UCL Minds


Transcript: Episode 29

How is the pandemic affecting pregnancies & new parents?


women, lockdown, contraception, pregnancy, ucl, people, pandemic, support, baby, pregnant women, services, survey, fertility, moms, patients, maternal deaths, fertility treatment, clinics, affected, exacerbated


Mary Fewtrell, Zeynep Gurtin, Jenny Hall, Vivienne Parry


Vivienne Parry  00:02

Hello and welcome back to Coronavirus: The Whole Story and the second of our two part a special on the impact of Coronavirus on women. My name is Vivienne Parry. I'm a writer, broadcaster and UCL alumna, and the host of this award winning podcast, all about Coronavirus and the efforts of UCL staff and students to understand it from every possible angle. Now last week, I spoke to two researchers whose work showed the wide reaching and disproportionate impact of Coronavirus on women, especially those from ethnic minorities. The pandemic, as we've seen so often has exacerbated existing problems and dumped a whole heap more on our heads and women's perceptions that they got the fuzzy end of the lollipop with lockdown with work, family and homeschooling seemed to be backed up by evidence. Some of this is coming from the extraordinary weekly survey involving over 70,000 people masterminded by Daisy Fancourt and her team. Last week, Daisy gave us an update on the increase in mental health issues experienced by women. And if you want to catch that episode, or indeed any other from our now substantial back catalogue, you'll find them on the UCL Minds website. This week, we've invited three researchers in women and child health to take us through the virus's impact on fertility, pregnancy, and new moms. And let me introduce those researchers to you. My first guest is Dr. Zeynep Gurtin, a lecturer in women's health in the UCL Institute for Women's Health. Zeynep's research focuses on fertility and reproduction, which she studies from social, ethical and gender based perspectives. During lockdown her research has focused on people whose fertility treatment has been affected by coronavirus. I'm also joined by Dr. Jenny Hall, a clinical associate professor and an NIHR advanced fellow at the UCL Institute for Women's Health. She is an honorary consultant in public health medicine at uclh and Public Health England, and has been working as a senior epidemiologist on COVID-19 since March. Alongside this work. Jenny is an investigative scientist on cap COVID a study monitoring the effects of the pandemic on pregnant women. And last but not least, my third guest this week is Professor Mary Fewtrell, a professor of paediatric nutrition. From the Great Ormond Street Institute of Child Health, she researches population health and reproduction and development with a focus on nutrition. But this year, Mary has been co leading on the COVID-19 new mums study which aims to understand how the pandemic has affected mothers who've had a baby in the last year. Zeynep, let's begin with you. Tell us about your research on how Coronavirus has affected people trying to get pregnant.


Zeynep Gurtin  02:40

And so I think as part of the experiences of lockdown, we've been very used to the narratives and the difficulties that people have been having when families have been indoors or homeschooling small children etc. But there has been a very large group of people who've had a slightly different set of difficulties. And these are people who were going through fertility treatments, and all of the clinics as a response to lockdown closed during March and April. And so these men and women were left with huge amounts of uncertainty, not knowing whether they will be able to restart treatment where the waiting lists were going to get longer, and how their treatment might be affected in the future as sort of coronavirus to cold. So our research we were multi multidisciplinary group collaborating across the reproductive medicine unit at uclh. And the Institute for Women's Health, we really wanted to do kind of a rapid response study to understand the experiences of these fertility patients. And really just, you know, very briefly, we found that there were some very, very intense feelings of anxiety and sadness and feeling, you know, extremely upset and distressed as people found their fertility treatment to be disrupted in this way. And we have to remember that this


Vivienne Parry  03:57

is an intensely stressful experience in the in the first place.


