I am an NHS obstetrician hoping to share some thoughts and experiences about my working life. Maybe you enjoy call the midwife, perhaps birth fascinates, or you are simply curious about what exactly an obstetrician is? You might be pregnant and preparing for birth right now. Perhaps you work in maternity care and want to know what makes your obstetric colleagues tick, or you want some fresh ideas and inspiration. Whichever of these is the case TheObsPod is for you. Each episode contains 'the zesty bit' the essence of what I hope you will take away from listening. I do hope you will subscribe and enjoy joining me. Find me on Twitter @FWmaternity & @TheObsPod & explore #MatExp matexp.org.uk to find out more about women and staff working together to improve maternity services. With thanks to Anna Geyer www.newpossibilities.co.uk for my beautiful artwork
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Can you run in pregnancy &how do you get back into running afterwards? Here I chat to Megan doing a PhD on running postpartum, what advice is there, do we know about it & how could we be more supportive & encouraging?
Thank you all for listening, if you have enjoyed my podcast please subscribe, rate, review &recommend my podcast on your podcast provider. Explore my back catalogue of episodes &feel free to get in touch to suggest topics, I love to hear your thoughts and ideas. If you have found my ideas helpful please recommend theobspod to others who may be interested in exploring all things pregnancy & birth. You can find out more about me on Twitter @FWmaternity & @TheObsPod & Instagram @TheObsPod please check out #MatExp matexp.org.uk for ideas about how to improve maternity experience. My beautiful artwork is thank to Anna Geyer www.newpossibilities.co.uk
Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider. If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth. Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small. Its easy to explore my back catalogue of episodes, I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor. If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Instagram @TheObsPod and email me on TheObsPod@gmail.com Please also check out #MatExp matexp.org.uk for ideas about how to improve maternity experience. My bea...
Florence
Hello, my name's Florence. Welcome to the Obspod. I'm an NHS obstetrician hoping to share some thoughts and experiences about my working life. Perhaps you enjoy Call the Midwife, maybe birth fascinates you, or you're simply curious about what exactly an obstetrician is. You might be pregnant and preparing for birth. Perhaps you work in maternity and want to know what makes your obstetric colleagues tick, or you want some fresh ideas and inspiration. Whichever of these is the case, and for that matter anyone else that's interested, the obspod is for you. A chat with Megan James. Fantastic. Today I'm welcoming PhD student Megan James to the podcast, and we're going to talk a bit about exercise, in particular, running in pregnancy and postpartum. And I came across Megan on Twitter where she was sharing some of the work she'd been involved in and also a current surveying questionnaire that she's involved in. And I was interested to have a bit of a think about the work she was doing. So welcome Megan. It's lovely to have you here today. Can you tell people a little bit about yourself and how you got interested in this topic?
SPEAKER_00
Yeah, so thanks for having me on to chat. So I first kind of did an undergraduate degree at Swansea University in Sport and Exercise Science, and I got really interested in the kind of biomechanics, injury prevention kind of side of things. Obviously, like a lot of people get interested in like elite sport performance side of things, which I thought maybe when I went into it that's what I'd do. But as I got to know more, I got really interested in kind of injury prevention and things like that, and just enjoyed doing lots of research towards my third, like the end of my third year. So that made me want to do a master's. So I then started a master's in sport and exercise science at Cardiff Met University. Again, kind of focused towards the biomechanics side of things, and started working quite closely with Dr. Izzy Moore, who supervised my master's dissertation. So I got quite involved with running at that point and kind of injury prevention in running specifically, and then worked quite closely with her on that and in my dissertation. And then I actually, towards the end of my master's, got involved with a project with her where she started looking at the postpartum population and returning to running in that specific population, as well as some pregnancy-related things as well. And it kind of panned from there where I just got quite interested in applying what I knew in biomechanics already and sports science into that area specifically and that population. So then it kind of just panned out that we worked together a little bit, and um I was lucky enough to get an ESRC funded PhD, uh, which I started in October at Cardiff Met. So I'm in kind of month eight or nine uh now. So yeah, it's going well. Um we'll just keep going.
