Emma Barnett: 'I have a hypertonic pelvic floor' - Episode Transcript

Helen

And we're back. Hi, I'm Helen, and this is Why Mums Don't Jump. Busting taboos about leaks and lumps after childbirth. All the stuff that happens to your pelvic floor that no one ever talks about. Incontinence, prolapse, pelvic pain - problems that affect millions of women, one in three. I'm one of them. I have a prolapse. My pelvic organs fell out of place after the birth of my second child five years ago. And if you'd told me then I'd be speaking about this stuff out loud, I would have told you to give your head a wobble.

Hi and welcome. Series two is happening and we are picking up where we left off, really. So if you're new to the pod, then please do go back and check out the last series as well as this one. And if you're not new to the pod, then thanks for coming back and I really hope you're going to enjoy this series as much as the last one. And you know what, I'm sure you are, because there are tons of brilliant guests coming up. More women sharing their experiences of pelvic floor dysfunction and the expert voices who have been helping us to get our heads around it all. I'm not going to waffle on about me today, because this episode, well, it's one that I've been trying to make happen for a while now. It's the award-winning BBC broadcaster and journalist Emma Barnett, host of the institution that is Woman's Hour on BBC Radio Four, regular presenter of Newsnight, author of the very honest and very funny book 'It's About Bloody Time. Period.', which looks at taboos around menstruation and Emma's own experiences of endometriosis. Oh and she's a fellow Northerner.

Emma

I am wearing Buzzin' Our Kid - my Manchester T-shirt...

Helen

Extra points for that one!

Emma

...which me, my son and my husband all have.

Helen

Emma and I worked for the same radio station until recently. And a couple of months ago, I produced a discussion about pelvic floor problems, which she hosted. And in the middle of it, she said in passing that she has a tight pelvic floor, right? Which is where the muscles are just too tense and can't relax, and it can be really painful. And nobody ever mentions that, least of all on the radio. So I asked her if she'd mind having a chat about it and she said yes.

Emma

Can I just say I'm so happy to talk about this and that you've asked me the question, because for a long time it was all in my head, or I thought it was. And if I can just help one woman with this, I would feel like I'd done a really good job, actually, because I would have loved to have heard this conversation when I was scrabbling around on the internet late at night when my son was around three months old, thinking, am I losing my mind here? But basically, I felt after my birth, once the C-section wound had healed a bi, and I was more mobile, I just felt like I couldn't...okay, so for women listening - obviously men have a pelvic floor, too - but for women listening, you know what I mean when I say I couldn't bring it down? Like when you're stressed and it's all up - your pelvic floor - which basically, if you don't know what your pelvic floor is, it's an umbrella of muscles, isn't it, supporting your undercarriage. That's not a technical way of describing it, but it felt like I was holding my breath in my body. And I don't know if I'm explaining that well, but I just couldn't relax my pelvic floor and I just I couldn't bring it down. And I wasn't. I mean, obviously you're stressed when you're a new mum and you're trying to figure stuff out, but even when I was relaxed, you know, I was watching telly, the baby was asleep or I'd just done a feed and it was all quite chilled, you know, I couldn't get this thing to go down and and it's one of those things that's a bit like when you're a kid and you think about swallowing. The minute you think about swallowing, you don't know how to do it. Or the minute you think about breathing, you forget how to breathe. I'd never thought about this thing until I thought about it and then I was like, oh, my goodness, what can I do? And it took me, I don't know, about another month from that point to realise I wasn't going mad and that there was an issue. And I could tell you what I did next in a minute, but just to get to a sentence that is actually more medical, I have a hypertonic pelvic floor since having my child. And I didn't even know that was a thing.

Helen

No because everything anybody says is that it will get weak or damaged. So you're thinking that that's going to be the problem.

Emma

And also we grow up with completely no education to speak of in this way about our bodies, as women or as men. And pelvic floor is always linked to sex, isn't it? Especially when you talk about women and having a looser pelvic floor and then urinary incontinence and that's just all really unsexy, right? And then the idea that your pelvic floor is anywhere near your genitals, and then you were to say, oh, it's really tight, people might be like, oh, that's great, isn't it? Isn't that a great thing? And actually it is one of the most upsetting things I've ever been through.

Helen

And was it painful?