Zeynep Gurtin  04:03

Absolutely, absolutely. And as you said, in that I was listening to last week podcast, which was, you know, fascinating this idea of the pandemic highlighting existing problems and divisions and inequalities. And really, that's what we saw with regards to fertility patients, too. So here we're talking about a group of people who are already going through what is an uncertain and very stressful experience. And that was very much heightened and exacerbated with with all the circumstances of the pandemic. And unfortunately, we did have a lot of our respondents we had sort of 501 respondents tell us about their experiences and we did have a lot of people mentioned how difficult it was to go through that experience with jokes around a lockdown baby boom, or with all of their friends, complaining about looking after their children full time at home or people making sort of slightly insensitive jokes around or while you're so lucky, you don't have to worry about homeschooling and things like that. So really exacerbating all of the difficulties that those men and women, particularly women experience anyway.


Vivienne Parry  05:09

And I guess that sometimes people don't appreciate that time is so much of the essence for these couples, you know, time ticks on relentlessly. And if your treatment is delayed by a year, it may simply mean that you don't get pregnant, because every year that goes on, so your fertility declines.


Zeynep Gurtin  05:30

Yes, unfortunately. And that was that was a cause of huge amounts of anxiety, particularly in the early days of lockdown when, when people didn't know how long the clinics would stay closed for. And, you know, we had some very heartbreaking quotes from women who said, You know, I really don't want to look back and think that, actually, these lock downs were the reason why I was robbed of my chance to try to become a mother. So a very keen awareness that, you know, time is of the essence, and especially for men and women who were slightly older unit feeling the sense that closure of even a few months might make a huge difference to their ability to become pregnant. But also, we had quite a few people who were concerned about time, not just in terms of age related fertility decline, but for other reasons, you know, people saying, Well, actually, no, we've been trying to get pregnant for a long time. And we're not we're not necessarily in the older category, but still for us, every every month or every few months that passes, it's very painful. So time was certainly a huge, huge factor in in people's thinking about this.


Vivienne Parry  06:34

So what's the situation now about clinics? Have they reopened? Or have they reopened, but with restrictions in place?


Zeynep Gurtin  06:42

And Well, fortunately, most of the clinics in the UK have now reopened, and they do have new working protocols in place to you know, wearing masks and social distancing as much as possible. Of course, that's not entirely possible when you're doing something like fertility treatment, and fewer, fewer patients allowed into appointment. So sometimes, women not being able to have their partners at appointments with them. But most clinics are, are open. I mean, unfortunately, what we did discover as part of our study was that support Patient Support wasn't really in place. So it wasn't so much about the fact simply that the clinics were closed. But that's the women who responded to our survey felt that there was no communication from the clinics about the situation and when the clinic might reopen, and how they would find out about it if the clinics were to reopen, and how the clinic might prioritise which patients to see. So it wasn't. It wasn't even just the fact that the clinic was closed, but that there was so much uncertainty around that closure and a real lack of communication that made life difficult for the patients.


Vivienne Parry  07:51

I want to turn now to the other side of this is about contraception rather than fertility, but contraception, because we've made the point lots of times in these episodes how Coronavirus has exacerbated existing problems. But before Coronavirus hit, a lot of women were having problems accessing contraception, particularly the type of contraception implants or the coil which involved having to go to a GP or fertility service. And of course, that's got even worse during lockdown. And there's been a lot of unanticipated pregnancies. And that's a lot of heartache to women. Is this something that falls into your work, Jenny?


Jenny Hall  08:36

Yes, this is so we set up a study in May that's called COVID with the intention of exploring the impacts of Coronavirus on pregnant women in the community. So lots of studies obviously have hospitalised pregnant women. But we wanted to make sure that we caught the experiences of women who are having perhaps milder symptoms, and to make sure that we could unfollow those women up to see if this did have any adverse impact on the outcomes of their pregnancy. But at the same time, we were really keen to explore women's experiences of accessing contraception around the time that they conceived. And so one of the things that we asked women was whether in the months before that they got pregnant, they'd found it more difficult, less difficult or about the same in terms of accessing contraception. And then we asked them a set of questions that gives us an indication of how planned or unplanned their pregnancy was, so that we could see whether or not women were having more difficulty accessing contraception during lockdown, and whether this would result in more unplanned pregnancies.


