a, as the government says in itself, it's a conservative government, which are very sort of family-centered. So they're

trying to encourage people to get married and have children, effectively. The number of marriages has doubled in those 12 years since they came to power. The number of births has improved slightly, or it's about the same, which doesn't sound like a great achievement until one realises that the number of women of childbearing age has fallen dramatically over those 12 years. So the government does turn around when you challenge them on that, saying that the number of births in Hungary, about 90,000 births a year, is actually fairly stable. They'll say, but look what it would have been like if we hadn't brought in all these measures.

So the numbers aren't exactly what the government might have wanted. But of course, they're saying that it is working using their own visions and models. But women themselves, through the conversations you've been having with Hungarian women, do they feel encouraged to have a career? Are they pressured to have children? Do these incentives therefore pressurize them to have more children? I think a lot of women I've spoken to, a lot of couples I've spoken to, have said that actually they were planning to have several children anyway.

And therefore this is effective. They'd be foolish not to take up these tax incentives, these loans, these opportunities to improve your house, improve, even build yourself a new house. So women in general are saying to me, on the whole, that, and I think people are somewhat reluctant to admit that the government could, you know, have any effect, you know, could shape or influence their, you know, what they do in the privacy of their own homes or their family planning strategies. But I think then you turn back to the authorities and say, so, you know, what's going on? And the authorities and say so you know what's going on and the authorities will say actually a lot of people do hesitate to have children because wondering if they can afford to have a first child wondering if they can afford to have a second or third child and so the government sort of says it's sort of trying to fine-tune all these different

measures and there's something between 7 and 15 of these different measures, to sort of help people, not to convince them, they say. They say the government also, in its defence, says we're not trying to manipulate families or pressurise, as you say, women, but we're actually trying to facilitate something that women or couples would think about, but then maybe not have that second or third child because they think they just can't afford it. There's one of the studies that the government's done, that they commissioned, said that newly married couples, on average, say that they would like,

I think the figure that's given is they'd like to have 2.7 children, is what it comes out as an average. But, of course, the birth rate doesn't support that I think it's only 1.55 now the so-called total fertility rate in Hungary but that is a big increase on what it was back in 2010 which is which I think it was 1.21 at that time. Nick explain to me what happens to that loan if you start to try for a family and find out that you're then unable to have one or that you change your mind do you have to give the money back what what are the consequences yeah it's an interesting question and quite a controversial one basically um it's there are

three kind of negative clauses or three punitive clauses in it. One is if you don't have children for whatever reason. Another is if you get divorced. And the third one is if you move abroad, because these are also measures trying to encourage people. There is a big net emigration from Hungary, and they are trying to keep people in the country and stop people emigrating so much. But to return to the question, basically one should understand it not as a grant but as a loan, a low-interest loan. And if you don't have children at all or perhaps if you only have one, you end up paying more interest and having to pay back the whole of the loan in due course.

That's not such a punitive thing, but obviously there's a temptation that if, say, you've got two children and you know that if you were to have yet another one, a third one, then the whole £30,000 loan will be written off completely, then one can see that it might act as an incentive to some couples. And Nick, considering Hungary's nationalist drive that you've talked about there, how inclusive is this policy? Can all sectors of society access it? Again, this is a really interesting question. And a lot of the criticism from the liberal and left side in Hungarian politics say that actually these are policies designed for the middle classes to strengthen people who are already relatively comfortably or well off and that they're neglecting our poorer strata of the population. So, for example, the £30,000 loan to build or improve your house, you need to match that with £30,000 of savings of your own. They're not just handing them out.

And of course, poorer or disadvantaged families won't have that kind of money in the first place. Again, when you put that to the government, they'll oh look we're increasing creche places we're increasing nursery places primary school places we're issuing free books free dinners at primary school free textbooks and so on and that they will say that if you look at a sort of map of Hungary in more deprived or less well-off regions, these measures have also been very popular there, and it's a relatively small country. You talk about this being targeted towards the middle class largely, and that the most deprived sectors of society are unable to access this. I imagine this would include the Roma community, often targeted by anti-immigration policies within Hungary.

That's right. The Roma are always sort of in trouble in Hungary as the poorest. Of course, there are many non-Roma people who are also very poor, but there are several hundred villages in the Hungarian countryside where a lot of children are still running around barefoot, sometimes even in winter, without inside toilets or bathrooms and so on. And this is a really long-term problem of Hungary, of how to bring those people into the workforce, how to improve their conditions, and a series of measures. One has to say that the socialist and liberal governments weren't much better at helping those communities either.

