ADHD and women, Author Claire Lynch, Gaming for good

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Hello, I'm Anita Rani and welcome to Woman's Hour from BBC Radio 4. What a lovely way to start the programme. Thank you and cheers to you. Good morning. Welcome. Um on the programme today. ADHD, attention, deficits, hyperactivity disorder. New research has found.

The number of women over the age of twenty-five on ADHD medication has increased dramatically. We'll be understanding more. We're also going to be discussing a very sensitive issue around miscarriage and what happens when we have to do this. to the pregnancy tissue in a clinical setting, what options are offered, if at all, to women going through this trauma? And we'll get an insight into the world of gaming and how games can be used as a force for good.

Plus, author Claire Lynch is here to talk about her debut novel Family Matters. The story is based around the little-known history of the treatment of lesbian mothers in British courts in the 1980s. Around 90% of lesbian mothers in divorce cases lost legal custody of their children, tearing families apart. The novel is about a child who we meet as a woman in her 40s who never knew the real reason she didn't see her mother. A secret kept from her.

So maybe this is a story you can relate to, in which case we would very much like to hear from you this morning or Is there a family secret that you only discovered as an adult? Maybe you're keeping a family secret from others. If you are, why are you and what toll is it taking? Please share your stories with me and remember you can remain anonymous. The text number is 84844. If you wish to email us, then go to our website.

And our WhatsApp number is 03700-100-444. And if you want to follow us on social media, it's at BBC Woman's Hour. That text number once again though 84844. Tell me your secret. A study led by the University of Oxford shows a 20-fold rise in the proportion of women over 25 using ADHD medication in the UK. The study looked at five countries, Belgium, Germany, the Netherlands, Spain and the UK, showing use has more than tripled in thirteen years, the UK having the highest relative increase.

Altho ADHD medication use remained higher among males, the gender gap in treatment narrowed over time and with increasing age. That's what the researchers have said. To unpick what lies behind this increase, I'm joined by Amanda Kirby, former chair of the ADHD Foundation and emeritus professor of neurodevelopment disorders at the University of South Wales.

Also with us is Kat Brown, author of It's Not a Bloody Trend, who was diagnosed with ADHD, age 37 and uses medication. Kat and Amanda, welcome. Um I'm gonna come to you first, Amanda. Why is there such a big rise in women over twenty five using ADHD medication. Well I think it's it's the way we've looked at ADHD in women has been historically really underdiagnosed. So the currently the prescribing partly reflects a correction of the longstanding misneed.

rather than a sudden rise. So we can go, why is this rise? But actually we weren't diagnosing women uh till relatively recently. We were looking for male symptoms predominantly. Um awareness has increased, so that's the other bit. So generally awareness across ADHD and other conditions like autism has increased, and professionals are being more aware of how to identify, what do I need to do and referring people, rightly so.

The other key thing is many women were previously treated for anxiety and depression. So and and and I always think of the term hysteria. Hysteria was in the diagnostic criteria, which is all about women's wombs, right? Yeah. It comes from till the nineteen eighties. So the knowledge and awareness around ADHD in women is relatively s really recent and we're now looking at

the hormone interaction between ADHD and looking at how it presents differently. Who knew that women had hormones till now? You know, so there's a catch up going on. And I think The UK just presents that we are perhaps ahead of the game in the sense of awareness is good. twenty years ago that we didn't we didn't really have adult services for ADHD particularly uh until recently. They were predominantly m boys and then men. So this is a new conversation. And the research in women

is relatively new. There was uh around ADHD in the menopause just that was only in twenty four, twenty five. This is you know, which is amazing when we think how long we've oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw oedden nhw.

Uh you were diagnosed at thirty seven cat. What was your experience of getting a diagnosis? Oh goodness me. Um well it was firstly just like lots and lots and lots of car crashes sort of through my life, up until it got to the point um when I literally just looked on Twitter one day and somebody had shared a thread by an ADHD coach asking adults how they'd had that light bulb moment about knowing that they had a ADHD. And I mean

Ever everybody's life is fairly specific to themselves, I'd say. But even so, looking through this thread, I was like, it's me, it's me. Uh but uh hang on, I'm not a middle aged man. How is this also me? Um

I had given up alcohol uh the year before, having desperately tried to understand how to manage it and tried endless tried Januaries and sober Octobers and all that sort of stuff. And what I really found was that not having alcohol anymore as a social crutch or anything else like that had shown what I later understood to be my ADHD symptoms and stark relief. And I mean it's not as if I haven't been near my GP in years either. I'd been treated for depression, anxiety. Um I'd even been surprised.

to be diagnosed with an eating disorder, which I didn't realise. I just thought I was greedy and disgusting and it turned out it was binge eating disorder instead. So I'd had all of these all of these sort of conditions, but nothing had sort of ever helped me, even though I'd, you know, paid for therapy, I'd had therapy on the NHS.