Vivienne Parry  09:47

And it did.


Jenny Hall  09:48

So we are analysing the data at the moment the study is still ongoing, but preliminary looks at the data suggests that yes, there's been a big increase in the profession. of women who said it was more difficult for them to access contraception in the months before they got pregnant. And that we are seeing that this is showing more unplanned pregnancies in those women.


Vivienne Parry  10:11

And presumably some of those women might have opted for termination. But how have How have those services been affected?


Jenny Hall  10:19

So those would have been classified as essential services, they were not closed. And women would have been able to access those in the usual ways, either going through a GP or going straight to those services, and they would have been been dealt with as essential care. So if they were in early pregnancy, they could have had all their assessments done virtually over the telephone or video conferences. And early terminations can be carried out medically, so medicines could be sent to the woman for her to take at home. Later. terminations obviously, require face to face care, but they should have been able to still access those. But there's obviously a difference between the service continuing to be provided. And whether women know that that is still being provided and whether they have their own concerns about accessing those services at the height of the pandemic and whether that presents a barrier, even if the services are officially open.


Vivienne Parry  11:16

It's something I want to come to you all later on at the end of the programme, when we're talking about what COVID has revealed about women's health services in general because it's actually exposed some some gaping holes, I think. But let me just first ask you, Jenny about the impact of getting COVID on women who are pregnant.


Jenny Hall  11:39

So our study was designed to look to see whether Coronavirus in early pregnancy would increase the risk of miscarriage. We're still collecting data on that. So from our study, we can't say anything on that yet but from studies conducted around the world, that doesn't seem to be it seems that the risk of coronavirus in pregnancy is greater later in pregnancy. So in the last trimester, the last three months of pregnancy, and that's where if women have got coronavirus, it's been more likely to be severe and for them to have complications. But in terms of translating into deaths, there was a rapid report done earlier this year, which showed I think of the 10 maternal deaths that had happened in the timeframe. seven women had coronavirus or was thought to contribute in some way. It's a bit too early to say kind of what that will translate into because with maternal deaths we normally look at sort of three year rolling averages because the numbers are small. But overall from the global evidence. It doesn't seem that Coronavirus affects pregnant women more which we have seen with


Vivienne Parry  12:51

Yeah, so the swine flu was was very had a huge impact and it's on


Jenny Hall  12:55

Yes, and so when when Coronavirus started the concern was would it be like that and so that's why I think very early on women were put pregnant women were put into the vulnerable category and particularly those in the last trimester. And so now they had to go have absolute social distancing, and so on during the during the pregnancy. But back to the your point about the exacerbating existing inequalities. We know already in this country, black and minority ethnic groups have higher rates of maternal mortality. So women from black and minority ethnic groups are more likely to die during or shortly after pregnancy. And that is also the case with Coronavirus.


Vivienne Parry  13:31

What about the babies themselves when they're born to a mother who has COVID is the transmission to the baby.


Jenny Hall  13:39

So know that that seems to be the good news that transmission from the mother to the baby seems to be very rare. It doesn't seem to happen very much. And on the odd occasion where it has it hasn't seemed to severely affect the baby. So yeah, that is the good news. The only thing that has been noted is that women who do have coronavirus in pregnancy, there is an increased risk of having what's called a preterm birth, which is a baby born before 37 weeks of pregnancy. But at the moment, that seems to be what's called oragenics. So the doctors are doing that they are delivering the babies early either because the mother is not well, or because the baby's not well, there's some indication to get the baby out early. So yeah, it doesn't seem to be necessarily a consequence of the infection directly on the baby, but just how that pregnant woman is managed, seems to be resulting in the babies being born sooner.