So there is a sort of solid group of the poorest of Hungary who no government has really managed to help, this government included. Our thanks there to Nick Thorpe, a take there from Hungary. I have been asking you for your messages on this recommendation that wedding venues have a major overhaul. You can now get married, or the recommendation is that you can get married to places that are considered to be safe and dignified. Julia's got in touch to say, As a child, I read Little Women

and was charmed by Meg's wedding, celebrated in the garden under a tree arch. As far as I knew, weddings were in churches or registry offices, no other choice. It's extraordinary that we've taken so long to catch up with America. Well, Julia's message leads me nicely onto our next segment.

It is about Little Women. The UK premiere of Little Women opens at Opera Holland Park in London later this week. The composer Mark Adamo has adapted Louisa May Alcott's coming of age novel set around the time of the American Civil War, featuring the independent and ambitious Jo March, her sisters Meg, Beth and Amy and their devoted mother. The award-winning director Ella Marchman joins me in the studio now, along with Charlotte Badham, who makes her professional debut as Jo and will be performing for us a little later. Charlotte, let me start with you.

This is a work that was originally written in 1868. We've seen many versions of it on many platforms over the years. How familiar were you with this story? It's a story I read as a child and have since watched many TV and film adaptations. When I saw that Opera Holland Park were due to put this work on this year, I just thought to myself, oh my gosh, I'd love to play Jo March. And lo and behold, here I am. Here you are indeed. Ella, tell me about the production. Have you stuck to the original story at all? So Mark has adapted this, obviously, 25 years ago now. So even from then, the world has changed quite a lot. The beautiful thing about the way that Mark's done it is he's

taken it from basically two thirds of the way through the book thing about the way that Mark's done it is he's taken it from basically two thirds of the way through the book. So the kids are a little bit older. So he misses out kind of a lot of a lot of that backstory, but they're little flashes that appear and you'll get if you know the books, you'll get little quotes that are recycled, especially like when Joe speaks to Laurie, after he's gone and married Amy, there's a lot of that speech is contained with it. So you get these kind of beautiful fragments and also his own imagination and what he's added to the piece as well. So you're moving with the times.

We're moving with the times and especially in the way that we staged it, we've added something. There are these four voices that are featured in Mark's piece, which we have decided to kind of reimagine as something that highlights the universal experience of woman. Yeah. Charlotte, you're playing Jo, often described as an outspoken tomboy,

this passion for writing. Did you resonate with the character at all? Absolutely. I mean, in the book, she struggles with balancing domesticity, with finding true love and also pursuing her ambition and passion, which is writing. And I think as an opera singer or anyone in the creative industries or, you know, women in general trying to work, it's really hard balancing those three things. Yes. And I'm very much someone who likes to wear their heart on their sleeve and so yeah absolutely connection was there yes and there's a lot of singing you're singing three big numbers how do you pace yourself um yeah it is a big sing but it wasn't as challenging as I thought it would be I think as long as you're absolutely present and you've got good singing technique behind you, it's fine, yes.

I think, you know, she carries me through. She's obviously there with me throughout the whole show. Ella, why make Little Women into an opera? I think it's a fantastic story that appeals to especially women growing up. I think we all identify with aspects of the girls personalities. And it's a really kind of comforting story to turn to. And whilst opera, especially with regards to women, if strong female stories are basically about nuns, and so actually to have something with real body and heart,

this is something really fantastic for the female voice, actually. And as someone who is so well versed in directing a play, how different was this experience? Yeah, so I mostly work in opera, but I've also done theatre and run theatre companies. I love having a score there because a score kind of gives you a foundation that you can always ask there's so much more psychology built into it rather than having to kind of work out the background to that for for yourself this piece especially we've got Mark has been in the room quite a lot as well so you've also got this kind of other source and font of knowledge and the beautiful thing about opera is it's a huge collaboration and you're creating this you're

putting all these jigsaw pieces together. And it's a really, really fantastic community and team spirit that we've got at Opera Holland Park. I do want to steer the conversation on to another aspect of this because you've co-founded a charity, it's called Swopra. Tell us about it. Yeah, Swopra is short for Supporting Women and Parents in Opera. And we basically are a charity that exists to not exist.

But within the operatic workplace, we did some research. And in 2017, there was something like 0% female composers and only 4% female librettists being performed on main stages across the country. So we felt like we needed to do something to celebrate female role models within the industry and also to enhance the female presence. And we saw that actually being a parent was counting as a bit of a hurdle coming back into the industry. So we decided to set up lots of programmes

that would enable parents to be better supported within the industry. And actually we had our first gala at Opera Holland Park where we performed a scene from Little Women, which is where I first found out about this piece. so it really feels like it's come full circle to four years later and I'll be here directing the full work. Yeah that personal connection um on a lighter note there is a quiz online which sister are you I'm going to ask you both which sister are you Ella? We're twin sisters. How are you? And actually, to add to that, one really lovely thing about working with Ella is we're so in sync with who Jo is. So I'll go to do something on stage and think, oh, this is a bit eggy.