Emma

Yes, because and I've had it flare once since. And so basically, I could talk about treatment and all of that in a minute, which perhaps you do want to hear about, but I had a flare up during lockdown, the first lockdown last year, and I think it may have been - this is me doing cod medicine here, but by the way, basically that's all I've got when it comes to my other condition, my disease, which is endometriosis, because we still don't know what causes it. We still don't have a cure. And for somebody listening who doesn't know what that is, it's where lining, which represents like the womb lining, doesn't leave the body and stays in and can cause all sorts of issues, mainly huge amounts of pain, but also infertility, which is why I had to have IVF. But I had this flare up last year and I just again, couldn't get it down. And I had to go back and have what I now know is women's physio, pelvic physio, which is usually for the opposite, like you're saying. And I had forgotten how bad it was because it had already been about two and a half years. And you know how your memory does that amazing thing of going, yeah, it was bad, but it wasn't that bad. But I was wandering around during lockdown in the park, the local park, because what else could you do? And I love the name of your podcast because never mind jumping, I couldn't run because it would aggravate it and that is painful, really painful.

Helen

And what was the point at which you were like, right I've got to go and get some help?

Emma

Well, I remember I was doing some work at twelve weeks. It was just the most...you know you have keeping-in-touch days? I used two of mine to guest present the Andrew Marr programme on a Sunday morning on BBC One, like you do. Never hosted that show before and very kindly - and all respect to the male producers - had me on their list if Andrew was ever to take a day off and he did. He wasn't very well sadly, and they still asked me, bless them, twelve weeks after giving birth, so respect to those guys, and I thought to myself, you know what, I didn't die. I think I could still do it, I think my brain works. Everybody said it was okay for me to do as two of my keeping-in-touch days. I wasn't breaking the rules with my mat leave. And the reason I bring all of that up is I was obviously quite stressed in the run up to hosting a TV show when I'd been off work for three months. And there were big write ups in terms of newspaper stuff afterwards. Not about me, per se, but actually about the interviews because they were quite eye catching for various reasons of the news at that point. I mean, I personally was thrilled because Gogglebox took a clip from it. So that's just me happy. But in the run up to the day, to the Sunday, you work on the Saturday on that shift. And I was with the producers and I was just like, I couldn't stop thinking about what was going on my pelvic floor. Like, I was trying to sit there thinking about Brexit policy and Labour's position on it. And I was trying to think about online and how the government were going to launch this particular paper. I remember I was interviewing Matt Hancock. He was the culture secretary. So I was trying to get my head around some quite complicated things, and all I could think about was my bloody pelvic floor. And I said to myself, right, if I get through the next 24 hours, I've got to get through them work wise. I am going to make myself a promise that I'm going to see somebody about this who's a specialist. And that is what led me on to a service on a website which was called Mummy MOT. And that led me to my amazing physios, who I don't know if I'm allowed to name check people?

Helen

Go for it!

Emma

But I just have to say the whole thing is so shrouded because nobody talks about it. I felt like I was looking something up that was kind of weird. I don't know how you found your....

Helen

Yeah it's like how do you get to that point in your life and not even know that these things can be problems and then find out that this whole medical world, or physio world exists that you've never heard about before?

Emma

Well, the shout out I really want to give is to my personal physio is Martha Kinsella, and she is one half of the Maria Elliott Physio Services, the MVPS. But, you know, I didn't find her straight away. I actually went to another place, which was just quite a random place. But this is a whole other thing I'm about to delve into here, which is insurance policies. So, I have no private health care, most people in Britain don't, but my husband did through his job and I thought, you know what? If I've got something serious here where I'm going to need some physio, I might as well look if there's a partner policy. I know I'm hugely privileged to be able to even say that and to look into it, but I did not have that because I was freelance at the BBC at the time, or I was semi staff. I don't even know if we do offer that at the BBC. But my point was, I didn't have the means to do it in terms of being covered, because I knew I'd probably need lots of sessions. Now, obviously, I am also in the very fortunate position to be able to afford these sessions, but even I found the sessions extremely expensive. And so the reason I'm bringing all of that up is I remember I managed to go somewhere else that was covered by my husband's policy and getting it covered and explaining it, by the way, to the insurance company - they were like, oh, you're having fertility treatment? I was like, no, this is the opposite of fertility treatment. This is me trying to cope with my body after I've actually had a baby. Bless the person on the end of the phone. They didn't even know how to enter it...