Vivienne Parry  14:38

One last question for you, which is we heard a lot from Daisy fancourt. About how women have the the incidence of mental health problems have risen really quite dramatically. And women are more at risk from mental health problems anyway. How about pregnant women during lockdown


Jenny Hall  15:00

This isn't something our study has particularly looked at. But I do know that from the maternal deaths data that was reported earlier in the year, two of those deaths were actually suicides. And that is a sort of big unrecognised factor in in in terms of maternal death that suicide is actually quite a large contributor all around the world, but in the UK as well. So certainly COVID isn't doing anything to improve that I can imagine it's only exacerbating women's vulnerability and isolation during pregnancy and certainly contributing to negative mental health.


Vivienne Parry  15:43

You're listening to Coronavirus the whole story, a podcast brought to you by UCL Minds. And if there's a question about Coronavirus, you'd like our researchers to answer, email us minds@ucl.ac.uk or tweet at UCL. So we've now dealt with conception contraception pregnancy. Now to newborns. Mary, what's the new mums study?


Mary Fewtrell  16:06

This was a study that my colleagues and I set up back in May, partly because normal research has had to be halted. Normally our students are out collecting data by visiting moms and babies at home. Of course that stopped. And we were interested to know what the effects of the pandemic and lockdown would be on, particularly on the feeding practices of new mums. But also we recognise that the pandemic was going to have effects on other aspects such as their mental health and their ability to cope as well. And that would all be intertwined with their decisions about infant feeding. So we decided to set up an online survey, it's a one off survey takes about 15 or 20 minutes to complete. And we have recruited mums who have a baby born in the last 12 months living in the UK currently. And the survey basically collects details Firstly, on their background characteristics from the impact of COVID on their lives in general, including their ability to afford rent, etc, on their employment, and then information about their birth experiences, because we were interested in what was happening around the time of delivery, and then on their infant feeding as well. And then finally, we collect information on how the moms are feeling on their different aspects of their mood, as well. And so in the initial phase of the survey, this was like for the last week of the strict lockdown at the end of May, we had responses from just over 1300 months, which we have analysed. But we've actually kept the survey open. So we collected more data over the summer when things were a bit more relaxed, which we're currently analysing. We're up to about 4000 participants at the moment. And we're also now trying to recruit some more moms to complete the survey in the current lockdown. And this is particularly interesting, I think, because some of these moms would of course, have been pregnant during the lockdown. And now we're


Vivienne Parry  17:57

we've got doubly lockdown.


Mary Fewtrell  17:59

Yeah, effectively, lockdown. So in some ways, you may say the current lockdown is less strict and restrictive. So moms are allowed to go out and meet another mom with an under five. So it's different to the first lockdown. But on the other hand, they've experienced these this prolonged period.


Vivienne Parry  18:14

And is it particularly tough for first time moms,


Mary Fewtrell  18:18

but it's interesting. So in our first analysis, so this was the data from a week at the end of the first strict lockdown, we about half of the respondents were first time moms and half of them already had a baby. We didn't find that that was a particular factor that influenced the outcomes, whether infant feeding, or indeed the sort of mental health aspects, either, although I guess it's something you might have imagined would would be important. But no, that didn't come out as one of the significant factors.


Vivienne Parry  18:47

And it's interesting, because one of the things that I think has been highlighted, I don't know whether it's eased I suspect it has now but at the beginning of the lockdown, there were really stringent regulations about who could accompany a woman in labour. And it was basically nobody. I mean, it was just nursing staff and midwives. And I think that was very, very hard on people.


Mary Fewtrell  19:13

Yes. So we found that in that original data from that first week of the survey, 39% of the moms who had delivered since the lockdown reported that their birth plan had changed. And that tended to be either that they had had to change the place of delivery. So, for example, they couldn't deliver in a local small centre, they had to go to the hospital, or they were restricted in having their birth partners with them at different stages. And it could have been, for example, that they weren't allowed to have a partner with them while they were being induced. The partner was only allowed in while they were in active labour, and then had to leave quite soon after the delivery, for example. So this clearly had had, I think, quite a major impact on the mothers even though it was understandable why this was being put in place.