I should have done that. And as I turn around, Ella says, you should have done that. And it's the same thought and idea. So, yeah, we're so in tune. You're both Jo. Listeners, which sister are you? Jo, Meg, Beth or Amy? Do get in touch at BBC Women's Hour.

Thank you so much, Ella Marchman and Charlotte Badham. All the very best as this opera gets underway on Friday. Lots of your messages coming through. This one from Jim on email who says, he rightly points out, in Scotland, we've had the opportunity to marry in any location for years. This new law will cover

England and Wales. Thank you, Jim, for being in touch and pointing that out for us. Christine on email responds to the survivors in scrub segment that we did

and says, the problem of misogyny in medical care becomes much worse for elderly women. It's always a battle to overcome the attitude that you are an old biddy with no understanding. I have recently had a nightmare weekend in hospital. If you challenge or just question anything, then you are regarded as troublesome. And this one, an anonymous person on email has said,

my son is a doctor who decided to steer clear of specializing in any surgical discipline because of the machista atmosphere prevailing there and here's an email that we want to bring you if you were listening at the start of the program then you would have heard me speaking to sue wyatt who was on the very first England women's football team and they have or they will now be awarded a cap an official cap because they pointed out or she pointed out to us Sue did that after the Lionesses beat Scotland in 1972 which was their first international victory her team were not recognised well they are going to get their caps and she was hoping that her fellow team player would be in touch

so that she too could join them in receiving their caps. And she wondered if Jeannie Allitt was out there. Jeannie's got in touch. Jeannie writes to us, good day. I've just been listening to Radio 4 about me. Well, I'm alive and I'm kicking. Blimey, finally a cap. Jeannie, we'd love to speak to you so please do get in touch this story

continues on to something slightly more serious the male contraceptive pill has been talked about for decades but so far has never got past the research stages well there's a current clinical trial through that is already yielding good results however However, it's not a pill, it's a gel. And it's already had positive feedback from couples who have tried it. I'm joined now by Diana Blythe, who leads the contraceptive development program at the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the United States. Welcome to the program, Dr. Blythe. Hi, thank you for having me. Well, male contraception

options, they are currently restricted to vasectomies and condoms. So why has the male pill, first of all, been so hard to get off the ground? Well, it's probably because a hormonal approach requires two components, two hormones in female methods, as well as male methods. And the first product of progestin, which inhibits ovulation in women or inhibits sperm production in men, is easily delivered by a number of ways. It can be an injection, it can be a gel, it can be a pill. But testosterone, which for men is the second hormone that's needed, estradiol for women, is cleared so rapidly that it's impossible to have enough testosterone throughout the day in an oral form. It would require multiple doses a day, and that's going to be impractical for a daily pill. So what we found is that the gel, which is applied to the shoulders,

which answers one question some of your listeners may be wondering about where it's applied, it's applied to the shoulders and it forms a deposit basically in the skin and so the hormone levels remain very constant but are delivered much more effectively and so a single daily dose will be effective at preventing sperm production. That's a really good guide there. In terms of these clinical trials how do they actually work? Well's uh it's about a two-year commitment on the part of the couple there's a lot of preliminary work that went into this to show that the both hormones were safe for men in a single dose form and then in a more repeat dose form and uh eventually to a six-month study to show that sperm suppression is effective and that all the men recover.

Because it takes, from the time you shut down sperm, it takes some time for the sperm that have passed that point to leave the system. So we need to have a trial that's long enough to identify that we can suppress sperm all the way down to zero or at least our target is less than one million per milliliter which still sounds like a lot of sperm but it's not enough to cause a pregnancy to occur okay in terms of this specific gel study how extensive is that i'm not sure i understand what do you mean the gel study meaning in terms of sites a number of countries taking part yeah so okay so the so the timeline again is there's a suppression phase and then there when the man gets down to a threshold sperm count there's an effectiveness phase where the couple uses this as their sole method of

contraception. The female partner stops using whatever method she may have been using. And for the next year, they use this as their method. At the end of that time, the man stops taking the method and enters a recovery phase and the woman begins to use another method or or if they decide to have a child they go that route we have nine sites in the u.s we have two in the uk one in scotland or edinburgh one in manchester we have uh sweden italy uh chile and kenya and we have just opened a site in zimbabwe okay and, and the couples who are taking part, what have they told you about their reaction to the trial? Well, we've just reached a milestone of 100 couples completing a full year, and they have said that they really like the product,

they wish they could keep using it. They complain about the fact that it's going to take us such a long time to get it on the market. Many of them want to re-enroll, given that it's a two-year study, that's an impressive expression of how much they liked being on this method. And the women in particular liked it because they were able to have a contraception free or hormone free if they were on hormonal methods or other methods that they may or may not have had some problems with. They really enjoyed that time off and depending on their partner to maintain the contraceptive effectiveness. Obviously, those couples taking part in the trial are interested in the concept and have therefore come forward.