Um uh they just never helped me understand why I was basically a suicidal, upset person. That that sort of parallels what Amanda was just saying. So uh how did the medication change things for you? Oh well my immediate happy response was, Well, I'm gonna be a completely different person and everything will be magic and fine and actually what happened was it took a solid year of working

uh with my psychiatrist because I I did originally go and do a TED talk to my GP. I went onto an NHS waiting list. But in the end I couldn't wait. Ha ha in the spontaneity, what a surprise. And paid to have a private diagnosis through my tax savings. And but not every single medication worked instantly. I think there's this imagination that

uh ADHD meds are just one tiny pill and it's no God not at all. I mean I'm on a what what's more like a sort of little scaffolding of things, not necessarily to hold me together, but all interacting in different ways. But what I will say is that the medication coupled with therapy to work on accepting that my life could have been different, but it wasn't, and that's totally fine. Plus also all the other non ADHD stuff that's happened in my life as well.

has been just such a huge factor in making me feel much less like a horrendous defective robot. Amand, rwy'n credu i chi. Rwy'n credu i chi. Rwy'n credu i chi. Rwy'n credu i chi. Rwy'n credu i chi. Rwy'n credu i chi. Rwy'n credu i chi. Rwy'n credu i chi. Yn yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n.

Well I think the first thing is we need to r raise awareness in clinicians, GPs, GPs are often the first port of call, to understand what women's symptoms and signs of ADHD are. And I think that's really important. Cat's experience of having anxiety yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n. I think your point was just a pill won't solve every ill and I think that's important so getting awareness that

medication is part of intervention and understanding what the interventions are for females because of we know that dopamine inter interacts with estrogen. So we also know in females that your symptoms of ADHD vary across your cycle. So this is really important that you can Rydyn ni'n fawr iawn i'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol a'r cymdeithasol.

uh maning managing your emotions. And also like Kat says Felly mae'n ddiagnos yn ôl, mae'n ddiagnos yn ôl, mae'n rhaid i'n rhaid i'n rhaid i'n rhaid, ac mae'n rhaid i'n rhaid i'n rhaid, ac mae'n rhaid i'n rhaid i'n rhaid. Mae'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid.

Oh hugely. Um I when I first got the diagnosis I felt almost as though I was walking off into the sunset and nothing would ever be bad again, but you know, it's life and and life carries on, you know, lifing. But It's just made such a a huge

difference to know. And what is fascinating is I keep getting emails, uh messages from people not just my age, I'm now forty three, but in their sixties, seventies, eighties even, because It's not as if you get to a point in life where you want to stop understanding what makes you tick, not just so that you can operate better, but so that the people around you

y we were discussing on the show the other day, PMDD, and lots of people anecdotally find that their ADHD meds simply don't work around the time of their period, which is not helpful. I'm also very much in the throes of perimenopause right now. Um I'm sitting here having a lovely hot flash as we speak. I do apologise to anybody watching visually. Um but ymwneud â phobl, ymwneud â phobl, ymwneud â phobl, ymwneud â phobl, ymwneud â phobl.

sway the potential people who will then be hopefully finding some help through meds. Well wonderfully we've got Amanda to kind of answer some of these questions. But by the way, if people are watching you, we are just I well personally I'm delighted by your fantastic wallpaper behind you and the combination with that Amazing shirt you're wearing. It's very, very good. Um

So Amanda, before we do discuss what happens when women hit perimenopause and menopause, we can't take for granted that everyone knows what we're talking about. What is it? What is ADHD? So attention deficit hyperactivity disorder.'Cause it says the things that we're challenged with. And actually it challenges because often people with a t a ADHD find it h can hyper focus on things but find it harder to shift focus.

In males there is overlap, all right, I want to make sure we say that. It's not males are this and females are that. Classically, but there are overlap. But inattention. So losing focus on the things which are boring are not so interesting. Procrastination, so getting started to get going can be really difficult. And time a time estimation, knowing how long something's going to take.

that can be quite hard as well. And that can have an impact on your uh your your organization, getting things done, getting things done to time. Um and hyperactivity that you see in the boys can just be busy brain, this brain that doesn't switch off. ac yn ymwneud â llawer o beth sy'n ymwneud â llawer o beth sy'n ymwneud â llawer o beth sy'n ymwneud â llawer o beth

The you know, people say there's lots of A oh we've all got a bit of ADHD. There's a difference between somebody having inattention and not being able to focus because of lots of things going on in their life or being distracted by social media and somebody actually the impairment

You don't get a diagnosis or shouldn't get a diagnosis of ADHD if it's not impacting. It's not all wonderful. If it was, people would not be going forward to try and gain a diagnosis, you know. So it's about the impact. impact on day to day, but it varies hugely. I think that's really important. Not everybody looks the same with ADHD and so that's why interventional support needs to be tailored to you in the context of your life. Thank you.

And this and this increase that we're talking about in medication uh is set across a a backdrop of concern on meeting the demand for adult autism and ADHD diagnosis that Kat just mentioned. And yesterday Wes Streeting, I'm sure you're aware, Amanda. speaking on BBC Radio Oxford admitted the NHS is falling short on this. He went on to say it was a national issue that he was very worried about. Should he be?

Rwy'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu, mae'n credu. to ensure that people are getting the needs led support. So let's have the help while waiting is nothing. Right. So while you're waiting, you're not getting anything.

So let's look at who's in the greatest need. And at the moment, because the rating the raisin are Y O N is we're all running to the gates trying to get an assessment. And what it means is If you can't get an assessment, you can't get diagnosed, you'll either go elsewhere like Kat did, or you won't. And individuals who are from socioeconomic groups or moving around systems really get left behind.