Vivienne Parry  19:58

Kai said just say I I'm probably a bit of being very ignorant about this. But I don't quite understand why the man you've slept with to get pregnant, who is with you all the time, why him coming in is going to be a risk to you and your baby?


Mary Fewtrell  20:15

I guess it's not so much thinking about the risks to the partner in the baby. It's perhaps thinking more about having more more people around in the unit and the risk of meeting other people and spreading the virus. I think that was probably the initial thought, in the early phases. I mean, I think things have become less restrictive as time has gone on. But I'm guessing that was the original thought behind it. It wasn't so much about the actual partner and baby being exposed. Yes.


Vivienne Parry  20:41

Although in fact, you very that doesn't, unless there's kind of a dad's corner where they're just saying, Oh, my God, how's it going with your end? Unless there's a dad's corner, which there isn't usually it's quite rare for men to actually meeting delivery suites,


Mary Fewtrell  20:56

I guess this was all sort of happening very quickly. And decisions had to be made, you know, rapidly in a involving circumstances. So maybe looking back, we would have done things differently. But that was the way it was at the time.


Vivienne Parry  21:09

I'm not getting it. You know, I know, I


Mary Fewtrell  21:11

know, I had no involvement in those decisions, fortunately. But I'm just sort of trying to imagine what you know what the thought process was at the time. Clearly, it did have a major impact, I think on the on the mums, although interestingly, we also found that there was some positive things around what was going on in hospital at the time, because the mums were getting good support with establishing breastfeeding. So with skin skin contact, and you put into the baby to the breast early on. So that that seems to have been maintained. The problem we found seems to occur after the moms had gone home were around, sort of more than 40% of them were reporting that they didn't feel they got enough help with support, particularly with breastfeeding. And that applied to both moms who delivered after the lockdown had started. but also those who delivered before who had a small baby, they also reported that the support had gone down. And a lot of the free text comments that we got talked about the difficulties with lack of face to face support, particularly with practical problems. And this was something that I think really came out of the those free text comments that you know, online consultations are fine for some things, but maybe not if you actually need sort of hands on help with a practical problem with a new baby. And


Vivienne Parry  22:28

I want to ask all of you because all of you in your each in in your own field have indicated some of the problems that your research has exposed, not just about how coronavirus affects your particular area. But actually, what did what did sort of highlights in terms of the services that were already existing and I wanted to devote some time before we finish to that zone, it wants it exposed as far as you're concerned.


Zeynep Gurtin  22:59

That's a really good point. So in the fertility sector, our our national regulator, the human fertilisation embryology authority, have been really keen to emphasise the importance of patient support for a few years now. And that's part of their code of practice is that all patients going through fertility treatment should receive support and sensitivity and caring communication. And that goes beyond sort of the availability of counsellors. It includes that, but it sort of, is really supportive treatment of patients right the way through their treatment. And I think what this you know, very unusual what this unprecedented occasion of the pandemic and the lockdowns revealed, were shortcomings that existed already. And that's, that's, that's a real shame. Because in many cases, what we saw was that there wasn't the infrastructure for patient support. So when something like this happened, many clinics weren't providing the adequate care and support and communication that patients needed. On the upside. What we did find is those clinics who did provide sort of mechanisms of support even those mechanisms that were sort of fairly easy and not particularly expensive, like providing Facebook groups or social media groups for patients, or a phone line that patients could call those things made a huge amount of difference. So I think while those shortcomings were revealed, one of the important things we can feed back is that actually clinics can action, much better support for patients without necessarily having to pour in huge amounts of financial or personnel into it. You know, we're talking about some fairly simple things that could be established here.


Vivienne Parry  24:39

So they could ditch some of their rather dubious add ons that a lot of fertility clinics offer, and actually concentrate on giving the thing that really matters and will really make a difference.


Zeynep Gurtin  24:51

Yeah, and communication and care were really the two big things that kept coming across and being echoed in the accounts of patients. Just one A little bit better communication.