Florence
So you're at the beginning of this this journey, yeah. Um and what are you hoping to find out or or achieve, I guess, by doing your PhD?
SPEAKER_00
So the kind of overarching kind of title that we went with when we proposed it was a kind of interdisciplinary approach to returning to running after childbirth. So, kind of the idea that um it like returning to running or kind of childbirth as a as a concept should be viewed in the same way as any kind of musculoskeletal injury should, that needs to be rehabilitated and it's not just something that happens and then you go, oh, after a after a certain period of time, you're okay to start running again. Um just with a view that it's something that needs to be like targeted from multiple directions, whether it be kind of biomechanics psychology that needs to be addressed, because it there's so many changes that women go through during pregnancy and childbirth, similar to you know, if if you have like a sporting injury that we that should be addressed, and they're all individual to each person's kind of journey. Um, so yeah, so hopefully the kind of project is about three or three years or so. Um, we're hoping to have kind of around three studies involved with that. Um, and hopefully by the end of it, we might have something to kind of add to the literature base in that we we try and use some kind of return to running program that's kind of informed by the earlier studies we do and see if it's effective or not in helping women get back into running.
Florence
Yes, okay. So at the moment, are you trying you're trying to explore why people don't get back to it or what the problems are?
SPEAKER_00
Yeah, so our kind of starting point we kind of agreed was um that we should first actually ask the target population and the users of the intervention what actually kind of stops you returning to running, um, what things help you return to running, and what things would you like when you'll be like when you're trying to return to running. Um, because a lot of the time I think as researchers we might not know, and there's not an awful lot of evidence on this population, it is starting to increase now. I think it's an area that's getting quite popular, so hopefully, like your work will complement some of the other stuff going on at the moment. Um, so it's yeah, the first kind of step that we're we're going in is trying to find out what they what they need, um, what they think will help, and then just going into a little bit more detail about how we could kind of shape that and target different things in an intervention. Obviously, they're using the kind of sport science theory that that we have already.
Florence
Yeah, and I so I saw your tweets and I thought it was really interesting because you know, theoretically, I should know lots about um exercise in pregnancy being an obstetrician, but I really don't, and we don't do anything in our training about what advice to give women, both antenatally or after they've had their babies. I mean, I guess you know that does overlap a bit with maybe physiotherapy more, but um, I have had women ask me, um, is it all right to run in pregnancy or when can they start exercise again postnatally? And I mean, there's really very little advice out there, and um I've I've even had women who've said helpful, and I say that slightly sarcastically, um friends and family have been like, what are you doing running, running while you're pregnant or running when you've just had a baby? And you know, given the population issues with obesity and um general health, um, it just seems really bad that there's such a kind of lack of evidence or advice, which I think is what kind of drew me to your stuff. It's like, oh, someone's actually looking at this.
SPEAKER_00
Yeah, um, because yeah, you know, like there are so many health and fitness benefits associated with physical activity generally, and then like running is one of the most accessible forms of activity because you can just go out and do it. Um, and yeah, like that there's there's been like a few like reviews on the kind of uh advice and guidelines around physical activity generally during pregnancy and postpartum, and the consensus is that there's loads of inconsistency between countries or just a lack of advice generally, um, but then in terms of running specifically, there's even less on that kind of area, and there's a bit of a stigma around running because it's like a high impact activity. A lot of the time, people will just say, Oh, just go and do some lowest, lower intensity stuff that isn't gonna put you at risk. But generally, like it's been said that it's considered safe uh during pregnancy and postpartum. Obviously, postpartum, you don't just you don't do it straight away, but um, there is guidance around that. But during pregnancy, it is a safe form of exercise, just as long as you don't kind of fall into a few contraindication categories and things like that, and as long as you didn't not run before, it wouldn't be a great idea to start running during pregnancy when you hadn't before. But there's just this kind of taboo around it as a as a subject, and as you said, like so many um, even in our research that I can talk to you about later, there's people like quotes in our in our research that say things like I feel guilty for going because so and so thinks I shouldn't, or you know, things like that where yeah, or like they feel like they're not giving enough time that they shouldn't be taking that me time because they know I'm a different role now.