And we see that in the justice system, high rates of ADHD traits but not being diagnosed because they've because of poverty and other reasons. So needs led, upstream, we need to get those systems. So yes, we need to be concerned, but there are solutions. And what do we know? Because it's something that comes up on the programme time and time again, the impact of menopause on ADHD symptoms in women's lives. What do we know?

Well first of all, perimenopause you're suddenly going blah blah, your estrogen is going all over the place and dopamine and estrogen interact with each other and it's really important for the helping you to focus and concentrate. And at that time when your estrogen levels are going all over the place and you're having the flushes and night sweats and all the other lovely symptoms that are are are related, you can get worse concentration, brain fog, increased for forgetfulness.

heightened emotional reactivity. So the it's some of the symptoms on steroid well, not on steroids, but but heightened, right? And I think that and you see the reduced effectiveness of your coping strategies. Yeah. The other bit is really understanding if you're on ADHD medication already, it might be that needs to be looked at. And we are really at very early stages. I'm I'm s I'm sort of upset by that in twenty twenty six.

We're only starting to talk about these things in twenty four, twenty-five. We need longitudinal studies about what do we treat, how do we treat effectively in this time of life which really is really important for many, many women who've been missed or misdiagnosed or misunderstood. And yet the numbers are so small as well. Um if I may just very briefly this increase This twenty fold increase, if you like, is from zero point zero one per cent of all over twenty five.

in 2010 to 0.20% in 2023. This is still tiny. Just because, you know, some rather bad faith people are going, oh, people are taking up the NHS's time. Yes they are, because the side effects, the impacts of not being diagnosed. are absolutely enormous. And very important, the ramifications of lack of diagnosis or wrong diagnosis cost in society. And as you say rightly, Kat, the relative increases...

we're still underdiagnosing. There's a huge catch-up, so we do need to do more. Really interesting conversation. I want to thank you both for joining me to talk about that. Amanda Kirby and Kat Brown, 84844, if you'd like to share your experience of that. I am recently diagnosed combined type ADHD. I think of all the years I labelled myself lazy, uncommitted, disorganised and impulsive.

Uh did you label yours yourself that or did other people? I don't know. I'm just putting it out there. There is relief A lot of grief at what might have been had I been diagnosed and supported earlier. I'm glad you have had your diagnosis now. Thank you for your message 84844.

Now, the nominations for this year's Oscars are out, and as you may have heard, the vampire film Sinners has broken the record for the most Oscar nominations received by a single film with 16 Yn ymwneud â llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o.

Hamlet has received eight nominations. Have you seen it yet? You may have caught my recent interview with its director, Chloe Zhao. Mae'n yw'n ymwneud â'r ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r Ymwneud â'r

Well, Chloe has history with the Oscars as only the second woman and first woman of colour to win Best Director for her film Nomadland, which won in 2021. When she came into the Woman's Hour studio recently, I asked her about that experience. When you were a little girl or just even being in film school, you look at that happening on the television.

And I usually watch the Oscars with a pint of ice cream. Mango sorbet is use was my choice. I used to watch it in my twenties every year. And you don't think it's so far from your reality because I didn't know anybody and I didn't you know, I I was an immigrant. So then one day you wake up with that nomination and really I mean we t since we're on the conversation of community

I started again knowing no one and and Sundance Institute, Film Independent, A F P. You know, all these labs welcomed me. That was a I met Ryan Coogler there, you know, and my David Lowry and Mario Heller and a lot of these filmmakers that are s supporting each other right now. And from the these institute and then the festival. Cam, Venice, Sundance, you know, um, Tailoride. And these festivals have supported me for all my films. And when you go to these festivals,

That's your community right there. So then when you c in that moment I go, I guess I guess I was held. Yeah. Yeah. So you feel it's really nice. Um, it's extraordinary. So just to remind people, Chloe is only the second woman to have won best director, Oscar, but also the first non white woman. And just to remind everyone, Chinese immigrants to America. As a woman going into the rarefied world of filmmaking to win an Oscar, it's extraordinary. What does it take?

What does it take to do that? Like how? I mean of course the work speaks for itself, you know, your art is your art and it's extraordinary. But, you know, to get into that world is uh Well so the women's hours, so like I do think as women we we value co collaboration and again community more you know more than what the I think sometimes the dominant culture were saying, like you gotta do it on your own and I have always been

you know, collaborating not just with my crew and cast, but the places I go into. Yeah. It really counts the director sounds very kind of singular. Um but a captain of a ship would tell you if you wanna live you need a good crew. And he and they trust you. They trust you. It's trust, right? There is a fine line between being in control and uh preparing everything. And

making sure everything is going to produce like we want it to be. And then also there's another half of the equation which is do the work to create the container. So when we actually are in it Then do the work of letting it go. and allowing everyone to bring forth what they're bringing forth and trust that sometimes something happens that is so different than what I envisioned.

And you have to look at that, go, There is a message there and you have to be on set, try to decipher what that message is and try to follow that. Because if you fight against it, then there's a chance you lose that extra thing, that mystery that's bigger than you. This is lovely. This is very good, profound life advice. I was gonna say to you, what advice would you give to any sort of creative who feels like they're an outsider? How do they get in? Oh that. Yeah. Yeah.