Helen

Oh, my goodness.

Emma

...into the insurance system. And I'm only telling you that story because obviously...I'm backtracking a tiny bit. The first thing I did was try and see if I can get it on the NHS. That's obviously my first route, because that's all I use, right? That's what we do in this country. It's the best thing in the world and we pay into it and we only want to use it when we have to. And obviously we're not in a pandemic where you're thinking, I won't go. I mean, that makes me so scared who's not getting support at the moment in lots of ways as we live through a pandemic, but I couldn't find anywhere near me. And then when I sort of got nearer to it within the NHS system, I could see I wasn't going to get anywhere anytime soon. And I was desperate, Helen. I was like, I've got to just at least get a diagnosis and then maybe I can do some exercises myself or something.

Helen

You need to try something. You need to have some hope that you can move forward with it, don't you?

Emma

Yes, completely. And I actually felt there wasn't a community out there about hypertonic pelvic floor. I know that it's still really taboo to talk about the opposite, the loose one - there's probably a good name. -but I didn't know who I could talk to. It was awful. And I remember going in to see this woman and she was French, and she said, oh, yeah, you've got a hypertonic pelvic floor. And I went, what? You know I'm a journalist, I love information. Obviously, I was on that the minute I got out of there, reading all about it, but she treated me and she began the physio and she said, yes, it's really bad, but it's not as bad as I've seen, so you're lucky. I was like, oh my gosh, it could be worse? And I'm getting quite emotional even thinking back to this, because I was lying on the table and it was the first time I'd sort of been apart from my son for a long period of time. I mean, I know I'd done that shift at work, but I don't know, because it was to do with him and his birth, and I thought, am I ever going to be normal again? Please fix me. And actually, it's like any other muscle. You've got to work at it, you've got to calm it down, you've got to learn techniques to relax it and a lot of is breathing. And then I found Marta and I've been with her ever since. And it's not an insurance coverage. I just want to be completely transparent. I've paid to see her and she does amazing work and I honestly can't tell you how grateful I am to have found her. But I really can't bear to think that some people don't know or can't afford or can't access this sort of care in their area. And the thing I really want to say to you is, actually, you can do quite a lot on your own, if you know - the breathing work. And the best one that was said to me was imagine you're in an elevator, if you want to bring your pelvic floor down, and you're on the 10th floor, and just be doing really deep breaths and imagining each floor coming down. And I'm not joking, it does work. Like, you feel everything relax a bit.

Helen

It's difficult, isn't it? Because it's inside, you can't see it. It's not like I've sprained my wrist and I can sort of see that it's a bit wonky or a bit swollen, and I can do things that will make it better. Like you literally - it's hard to see that progress when you cannot see inside yourself.

Emma

Yeah

Helen

And it's interesting as well that you mentioned the emotional aspect of it, because I think I had a similar experience when I went to see the physio that I have now. And I remember bawling my eyes out in there because I think it's just the first time that anyone really asks those questions, and it's your first opportunity to really let them out. And it is very linked to childbirth and the emotions around that. And I think sometimes - I've said it to her - she's almost as much of a counsellor or a therapist as she is a practitioner of physio.

Emma

Yeah, I agree. They sort of understand you and they know what's going on and they're trying to get you back to where you were, if you can get back there, or at least give you back to yourself.

Helen

Yeah. Yes! Get back to yourself. That's exactly it. That sums it up entirely. I've lost me because of this. How do I get back to me? Or at least get somewhere back to me? And it's not...a lot of these things may never be 100% fixed, you may never be 100% where you were before, but there is definitely progress to be made with all of it, I think, if you can if you can talk about it and if you can get the right help.

Emma

Well, I mean, I know that since we last spoke, obviously, I've got this new job with a big programme called Woman's Hour, and I hope with these sorts of podcasts and those sorts of programmes, we can get into people's ears who might not know about certain things. That's a big part of what we do as journalists. But I feel I listen to those programmes and I also read websites that will have news sites and features sites that have lots of things that are taboo. I wrote a book about periods and obviously that's a huge taboo and a lot to do with what we don't know and the history of the way they've been talked about and treated. But this wasn't even like it was taboo. It's just like nobody talks about it at all.