Florence
Yeah, yeah, and and and and I was really so so looking up when one of my um patients asked me actually, um, and she was saying I mean she'd had a potency complication, and one of her family was saying, Oh, it's because you weren't running, and I was like, No, absolutely not. And and I found this lovely infographic um which presumably you've seen, um, this I'll put it in the programme notes, but this one, the physical activity for pregnant women and postpartum, and it says, aim for 150 minutes of moderate intensity activity every week. And I'm looking at the women in my antenatal clinic thinking I doubt very much that any of them know that that is the actual guidance. And certainly, as obstetricians and midwives, I don't think we're telling people that. And I know some of my colleagues, when they've been pregnant, have done you know, specific pregnancy fitness regimes and and stuff like that, but we often tell women to walk or go swimming and do low impact stuff like you're saying, um, but without any really good or you know, reason, um it's it's not good really.
SPEAKER_00
Yeah, and and my argument is always I feel like I repeat myself when people ask about it, but is if you got injured running and had a musculoskeletal injury, your like healthcare professional or whoever wouldn't just say, Oh, just don't run again, just go and do something else. Yeah, after both people seem to go, oh just go and do something else. And it's like, why should that happen? Why should there not be just more research and evidence and advice going into this instead of just brushing it off as not a big issue, you know, and it also kind of encourages then that active lifestyle for the children if they're growing up in so it's it's a very beneficial activity, it's one of the most accessible activities, but it just doesn't seem to get the attention or it's you know, or the sample the target population doesn't seem to get the attention it deserves. Um, I do think that's time to change. Um, but obviously doing a PhD in an area with little research is sometimes challenging as well. Um but it's a lot we've got to start somewhere, I suppose. And that's like we've I've spoken to my supervisors and we've said, okay, we've got three years, um, we'll try and do something. Obviously, we're gonna try and do something good, but it it might be the case that it's a stepping stone because there's so much that needs to be done. We're not gonna do anything absolutely life, like world-changing with rules, but it hopefully will start complementing other work and kickstarting things in the right direction.
Florence
Yes, yeah. And when you're talking about she mentioned a bit about biomechanics, so I'm interested in that because biomechanics is a bit of a buzzword in the maternity world at the moment, you know, kind of how you can manipulate your pelvis and exercises and things you can do in labour to try and get the baby in the right place and so on. But um, you know, I kind of at a basic level, I suppose I think, well, I know there's hormonal changes on your ligaments and joints, I know your centre of gravity is different, you know, there's different pressure on your back. Um, but you know, I don't know a lot about the physiology and and changes that that means would happen in terms of your musculoskeletal system.
SPEAKER_00
Yeah, yeah, so like a lot of the focus of my PhD is we've decided to kind of at the moment anyway, things always change, but at the moment we're we're looking predominantly at the pelvis in terms of biomechanics, which is obviously not a surprise. Um just because of the kind of trauma that you know goes through the pelvic floor, it's got it's one of the main, it's one of the you know, the main sight really, isn't it? Um and so we're kind of the main thing we're looking at is like loading on the pelvis. So obviously, like this the stigma around running is that when you run you hit the ground, and the ground reaction force or you know, that comes and shocks through the body is then shocking the pelvis, and that's supposedly supposed to lead to pain or um you know those kinds of things, it basically increased loading. Um so one of the things that we're looking at is how we might kind of measure that on a kind of graded pathway of exercises, um, just to see between like individuals or whatever how how there are differences between them, and like see, you know, how when you're certain stages how that looks, and maybe to see like how you know, if you're doing X amount of running, how is yours compared to this person who's doing that much, or if you haven't returned, um, and just kind of looking at as well strategies that we can employ and movements that we can use to either change running uh technique or kind of just other movements that get you ready to run but aren't actually running or you know, a little bit less intense, just to see if that reduces some of that load. Um, because there's a lot of stuff on kind of gate retraining and lower limb injuries, like like with the tibia, you know, you get a lot of work around like patello femoral pain at the knee, um kind of stress fractures and stuff in the lower limb, um, you know, measured with kind of things like ground reaction forces, tibial acceleration, but there's not a lot done further up on the pelvis. Um, a lot of the time when people talk about things like shock attenuation, which is kind of absorbing the force where from where you hit the ground through the body, it's often measured from the leg to the head, and nothing in between is thought about, and it's like there's a lot going on from those viewpoints. Um, and I know that obviously it's uh you know, we there can't be research on everything, but it is it is a bit of a gap in the literature, we don't know exactly from what's going on, and if you think about then you know, postpartum women, that's like the main sites where they've been through trauma. We don't know what's going on there, so a lot of my PhD is is probably going to be quite exploratory and just looking at okay, so what does this kind of look like? Yeah, um, so yeah, it's gonna be interesting, I think.