That is more um, you know, because I I I wasn't given the mainstream opportunity, the first two films I just had this people had asked me during that time and I always said, you know, if if if you're trying to get to the top floor of a house And then they're not letting you up. And you can spend a decade of your life trying to climb one flight up. Or you can w walk out of the house and and you see like, whoa, there is a a whole

undiscovered countries out there. But then you have to humble yourself because you're not gonna have the infrastructure of the existing house. And then can you can you talk to your ego and go, Well, I'm not gonna be able to rise up, you know, I'm not gonna have all this convenience. I have to cut down the trees. I have to get people to help I have to build a foundation. It's gonna take time and you have to weather some st bigger storms. But then when it's all finished it's your house.

Build your own house. Chloe Zhao, there, the director of Hamlet, talking to me recently. The film star Jessie Buckley has also been nominated for Best Actress alongside Rose Byrne. uh Renate Rensfe and Emma Stone and our recent guest Kate Hudson for her performance in the film Song Sung Blue. She told me when she popped in to have a chat how she found her voice to sing in the film. See it was a huge part of opening my throat chakra and giving me confidence as a singer. And you've seen her face.

What? And I've seen that Hell yes, I have. Your throat chakra. Come on, tell me. How did you do that? Well, I just feel like it's been clo it was so closed, I was so fearful of like m sharing my voice and multiple ways, like writing music. I've been writing music my whole life and just opening this part o I was always so timid and a f and afraid to do it and There's been a lot of people along the way who were really wanted me to get in the studio, wanted me to be singing more.

I don't know what was it was that was holding me back until I got a little bit older. And then working with Sia and her musicality, her writing. And her songs, which are big, you know. You have to really be co c very confident singer to to really get her songs right. And she just gave me so much confidence. She had so much belief in me. And I I I just she really like unlocked it. Is it significant that it was a woman who did that? Yes. Absolutely. Like a th hundred thousand percent for me, yeah.

I think people will be surprised to hear you say that you there was something holding you back.'Cause you can obviously sing. I bet there's people who've told you this your whole life and you knew you knew on some level yourself that you can sing. Well and I had been singing. You know, I sang in nine, I sang in glee and it's not like my voice I wasn't able to access

certain parts of my voice. It was like the whole embodiment of myself and the belief in myself as a singer, you know, is different. It's d and and Sia really was the one who was like, This is this is who you are. So once you've felt the belief and you fully embraced it and uh throat chakra flew open. Yeah. I'm just thinking about pe women listening who will full well, me included, we all have our thing, know the thing that we want to release but something is holding us back.

Give us some advice, Kate. How do we Well, I don't it's so different for everybody. I think the thing is is that it comes at the right time. I think d you know, it's a I think the only advice I would give is to be patient with yourself. You know what I mean? It's like I think sometimes we're fighting so hard to make something happen, you know? And maybe sometimes you just need to be patient and

be okay with it that you're not there yet. Yeah. You know? And I have that with music. Some people go, What took you so long? And I'm like, Life. Like that this is exactly where I'm supposed to be and why I'm here now is cause everything that I was afraid of And all of the people along the way that empowered me, see a being one of the biggest ones. Help me be here and like open this up for me and

I remember hearing a woman talk about not liking the word empowerment because it means that someone else has to give show you your power. I thought that was a really interesting thing. I thought about it a lot. I love provocative statements. I'm thinking about it now. And and and as I thought about it, and I and I I'm I'm all down I'm down for everybody's point of view, right? But like I don't know where I would be without other women empowering me.

I needed it. Maybe some women don't, but I did. And in many ways, whether it be from my mother or from my girlfriends or from colleagues Sometimes you do need a little bit of that push to it doesn't mean your power doesn't exist. It means it just helps you find it, you know, and access. Kate Hudson there who came in to speak to us at the end of last year about her film Song Sung Blue, that she has now been nominated.

uh um for best actress at the Oscars for also um a mention of the uh documentary, beautiful documentary, Come See Me in the Good Light about activist and poet. Andrea Gibson, her wife Megan Fally, came in last year. You may remember to speak about this. Mae'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid i'n rhaid

84844 is the text number. My workplace brought in an organisation who initiated a How to Work with Me sessions and it was so helpful for me as a woman in my 50s with ADHD and menopause. Our whole team did it. It gave us all an insight into what helps us. We've started body doubling, changing lighting, buying noise reduction headphones and a fidget treat box.

Mae'n wedi'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i'i' Mae'n ymwneud â'n ymwneud â'n ymwneud â'n ymwneud â'n ymwneud â'n ymwneud â'n ymwneud â'n ymwneud â'n ymwneud â'r adh.

Rydyn ni'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, mae'n gweithio, What a lovely message. Thank you so much. No, thank you. And keep them coming in. 84 844 is the text. At the BBC, we go further.

Clearer. With a subscription to BBC.com, you get unlimited articles and videos, ad-free podcasts, the BBC News Channel streaming live 24-10. Plus hundreds of acclaimed documentaries. From less than a dollar a week for your first year, read, watch, and listen to trusted independent journalism and storytelling. It all starts with a subscription to bbc.com. Find out more at bbc.com slash unlimited.