Helen

Like hidden on the dark web or something.

Emma

Yeah. It's like the first rule of your ruined pelvic club is not to talk about your ruined pelvic floor.

Helen

Yeah! So one of the things I wanted to ask you about, actually, was the book, because the way you talk about periods in that, really chimed with a lot of my thinking around this kind of pelvic floor dysfunction. And it comes down to the shame and the taboo and the lack of research around it. You talked about a lack of education in your book and just this sense that we should just put up with it all. That's the lot of a woman. It's really deep rooted and it felt a little bit like a call to arms for me, like, we need to stop messing about and ask for help and start to talk about this more. Is that sort of what you were feeling?

Emma

Yeah, I mean, it's not just talk about it. The most important thing you said for me there was research. Right? So I love you as a fellow Northerner going 'we need to stop messing around and we need to just deal with this'. And what that means is several things -talking is very important, lifting the shame, the taboo, the silence. I wrote my book, which its full title is 'It's About Bloody Time. Period.' because I was really intrigued by having unwittingly become the first person on live television to say I was menstruating on air, and it was really hurting, during a debate on Sky News.

Helen

That made me laugh out loud, by the way.

Emma

About menstrual leave, because a company in Brighton had tried it -whether we thought it was a good idea or not. And I didn't know it was a big deal to say I was having a period, because most of us are at a certain age once a month. And my fellow co host Nick Ferrari, who's a dear friend of mine, I mean, he looked like he'd vomited and eaten it again. How ill he looked. Graham Le Saux, the footballer, was trying to put a better face on it. But I bring that up because I then got all these women and some men get in touch with me and say, thank you for saying it hurts. Right?

Helen

Yeah

Emma

And because I've got a bit of a rep as a sort of tough journalist who asks difficult questions here and there, I think there was also a good thing to show that you can be strong, but also weak. And that weak is not bad. Weak to pain is reality. I walk around for ten days of the month like a little old lady. Nothing wrong with that. But I'm not. I'm 36 and my husband can see when it's begun. You know, I walk down in our hallway of our home and I come in and I'm sort of bent over double, and I walk in looking about 86, not 36. And I wrote the book as well, because when I said that on TV, I didn't know I had this disease. I didn't know I had endometriosis. And it took me 21 years to be diagnosed. And I was so ashamed, actually, despite having said I shouldn't have shame. But it's different what I'm about to say. I think it's okay to feel upset and frustrated that you didn't get a diagnosis when actually I'd gone to the doctor a lot, and through a mixture of GPs not knowing, and me not also being able to explain or express the pain, because I think the language of pain is very interesting. A lot of people cannot adequately describe pain, women or men. They can't pinpoint it, they can't answer the question. My whole life is about getting people to answer a question and I couldn't describe, I couldn't adequately answer. Although not all of it's my fault. And that comes down to the fact that one in ten women have endometriosis the world over, at least. Come on. We don't know. It's probably way more. And it takes an average of seven years to be diagnosed. That's just not acceptable. So I think it's not acceptable that in Britain we don't have postnatal care. In France, and this French woman who looked after me at first, they have six sessions for free, I believe, but you can double check me, of physio to help them.

Helen

Yes, I've heard that as well.

Emma

So my sister in law lived in France for the last few years. She had one of her children there. She said the aftercare was unbelievable...well why don't we have that?

Helen

So why can they do it there..? Yeah, exactly.

Emma

Can we please just agree that we need a bit of aftercare when we've done the equivalent of a marathon in our body once a day for nine months?

Helen

It doesn't feel like a great deal to ask for, does it?

Emma

No, it does not.

Helen

You mentioned about announcing that you were menstruating live on television. I guess I'm also on this mission to try and end some of the stigma around it. And for me, part of that has been getting past the embarrassment of even saying the word vagina and vulva. And I'm just wondering, have you ever found gynae issues hard to talk about? Or is it just not part of who you are?

Emma

No, not at all.

Helen

It's not like you've had to fight to get past the embarrassment? It's just never been a thing?

Emma

No. I remember when an MP asked me what my book, my first book was about - I say, first - it's the only book and probably will be the only book I write. But he asked me what the book was about and I said, Periods, and he said, oh, which period of time? I said, no, the one in my pants.