Vivienne Parry  25:02

Jenny, what about both contraception services and early pregnancy services?


Jenny Hall  25:09

Well, the community based sexual reproductive health services that offer family planning have had a really, really bad few years in terms of funding cuts and NHS reorganisations that have fragmented the provision of care. So it's complex. Now, some GPS provides some services, but not all, for example, it might not be able to have a coil putting in your local GP. So you might have to go to a different service. And it's often very hard to get appointments just because they're massively oversubscribed. So that's sort of been a pre existing issue. But much like Zeynep said that there has been a positive side to the coronavirus pandemic, in that very, very early in lockdown, the faculty of sexual reproductive health came out with guidelines and recommendations on first of all, that these services are essential and should continue both contraception and termination services, and also how to how and where you could adapt to provide services remotely. And where face to face was necessary. So there were recommendations, for example, that if someone was on the combined pill, and they'd had their blood pressure checked in the last year and their weight was stable, then you could just reissue a prescription without them having to come back in have their blood pressure checked again, and so on have a face to face. There was also recommendations for bridging contraception. So women could have a six month prescription of a progesterone only pill, even if that wasn't something they were currently on. Because it has a very good safety profile, it's very few women that have not able to take it. And there was also joint guidance released from again, the faculty of sexual reproductive health, but with the Royal College of midwives, and the Royal College of Obstetrics and Gynaecology, looking at how postpartum contraception could be improved. So when women have just had a baby, either, you can put a coil in, if you're doing a Syrian section, you could do that at the same time. So women go home with an effective form of contraception in situ. Or you can start the progesterone only pill, straight after birth, or within three weeks of birth, whether or not the woman is breastfeeding, to prevent a rapid repeat unwanted pregnancies. So there have been some positives that have come out of it. And if things like that are maintained, then then that would be a really good thing to come out.


Vivienne Parry  27:33

Yeah, I was wondering about the things that are maintained, because one of the things that we've seen with COVID is that change, which might have taken years to achieve has happened extremely rapidly, you know, within a matter of weeks sometimes. And some of those things are kind of things we might not want to continue with. But some of them have just radically changed services. And we need to keep them. Do you think they will be kept?


Jenny Hall  28:01

I guess it's difficult to answer. I expect some will and some won't. I think it depends where you've been able to make structural changes that will enjoy and where they're where it's just been a patch, and things will have to revert I guess that will be what's key.


Vivienne Parry  28:16

What about your area marry in maternity and newborns?


Mary Fewtrell  28:20

Well, I think there were already recognised issues with the sort of workforce, particularly with health visitors even before the pandemic. And I guess that it's just sort of highlighted those issues in a way, particularly as some staff were redeployed to other areas, which made it worse in the in the initial lockdown, things have definitely, I think, improved, there's more guidance about, you know, trying to have face to face visits where possible, particularly for vulnerable women. But I suppose the other thing to bear in mind that during the initial lockdown, it wasn't just that the health professional support might not be there for mothers after delivery, they will also cut off from their other sources of support their friends and family. And as I've already said, having to rely just on online groups and support doesn't necessarily do the trick. If you've got very practical problems. We interestingly found that when we looked at the predictors of better mental health and coping, the mother having adequate support with her own health seems to be a very strong predictor, along with joining some sort of infant mother infant support group. So clearly, those things were very


Vivienne Parry  29:28

helpful when I meet pregnant women. The one piece of advice that I would give them after having spent a lot of time working in Obstetrics and Gynaecology, the one thing of advice is when you get home after you come back from hospital, hang up the phone, retreat, answer the daughter, nobody. And just wallow in being new parents because actually that that period two or three days after the birth, we know when somebody asks you Would you like a cup of tea and you burst into tears. And you find yourself you know, constantly washing up, while other people carry over the baby and don't give you any help. And you're kind of a hotel for all these people that come trooping to your home. And sometimes not having that is quite nice.