Now to a very sensitive topic and you may find some of the discussion and terminology distressing. Miscarriage in the early stages of pregnancy is common, but clinical NHS practices for the disposal of pregnancy tissue after an early stage miscarriage. can sometimes appear to be at odds with women's wishes and not conducive to inclusive care.

to a new study published in Social Science and Medicine and reported in the British Medical Journal. The study's author, Susie Kilshaw, is a professor of medical anthropology at University College London, and spent nearly two years observing miscarriage care inside one of England's NHS Foundation Trusts, interviewing women about their experience. Current national guidance in clinical settings says women should be offered three options after a miscarriage cremation, burial or incineration.

But this study found that the choices available often don't match what women want. Well Susie is here to tell us more welcome to Women's Hour. Um What first of all motivated you to look at this specifically? Yeah, absolutely. Um so I am a medical anthropologist and my previous work was on something quite different. It was I was quite interested in emergent and contested illnesses.

and I worked on masculinity and men. Um and but about fifteen years ago my um my research trajectory really changed after I had my own experience of miscarriage. Um and when I had that experience I felt that it it really shook me. Um it it really I was really devastated.

And I became very interested in the fact that it seemed like something that's such a common woman's health experience globally. Um I didn't know very much about it. Um I knew lots about how to not to get pregnant, I knew lots about how to get pregnant, um I knew vaguely what miscarriage was, but I just didn't know how complicated it was. And at the time of my miscarriage, um, there was quite a lot of silence and um and around it.

So I realise that this might be something really interesting anthropologically. So I started thinking about it and then I had two subsequent miscarriages and that really sort of piqued my interest. So I be I began a fifteen year um research trajectory looking at um women's experience of of miscarriage in different cultural settings.

For this particular project, which is a welcome-funded project, it's very much informed by my previous research. So when I conducted a comparative project between women's experience in Qatar, so Qatari women's experience. and also looked at women's experience in the UK, there was some interest so s things started coming up about what happened after a miscarriage, what whether people did had memorialization practices, whether they might bury at home.

But in the UK there was a lot of uncertainty, there was a lot of um sort of People weren't really sure what they should do. Um so I realised that this was something quite interesting to look at. And what's the time frame? Are we look you were you looking at miscarriage in a certain period of the pregnancy? Absolutely. So my current project it was from twenty two weeks.

below um gestation, but really the majority so all but one of my participants had an early miscarriage, so in or around the twelve week gestation period. And what were women women telling you?

Yeah, so I should say that one thing that women sort of um unanimously told me was that they received really excellent care. Um they consistently said that they were very um happy with the care that they received, that they received very sensitive, um, very caring care from the NHS Trust where I worked and that came up again and again and again.

But the one thing that women again consistently said and they used the term jarring unexpected was around discussions and the discussions and options around pregnancy remains disposal. So they said that that was really at odds with otherwise really excellent care. So this just came up again and again. So as an anthropologist we often just follow what our participants are talking about. So that's what I did. So um what Disposal options was the trust offering. Yeah.

known about. So for me even preparing for this interview and it was a lot actually even just preparing for it. As someone who has uh gone through a miscarriage myself and I've spoken about it publicly which is why I'm bringing it up, you know, it was just Fasinatig. Rydyn ni'n ymwneud â phobl sydd â phobl sydd â phobl sydd â phobl sydd â phobl sydd â phobl.

So I think what you're saying, um, my participants very much said as well they hadn't really thought about this um before they went into the clinic. They so they consistently said, that they um it was unexpected, they hadn't even thought about it, so they were really surprised and really shocked and some quite distressed about having to have this discussion.

particularly having to have this discussion so close to surgical management of miscarriage where they were kind of focused on having the surgical procedure. Um so they often say that it was jarring, they were kind of shook by it. Um

And what women were s so the option, sorry, that you were asking. So at the trust where I worked, um, they offered uh hospital disposal, um which was burial, communal burial. Or um the person could uh make private arrangements and those private arrangements would either be through a funeral director or the person the woman could take that m uh material or those remains home.

Um so the trust where I worked was fairly typical in the fact that there was a discussion that there was um what they called a kind of consent procedure. I've written separately about why we shouldn't really call it a consent procedure. Um so the women would have to sign um a form to say which option they chose. Um and the trust again was very typical in terms of the the process.

Slightly atypical in that burial was the um the hospital disposal um management option. Um trust most NHS clinics use communal cremation, so that tends to be the most common um form of hospital disposal. But as I said, my trust was very typical in that there were there were options, um and that the person had to the woman had to sign her um her name.

and that they could take it home if they wished to. Yeah. Um and also what is quite typical of the trust where I worked is that sensitive incineration or incineration was not offered and that's very typical of most NHS. I know the reactions from the women that you spoke to varied.