Helen

Eyes popping out his head.

Emma

It was great. No, I've never struggled with it. And I think I've been a defiant girl into a woman about that stuff forever.

Helen

Yeah, you're lucky

Emma

I blame Judy Bloom. I read her as a child and I felt like she gave me the language. Nobody else did. She did.

Helen

She made it acceptable. And I guess Westminster not massively known for being female friendly, and you are known for your big, hard hitting political interviews. I'm just curious, career wise, has there ever been a point where you've worried that writing about periods or advocating for women with endo or saying vagina on the radio would have you pigeonholed into that sort of 'women's things'? Emma and her vagina again, and not allowed or not been accepted in the world of political journalism? Has that ever been a consideration or has it always just worked out?

Emma

I like the idea of that headline. It's Emma and her vagina again. I think what's interesting, to reflect quite seriously on that, is that 'women's issues' in inverted comments are not talked about with the same seriousness of tone as, let's say, football. Right, so, but let's put maybe fashion in for women's issues, which is seen as a female issue, although the last time I checked, men wear clothes. Fashion is a multibillion dollar business around the world, incredibly important to our country and our GDP. Football the same. One is talked about with the breathlessness and the seriousness, as if life and death depended on it. And one is talked about as, oh, isn't it lovely to have a new pair of high heels? I think the way we treat 'women's issues', or issues that pertain to women as soft, fluffy and not as important, is as old as time began. And that is what I rage against and that is what I like to change and I like to do it through humour. I hope you can hear that. I think you can take people with you who aren't necessarily against you through making them smile and making them laugh. Not always. You've got to say some serious stuff in between all of that. But I remember going on to - they will remain nameless because I don't want to get her into trouble - but I remember going on to a particular radio programme when I was talking about my book and the person to do with the programme said to me, there's no way, if you or anyone else who'd written this book, that we would have been allowed to have you on and do half an hour on periods. But because you cover Brexit and because you cover politics, the editor is hoping you will actually spend quite a lot of your time lifting a lid on Westminster.

Helen

Oh, wow, okay.

Emma

And I said, Well, I hope he's tuned in, because we're not going to talk about that. I got a free pass. Not a free pass in terms of the interview, but I got a few interviews I don't think I would have got had I not been, quote, unquote, a 'serious journalist'.

Helen

Yeah. Wow.

Emma

So I used it to my advantage, is what I'm trying to say. But I shouldn't have to play that game.

Helen

Yeah, this should be as serious. End of.

Emma

Yeah and I remember going to see - again will remain nameless. And when you write a book, as I've only done the one, and I learned about the book industry, you go and see people who might like to buy your book, as in the publishers, to get a book deal. And I remember being seven months pregnant, wandering around, dragging my sorry body into these places and into these publishers. And there was one man who insisted upon seeing me despite not liking the book idea. And I thought to myself, well, this is a bit odd. And he's very important. And he said to me, he wouldn't say the word 'period' during the whole meeting. He called it 'lady issues'.

Helen

Okay. Good. Right.

Emma

I was like, wow. He was like yes, I've got three daughters you know and 'lady issues' are a big thing in my house. And I was like, mm-hmm. Lady issues. Maybe we should rename Woman's Hour that. I'm joking. But it was just a funny phrase and it stayed with me. And he said to me, Listen, nice idea. Maybe for the second or the third book, but don't you think you need to write a proper book? A proper book about politics, news, Britain, history, power, leadership. I thought, wow, okay, I'm having this meeting and you don't want to do the idea I'm come with. So are you just expecting me to change my idea, which I've written thousands of words of? Just on the fly here, mate?

Helen

Wow.

Emma

That was a meeting to remember. He didn't buy the book. I just want to clarify that.

Helen

No, clearly not. I'm going to let you go in a minute, but you've got this new big job at Woman's Hour, you've got a child, it's a very busy time. How are you feeling physically? How's the pelvic floor? How's the endometriosis? Just, how are you doing, Emma?