Mary Fewtrell  30:19

And certainly though there were some positives, I think that came out in a survey along those lines. But I suppose we're not talking about just a few days here, this went on for weeks or months with inadequate support. And it was very clear from the comments that mothers made that they were very much missing out on, sharing the baby with family and friends and getting that sort of not not even just practical support that sort of mental support as well. And we should give a particular shout out to grandparents here because a lot of grandparents have been completely cut off from their families, and not meeting newborns is is a is a terrible thing. for them. A phrase, which I think has been used in responses to other surveys is that mothers are feeling sort of robbed of the experience of motherhood, that the whole experience has not been what they expected. I guess you could say that for a lot of our lives. But this, I think, you know, having a baby is a particularly important part of the life experience that you can't get back. That was what people think we're trying to convey. And who knows what whether that will have any sort of longer term consequences for women in the way they interact with their babies.


Vivienne Parry  31:29

What is your own experience of knockdown been? I want to come to you, Jenny, because you've got twins of a year old. It's been tough, isn't it? What's your experience been?


Jenny Hall  31:44

It's been really tough. I started working at Public Health England in mid March. A tough case for a lot. Yeah. But it meant I was a key worker. And it meant there for my three children stayed at nursery. So I felt like I got off lightly, I had a very different lockdown experience to people who had, you know, 123, or more small children at home that they were attempting to look after, and entertain, and also still, you know, trying to do their job alongside but since late September, I'm now back mostly at UCL. And you we've already had my school son close for 10 days due to cases, we currently have the twins at home, because as a case in their nursery, and so, you know, my husband, and I just tag teaming, childcare and sort of two hours on two hours off, to look after them to try to still do our jobs, you know, work in the evenings, and just kind of try and keep everything going. It's it's hard. And I think it's it's the uncertainty of you just don't know, when it's going to happen. Again, there's no guarantee that the twins will go back next week, it's no guarantee that two days later, one of them doesn't spike a fever. And if you've got small children, you know that, you know, they're just prone to randomly having a fever at any, you know, any moment. So you've always got that kind of, I'm working now. But how long have I got?


Vivienne Parry  33:05

Married? What about you?


Mary Fewtrell  33:06

Well, my children are older, they're both at university. So I guess they it's not affected me practically so much in the sense that I don't have small children to juggle with work. But on the other hand, you have the worry about how young people's lives are being disrupted in a different way,


Vivienne Parry  33:25

I guess, and sending food parcels. Xena, what about you?


Zeynep Gurtin  33:30

Um, well, if I may, actually, I'd love to give the last word to one of our respondents. And I think it's just, you know, it's nice to be able to represent some of their words. And what one woman wrote was, she said, IVF is one of the most stressful things you can go through, to then be in the middle of that during a global pandemic makes it even more stressful. The cancellation of fertility treatments were heartbreaking. And jokes about the lockdown baby boom, we're incredibly triggering for those of us who have been desperate to conceive for so long. And I just, you know, I would just make, please, I know, it's very, very difficult to make massive structural change. But I think it's really important that we all look out for, you know, family, friends that are around us, and I think I would I would like to make a plea or sensitivity, I guess, for all of us to be aware that there are some, you know, there are some people out there who are having a really difficult time not because they're looking after small children, but precisely because they're not.


Vivienne Parry  34:27

That is a perfect way to end zone. Thank you so much for that. You've been listening to Coronavirus, the whole story and this episode was presented by myself that Vivienne Parry produced by UCL with support from the UCL health the public and UCL Grand Challenges and edited by the splendid Cerys Bradley, our guests today were Dr. Zeynep Gurtin, Dr. Jenny Hall, and Professor Mary Fewtrell. If you'd like to hear more of these podcasts museum as of course your word, subscribe wherever you download your podcasts or visit ucl.ac.uk forward slash Coronavirus. This podcast is brought to you by UCL Minds, bringing together UCL knowledge, insights and expertise through events, digital content and activities open to everyone. Bye for now. Hope to be with you again soon.