Some felt that being offered a burial was almost too ceremonial. Mm-hmm. Yeah. So what I found a as you mentioned And this is early miscarriage. Early miscarriage, yeah. That um there was huge variation. And I think that really points my research over the past fift fifteen years has really highlighted

the diversity and contingency of experiences and reactions to miscarriage and that it's really, really important that we don't make assumptions about how someone might feel. Because someone absolutely might be bereaved and they need to be supported in that and and that bereavement may focus on the fetal body or the pregnancy remains as a kind of fulcrum of that loss and absolutely they should be offered ceremonial disposal. But for some people, um, some women

They might be bereaved, but they might not be that worried about what happens to the pregnancy tissue. They may be thinking of it as tissue, for example. Um and they may not want to engage with that um element of of care. For other women we have to remember that they may not see it as baby loss and they may not

they may be ambivalent, they may um be relieved as one p one of my participants was relieved when she had a miscarriage. So you could see how th these sort of practices would just not be um Relevant or in keeping with the way that they understood their miscarriage.

So the national guidance that my um the ho the hospital trust where I was working was following the national guidance. So in twenty fifteen the HDA, the Human Tissue Authority issued guidance around pregnancy um which they call remains disposal. And they say that um women should be offered options and that this these options should be documented.

Um those options in the twenty fifteen guidance were burial, cremation, and then they said sensitive incineration in some circumstances. So because of that wording, most NHS trusts there's huge variation in terms of what different trusts do. different NHS settings do, but many um sort of took that as thinking that incineration was inappropriate and there was a real bias in thinking that

incineration was inappropriate. And would you like to see the guidance made mandatory for consistency? Yeah, that's a really good question. So they did just r recently revise the guidance. So the HDA guidance was revised in September two thousand and four. Um the RCN, the Royal College of Nursing also revise their guidance. So they've made it much clearer that those three options and also taking home are um absolutely appropriate and should be offered.

In turn I definitely think that we should have more consistency because what I see quite often when I interview someone is that if they think if they've been offered something and their friend or family member has been offered something else, that can really cause upset. So I think we do need to move toward towards consistency. However, I do think that sometimes certain options aren't available. So the trust where I work, it's not that they didn't want to offer

cremation. They worked quite hard to offer cremation, but they couldn't find a crematorium that would work with them to do this. And there's legal reasons around that which I won't go into. It's a bit complicated. Um but I am pleased to say that the Trust where I work has now found um a crematorium that will work with them. So they are now working to offer that. Susie, thank you so much for coming in to speak about this. It's really important to have this conversation. Thank you, Susie Kilshaw.

Uh and of course if you've been affected by anything you've heard in this morning's conversation or anything else in the programme you can find help and support on the BBC Action Line website. Rydyn ni'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw. ymwneud â phobl ymwneud â phobl ymwneud â phobl ymwneud â phobl ymwneud â phobl ymwneud â phobl ymwneud â phobl.

with arrangements in place so that an individual's wishes are dealt with in a respectful and lawful way. This includes developing a baby loss kit, including appropriate containers where remains may be stored following a miscarriage at home, and uh we are helping to introduce measures so all A and E's and early pregnancy units have appropriate storage facilities available at all time. The text number eight four eight four four four four four four four now.

Claire Lynch has spent her career teaching literature in universities, but her debut novel, A Family Matter, recently won the Nero Book Awards Prize for Debut Fiction. a mother following her heart, a father with the law on his side, and a child caught in the middle. The novel alternates between nineteen eighty two and the present day, and explores love and loss, intimacy and justice, custody,

And cl and care. Claire, welcome to Woman's Hour. Thank you for having me. Uh congratulations. Thanks. I'm not surprised it won. It's brilliant. It's very kind. Couldn't put it down.

Um so as I've just said it's set in two time periods, nineteen eighty two, twenty twenty two. Can you give us an outline? Yeah, I think that's about right to be honest. To me anyway, it's a novel about a father, Heron, and his daughter Maggie. And the thing about them is it's a family where it's just been the two of them, they're very close.

Um and the mother is kind of a missing piece of the jigsaw. Maggie's been told a version of where her mother's been and as we go back to nineteen eighty two we sort of See Dawn's story and fill in the truth really, the full

truth, the reason that she's been missing all this time is not quite what Heron's told her. Yeah. Big family secrets. Can you tell I mean you can reveal what we can reveal. I don't think it's a spoiler to reveal because I mean w w the Yn ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r ymwneud â'r hyn. Late seventies, eighties, even into the early nineties.

So the number of women who were married had children but then met and fell in love in love with another woman, which happens. Of course. Um, and then were involved in custody cases and and lost custody of their own children. How did you come across the history? I came across it, I suppose, in in a way that I'm slightly em embarrassed in the sense that I had a vague idea that, you know, I probably knew that Life for Lesbian Mothers in the eighties wasn't all, you know, rainbows and unicorns.

Um and then when I met mothers from that generation they would sort of say to me, um You know, it's great to hear what your experience is like now, but it was different for us then. But they wouldn't quite tell me the full story, I felt. And then when I started to look into it, started to read the transcripts from the court cases, started to read the newspaper reports from the time and realized that it was a real yna, yna, yna, yna, yna, yna, yna, yna, yna, yna, yna, yna, yna.

You know, you could be a mother. And the moral judgment. Exactly. The moral judgment of society. And the sort of uh the weaponization of shame, right? So you could be one thing, but you couldn't be both.