Florence
Yeah, and are you um and with that, I guess there's also um sort of as an obstrician gynecologist, there's the pelvic floor, and I know some women have said to me, you know, they've had difficulty perhaps taking up running again because of um consonance or you know, difficulty controlling their their bladder. Is that something you've found in your kind of surveys and things so far?
SPEAKER_00
Yeah, so we've done a couple of studies. Um one of the uh papers that we released, so the paper that we released first was uh it was published in 2021 um and in the uh BJSM, and it's called multidisciplinary biopsychosocial factors contributing to return to run-in and run-in-related stress urinary incontinence in postpartum women. Um, and some of the things that we we kind of looked into things and looked at, you know, what are the factors that contribute to returning to run-in, but also returning to the same level of run-in as before pregnancy, because for a lot of people that's important, like it's one thing having just got back to running, but it's different getting back to where you were. Yeah. Um, and we kind of found that this was another survey study, we we found that obviously running during pregnancy, a high weekly run-in volume, a low fear of movement, so kind of the psychological psychological component, uh, and not suffering from vaginal heaviness increased the odds of returning to running. Whereas a low weekly volume before pregnancy, having more than one child, a lower fear of movement and being younger, and a shorter time to their first run after childbirth increased the odds of returning to that pre-pregnancy level. And then we also looked at the kind of risk factors that affected uh stress, urinary, incontinence, or likelihood of having postpartum running related specifically, so you know, experiencing during running. And we found that if you they suffered from it pre or during pregnancy and had returns to running, they were more likely to have it. Um, and if they had a cesarean delivery, they were less likely to. So there is that kind of debate around, you know, like delivery modes and things.
Florence
Yeah.
SPEAKER_00
Um so that kind of gave us a little bit of ideas of things. That was like, you know, the the first kind of study that I was involved with anyway, um, that gave us some ideas of things that obviously need to be addressed in advice and things going forward. Um, and then yeah, we did a second and third paper following up to that um in the Journal of Women's Health Physical Therapy. Um, I can give you links or whatever to these if you want to post therapy. And um, yeah, so our part A looked at why women stop running during pregnancy and don't return to running during postpartum. Um, and we found that things like morning sickness, fatigue, things like that obviously like stopped people running, and then kind of not returning was due to like symptoms or pain and postpartum complications. But also like women, even who had returned, were concerned about leaking urine, pelvic floor dysfunction, um, and it was just pelvic floor was just prevalent throughout pregnancy postpartum, and people who'd returned and not returned. So it's and it's one of the reasons I think why we're so focused on the pelvis in our in our work. Um, but it just shows how much more evidence there is that's needed. And um a lot of people said they were concerned they didn't know how to run safely afterwards, and we went on to do then a part B to that, which looked at kind of how advice uh affected their habits. Um, and we found that only 37% of women received any prenatal advice. Um, 31% received kind of broad postpartum advice, yeah. Um, which is not high, like one in three-ish women um people are runners, so I'm um sad to say that I'm not that surprised that people are not getting that advice because I'm thinking the midwives and doctors they're saying probably don't have the knowledge and physios who might have the knowledge are just spread so thin.
Florence
I mean, to have a women's health physio is you know it's difficult. So I can see that there's that massive gap potentially in advice.