But as a wider society, do you think we are ready for this? Well, surveys beginning in about the early 2000s and continuing now indicate that about 65% of men say they would be willing to use the method. And contraception is used for a long period of time in people's lives. So it would make sense that the male might be willing to use it for some period of time and the woman might use it for another period of time. What works well, and it's not necessarily only couples who would use this method. Single men would like to be able to control their own fertility and there would be less tendency for people to forget and have an accident because many unplanned pregnancies happen from, you know, incorrect

use of a contraceptive method, forgetting to take the pill or whatever. This method has some forgiveness in that regard in that a single not taking the gel for a single day is not going to impact sperm production. It doesn't bounce back that quickly. But again, if someone is not a perfect user, but they're in a partnership with someone else who is not a perfect user, but is also using a method, the likelihood that a pregnancy will result unintended is less. If there's a man listening to this, Diane, thinking, okay, this interests me going forward, are there any adverse side effects that they should be concerned about? We have seen very low side effect profile, particularly relative to some of the things we were

potentially expecting. I think the transdermal delivery has a constant delivery of hormones instead of a fluctuating profile so that we don't see effects on mood, we don't see effects on sexual function or libido or any of those things that someone might worry about. And in fact, the men who have participated in the trial have commented on how little the side effects were, that a couple of them have actually had positive side effects, more energy, more sex drive, and so forth, that they've found to be a positive effect of using this method. So in general, I would say that it's been a very low side effect profile. Going forward then, Diane, what are the next steps? Because you said the road is very long when it comes to male contraception

in terms of the pill and the gel. Well, since this is a two-year study for the couples who enter, basically, from the time they enroll or inquire about the study until the time they fully recover and leave the study, anyone we are enrolling now will still have about two years before they complete. And so our next stage is to talk to the regulatory agencies. Since this is a first-of-its-kind product, there isn't a pathway to follow toward regulatory approval. And we need to speak with our regulatory agency, in particular the FDA, and try to find out from them what they would like to see for approval of a product. If this were a product for women, we know we need

about a thousand women completing a full year of use. So we expect that there will be a similar requirement for men. So that's a much larger phase three study that needs to be done. Okay. Diana, you're in the United States and and in recent weeks we've been discussing the implications of the overturning of Roe v. Wade. Do you think women in the United States losing the constitutional right to an abortion could lead to more interest in a product like this? Both accessibility and availability of a variety of methods that people can use to prevent an unintended pregnancy is very important and more important now that there are limits on whether or not they can terminate a pregnancy that was not intended. Okay. Thank you so much, Dr. Diana Blythe, who leads the Contraceptive Development Program at the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the US. Good to get your insights there on developments

on the male contraceptive options. Thank you for joining us here on Woman's Hour. Just a bit of time to read a few more of your many emails that are coming in on many of the subjects that we've been talking about throughout the programme. This one on the matter of population. Leslie on email writes, is it me? world population by producing more children in times when we are trying to reduce consumption of the world's raw materials and consumption of energy. We've also had plenty more on the subject of getting married at a venue of your choice. Simon says, myself and my partner are getting married in my parents' back garden next month. The location means a great deal to us both

and we are very much looking forward to the wedding. Unfortunately, due to the current system, we are having to have an official register or registry office ceremony in the week before. The reforms are overdue and would mean that people could have official ceremonies in places that mean something to them. Like Simon, I too had to have a double wedding,

one in a registry office, one in a hall, because that was the Hindu ceremony, much larger, much more extravagant. But it would certainly save a lot of people money if they don't have to have a double ceremony. And this one is a text that we've had in which says, I'm an alternative wedding photographer, and I'm so excited about what these changes mean for my couples. I've had many couples choose alternative locations.

The most unusual one, wait for it, was a cave with a button moon theme. Please do continue this conversation, of course, by text 84844 on social media, over on Twitter, over on Instagram. We are at BBC Women's Hour. And of course, you can email us through our website on this story or on any of the stories that we have been talking about on the programme. But for now, it's been very good to have your company here on the programme over the past hour. Please do join us again tomorrow. Thanks for listening. There's plenty more from Woman's Hour over at BBC Sounds. always follow it. Hoover was basically creating a secret police. Find out what his FBI

looked like. This is like Stassi. And hear firsthand from the group who had an astonishing plan to expose him. We became convinced that the FBI was illegal.

From BBC Radio 4, The People vs. J. Edgar Hoover with me, Emily Maitlis. Listen first 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's faking pregnancies. I started, like, warning everybody. Every doula that I know.

It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.