Um and so the sort of use of that um Yeah, that kind of pressure put upon families to say the best thing to do in this situation is to remove the source of embarrassment and shame, to take this mother away from the family and you know, the intention was uh in the best case scenario the child would be very young and they would forget

Felly mae'n ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud ymwneud. I think she's uh she's very young as you say. She's twenty three when we meet her and she's done everything that people expect of her. She's met someone who's nice and got married and she's got the house and the baby and she's trying to do what is

Uh, the sort of normal thing is kind of the word I think. She's trying to do the right thing, but she hasn't really had a chance to know who she is or how she wants to live. So this jumble sale is this kind of moment where she meets someone You know, and it's just a moment of like, Oh, hang on, life could just be slightly different.

Here's an opportunity to think about we we sort of wanted to have that different life. We do. And then but then you remember, oh no, it's the nineteen eighties. I mean the way you develop the story is just Like I said, I I couldn't put it down until I got to the bit where she's in court trying to get custody of her child. And that point I did have to put the book down and walk around and let off some steam and come back to it. And these are

I'm going to get you to read a bit, actually. These are scenes taken from actual transcripts from court cases of the time. Yeah, exactly. So the the job for me was just to sort of I could find out what had been said in court. And then the novel is me thinking, Okay, but what was said at the kitchen table or what was said, you know, falling asleep at night, what what happens beyond that? But the stuff in the court case I thought as I read it, I couldn't actually

I couldn't make it worse to be honest. So I brought things from real court cases and m and put them together because it was these were the things that women reported from their own cases, the things that stayed with them for their whole lives. You know, if someone had said this to you in court Okay, so I'm gonna read this bit which is the the court case. This is the barrister speaking and it's it's it's acknowledged, it's very clear that what he's trying to do is is embarrass her.

ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw James Paul opens the folder on his desk and brings out the list of questions he knows will catch the judge's ear. Mrs. Barnes, he begins, will you please explain a practical matter to the court? Dor nods.

When you and your lover have and here he pauses, makes speech marks in the air with his bent fingers around sex, what appliances do you use? Dawn blushes at the question, and she does not understand it. Appliances? He goes on Do you, Mrs Barnes, make love in front of your child? Do you make a noise when you have sex with that woman? Has your child heard you?

When Dawn looks at her lap, at her hands clinging on to one another and says What do you mean? Or of course not? Mr James Paul simply fires another question and another Kissing then or holding hands. Has that little girl seen her mother kiss another woman on the lips? You must answer, misses Barnes, the judge says. You must answer. Shocking. Yeah, is horrendous. And you feel it. When I was reading it I felt it. Fi you know, the sh the shaming of her. Um and you've spoken to women who've

lived through it and had their t children taken away. What what stories did you hear? Well w when I was writing the book I was gathering things from handbooks that people had written at the time women had written to each other in a way as a kind of guide. Um But it's more since the books come out. So now I get messages from women from the UK, from America, Germany, Italy, who say, you know, they recognize this was their experience or something similar.

Um and I think it's a it's a tough experience actually to kinda go back there and to think about it. But the most wonderful thing is that they also tell me what their lives have become since. Yeah. Or how their children and their grandchildren are thriving and and you know, there's this kind of hope in how distant that kind of past seems, however close it is to us, and what these women's lives have become Anyway.

Um how do you view the father in the story, Heron and his decision to do this? And not just Heron, it's everybody around him, his mother, the the f the community, everybody shunned Doran. I mean I can't condone what he does, but I also really understand why he does it. I think there's a sort of sympathy there, I hope, with

you know, it's very hard to be the person who does the different thing from everyone else. He does what he's advised to do by lawyers, by, you know, social workers, he does what seems the right thing. So I've got a lot of sympathy for him. What he has to do is forty years later work out. How do you make peace with something you've done that maybe now with the

You know, benefit of retrospect, maybe you would have done something differently. And then what happens when his uh forty something year old daughter, who has two children of her own, learns the truth? Exactly, exactly. That's what family secrets are all about, aren't they? How it you know, over the layers of generations, what do you do with that then when it's kind of

evolved into something else when you've got to face your grandchildren with that truth too. Well it is a brilliant book, so I want to congratulate you. Dave you novel, I mean talk about Yn yw, mae'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw.

by Claire Lynch. I'm going to reveal some of your family secrets because people are getting in touch. And eight four eight four four is the text number. I'm in my forties and just before the COVID lockdown, my dad told me he'd been married before he married my mum and I had an older half sister. My dad had been diagnosed with dementia which progressed quickly during COVID.

Felly rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'n rwy'. Um another message here from Andrew saying, I found out I had a half brother when I was sixty five. I found out by accident when my aunt, who's ninety, mentioned it in a passing conversation. That little boy your mum had.

I was so shocked that I researched this through a local mother and baby home and found it to be true. It's left me profoundly shocked and feeling as though I really never knew or understood my mother. Keep your thoughts coming in.

Rydyn ni'n ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru ymwneud â'r Cymru Mae'r cymdeithasol'r cymdeithasol mae'r cymdeithasol mae'r cymdeithasol mae'r cymdeithasol mae'r cymdeithasol.