Emma

Yeah, I mean, do you know what? I had a really bad flare up at Christmas again with my endometriosis. Not with my pelvic floor, actually. And if you'd asked me then, I would have said that I was a bit of a walking wounded situation. I've had a bit of a good wind for three weeks, for which I am grateful. And the pelvic floor was a bit bad last week, but it sorted itself out. It settled down a little bit again this week. I mean, I do have a job at Woman's Hour and a job at Newsnight that are live broadcasting jobs and they are not for the faint hearted in the sense of live broadcasting, as you know, having produced and edited people like me, is a very exciting environment and it's a huge privilege, but you are processing a lot of information very quickly and you've got to...

Helen

You've got to turn up, you've got to be present.

Emma

...yeah it's adrenalized. Right? And I actually say my job, although some people would find it hard just anyway, it is hard, obviously, with a chronic pain condition and, for instance, I do find sometimes standing at the beginning of Newsnight, like you need to, quite hard if I'm having a bad day with my endometriosis. So there are little things like that. But by and large, I actually find my work is my salvation when it comes to living a life in pain, because it completely takes over my body, because my mind is active. And to have such a busy job is - apart from the fact that it's a great job and I get to talk to such interesting people and think about so many different things and educate myself and be educated by those talking to me - it's a great job for my illness as well. I have learned how to use it to distract myself.

Helen

Yeah. And I guess the last thing that I tend to ask people is for women who will listen to this and are dealing with whatever pelvic floor problems or endometriosis or gynae issues of whatever kind, and are suffering in silence, what message would you have for them?

Emma

Get as much information about it as you can. Write down what you think you're feeling as you're feeling it. So I'd keep a diary or use one of the apps to monitor your symptoms each day. See if you can really be the best advocate and the best person for you to tell a professional how you feel. For years, I couldn't articulate something I used to have when I menstruated, which is I have a feeling down my legs, it's a really bad leg ache and I feel like I'm being pulled towards the centre of the earth. If you'd asked me that, I've had it for years, I couldn't say it to you until I read on the Endometriosis UK website, which is why I say, tool yourself up with as much information as possible, but that is a classic hallmark of my disease. So I think if you can write down or say it to your friend, partner, husband, whatever, cat, dog, if you can say what you're feeling and keep a good note of it...and then the real work begins of trying to see somebody and actually get some treatment. Treat it like a full project, like a full time thing, even if you can't do it full time, because there's nothing more important than your health. Everything else suffers if you don't give it the attention. It's like people who say oh I'm too busy to see the doctor or make the call. But you're not too busy to watch 40 minutes of Netflix, are you?

Helen

Yeah. It's priorities and it's important. It's important.

Emma

All the love, all the feels. I'm sending you all the solidarity for living with something horrible and you scared and you think it's just you. I've been there. I really have. But I'm a great do-er. And if I knew you, whoever you are listening, if I was allowed, and we weren't in lockdown, I'd come round and I'd sit with you and I'd interview you and get all your symptoms out of you and I'd write it all down with you. And then I'd try and find the best person locally for you to go and see.

Helen

Great advice. Oh, Emma, thank you so much. I really appreciate you finding the time to speak to me. I know you're really busy, so I'm sure that'll be really helpful to a lot of people.

Emma

I'm never too busy to talk about my hypertonic pelvic floor!

Helen

Oooh sentences you never thought you'd have to say.

Helen

So many sentences we never thought we'd have to say but getting this information out there has to be a good thing. If you want to know more about type pelvic floors, I'll link another couple of episodes in the show notes, as well as putting links in there for the things that Emma and I talked about today.

In the next episode, I'll be speaking to Tiffany Sequeira, who's @gynaegirl on Instagram. And just like Emma mentioned, we'll be talking about the need for better education around pelvic health, as well as how to make it more inclusive. She's brilliant and fun, and I highly recommend it.

Before you go. This is really cool and perfectly demonstrates what a brilliant community we have. I want to say a massive thank you to Cat Pearson, who listened to the podcast and was so keen to help spread the word, that she sent me a message to offer her design skills, her amazing design skills. I obviously said, yes, please, and she's taken the website and the logo to a whole new level and created some gorgeous illustrations which say exactly why Mums Don't jump. Cat, you are awesome. Thank you.

I am not a medical professional, so please don't take anything you hear as medical advice, but do subscribe, post a review, tell me what you think and spread the word. You've been listening to Why Mums Don't Jump with me, Helen Ledwick.

You can find me on Instagram at Why Mums Don't Jump or online at Why Mums Don't Jump.com