Now, on to my next guest on the subject of gaming. My next guest has spent the past two decades working in the industry, finding ways to use video games for good. Earlier this week at a games industry conference, Jude One of the ten women to watch by the Aurora Awards. Jude's the author of Gaming for Good and is currently the Chief Strategy Officer at Planet Play, a not for profit gaming platform which has engaged millions of gamers

to raise more than four million dollars for long term environmental projects like reforestation, renewable energy and water com uh conservation. Welcome to Woman's Hour Jews. Thanks for having me. Uh first of all congratulations. Thank you. Tell us what this award means. Take the industry beyond entertainment.

Leverage the power of gaming for good. You're going to have to lift the lid on it and explain it to us because many of our listeners maybe don't game or maybe people around them do and we know lots of women do game. Why do you think that does gaming have a bad reputation?

It does. I think it's it's misunderstood. Yeah. Um you know, uh typically we see kind of negative stories or you know, it's the um only two percent of games are adult content and they t tend to be the ones that are seen the most. Rydyn ni'n 3.6 yn ymwneud â phobl sy'n ymwneud â phobl sy'n ymwneud â phobl sy'n ymwneud â phobl.

Rydyn ni'n gweithio, rydych chi'n gweithio, rydych chi'n gweithio, rydych chi'n gweithio, rydych chi'n gweithio. Rydych chi'n gweithio, rydych chi'n gweithio, rydych chi'n gweithio, rydych chi'n gweithio. yn ymwneud â phobl yn ymwneud â phobl yn ymwneud â phobl yn ymwneud â phobl yn ymwneud â phobl yn ymwneud â phobl Mae moddwch yn moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n moddwch chi'n modd.

It's not spoken about in such a public forum, so it's great to be able to talk about it today. Yeah, really important. And you founded a gaming for good company, Playmob, in 2011. What was the aim of that? Felly, yn 2011, yng Nghymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, a'r Cymru, So they sold a seed, a virtual seed, that you can plant on your virtual farm.

ac mae'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio'n gweithio

ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n mynd. Felly mae'n ymwneud â'r cymdeithasol o'r cymdeithasol o'r cymdeithasol o'r cymdeithasol o'r cymdeithasol o'r cymdeithasol o'r cymdeithasol. Microsoft has estimated that the average modern gaming console emits around 72 kilograms of carbon dioxide emissions every year. Then you've got the manufacturing process.

excess packaging. Uh and in two twenty twenty four your company was acquired by Planet Play. Uh that's where you currently work. And you co founded the Playing for the Planet Alliance with the UN Environment Programme.

Dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod, mae'n dwi'n gwybod.

Rwy'n gwybod ychwanegu Sam Barrett yn ymwneud â unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw unrhyw mewn gwirionedd yn ymwneud â llawer o beth ymwneud â llawer o beth ymwneud â llawer o beth ymwneud â llawer o beth ymwneud â llawer o beth ymwneud â llawer.

Rydyn ni'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i'n mynd i

yn gwneud gwaith, yn gwneud gwaith, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr, a'r rheolwyr.

you know, change behaviour, raise money or even um yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n yw'n

I mean, there's more women now in the industry than there was before. I can't remember the exact stats, but it's getting better, but it could be better. In terms of women leadership, yeah, it needs improvement. And that could help. But um

Yeah, I mean s so many women play games, so it'd be great to get more women into the industry. Tell us about your green game jams. What are those? Yeah, so the green game jam, that was actually from the um that was a an idea that came from the Playing for the Planet Alliance. And the green came jam is Studios like to do something together and when you can do something together you can create real impact.

A jam is typically, studios get together and they make a game quickly, but this is the biggest entertainment games. We've got like Pokemon Go, Haydee. uh Angry Birds, you know, all these games that are big and have got big audiences. So they come together to think about an environmental theme, whether it be forests or food.

Rydyn ni'n ei wneud yn ei wneud yn ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud Mae'n llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer o'r llawer?

Rwy'n ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud ei wneud Um and the the app stores are getting behind this as well. So, you know, around Earth Day, around World Environment Day you will see kind of editorial on games that are green. So you can, you know, play games that um are either giving back or raising awareness.

Um but yeah, it's really thinking about your energy consumption but also supporting the games that are helping to protect the planet too. Um absolutely fascinating. Thank you so much for coming in and congratulations once again on winning the awards. Uh Jude Our And if you're interested in hearing more on this topic you can listen back to our Women in Gaming series in full on BBC Sounds. Just search Women's hour, women and gaming.

I'm going to end with a couple of your messages. Just about the conversation we were having. I'm one of those lesbian women divorced in the early 80s. Luckily enough, I ended up with joint custody, but my sexual orientation was... front and centre of the whole thing thank you for highlighting this forgotten issue and that's from tina and uh another one here, l long after losing my parents and brother, I discovered that my father was not my brother's father.

Mae'n rhaid i'w wneud hyn yn ymwneud yn ymwneud yn ymwneud yn ymwneud yn ymwneud yn ymwneud yn ymwneud yn ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw'n ymwneud â nhw. family secrets and we'll be talking about lots more on woman's hour tomorrow join me then that's all for today's woman's hour join us again next time

I'm Paul Kenyon, and for Radio 4 and the History Podcast, this is Two Nottingham Lads. When the invasion happens, completely hell on earth with the sounds. The sad thing about war is people lose their I want to know how two men from Nottingham ended up on opposite sides in the war in Ukraine and what became of them after a chilling encounter in a prison in Donetsk. On two.

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