SPEAKER_00
Yeah, and um, you know, and the thing like one of the most important things we found in that paper as well was that kind of having received any kind of broadly sourced running advice postpartum was related to them having returns. So those who actually got advice had returns. Right. Um, and then kind of there's um, I should mention there's been released, I think it was 2020, um, clinical guidelines, which are the first kind of return to running guidelines released by a team of um uh physiotherapists, um, Tom Goom, uh Grania Donnelly, and Emma Brockwell. Um, and they've released them as the first kind of return to running clinical guidelines based on like clinical opinion. Um, and you know, they they emphasize that they know themselves that it needs to be evidence-backed, yeah, but this is kind of our best, to the best of our knowledge, what we would recommend based on the literature, the limited literature that's out there. Um, and we looked at kind of if people were aware of these guidelines as well as kind of generally what's out there. And women who were aware of those guidelines, I think it was 94% find them useful out of the women who'd seen them. And um Those who actually had read them took longer to return to running, which we actually were surprised by at first, but then thought, actually, are they just being more cautious and informed in their return? Um, so yeah, we just thought like that paper as well, just highlights how important it is to get advice to be more accessible, and also that it just needs to be individualized and specific to people as well, like because there are so many. I know it's it's impossible to do it to every single person, but when there are so many factors to think about, you know, delivery mode, age, number of children, or like loads of different things that might affect how women recover. Um just need there just needs to be so much more, basically.
Florence
But even a start about women or you know, the healthcare professionals looking after them, knowing there is some guidance, yeah, and publicising that guidance and people finding that guidance use useful, it's a start, isn't it?
SPEAKER_00
100%. Yeah, that's one of the things we said, I think, was that it needs to just even like as well as women being educated, everyone needs to be educated.
Florence
Yeah, and that's kind of what why I thought it'd be good to get you on the podcast because I know quite a lot of midwives um and obstetricians listen as well as uh pregnant or uh women or new mums, and so actually, um if you can give me the links to some of these things, then hopefully that might disseminate things a little bit more.
SPEAKER_00
Yeah, of course. Yeah, like that's the thing, it's it's like bridging that gap as well between academia and um practice, isn't it? Because some even even though there's limited research, if there is some, it's maybe not getting into the where it needs to be used.
Florence
I think they say it's something like seven years or more, isn't it? From from something being discovered to actually being implemented minimum.
SPEAKER_00
Yeah, probably. And I think we I think as part of my PhD, um, one of my supervisors as well is um kind of very big on public health, and I think part of the PhD will be okay, we can find something out that might be useful or not, even if it's unsuccessful, it'll be good because people will know it doesn't work as much as anything else. Yeah, but okay, we can find out whatever, but we need to be able to disseminate it effectively, otherwise, there's no point. Yeah, um, and I think part of the PhD will be working with the uh target population to talk about how best we can get this information to you because if we can't get this information to you, it's not that not that worthwhile in the end. Um you know, obviously it adds to the literature base, but we want it to get to people, it's gonna help. Um and hopefully, with some of the things that we're looking at doing and and trying to see if things work, we're hoping to have kind of measures that people could maybe do themselves that make it more accessible rather than saying, well, you're gonna have to come into the lab with us. Yeah. Um, but we'll have to see how it goes.
Florence
Yes, yeah. No, that's really good. So I know you've got um so you've got an e-survey out at the moment. Do you want to talk a little bit about that?
SPEAKER_00
Yeah, yeah, so um, yeah, so our study one, as I kind of meant briefly mentioned earlier, is trying to figure out um what helps and hinders women returning to running and what could help them or what they would like to help them return to running, um, so that we can then later on target those specific things with an intervention or return to running program uh to try and actually address their needs. So it's basically for anybody who's over 18, gave birth in the last two years, and ran for at least 30 minutes before their most recent pregnancy. Um it's about a 10 to 15 minute e-survey. It asks a bit of descriptive and demographic information and kind of history first, just to see kind of what people we have answering and if we can like link things to things. Um and then it specifically asks those questions of what helped you, what hindered you, what would you like to help. Um, and if ever like if anyone responds, if you could just give as much detail as possible so that we can help you. Um and yeah, it'll hopefully just help us understand what we need to look at. And the link is on my Twitter page, I've retweeted it so many times. Um, so my Twitter handle is at Megan L James16. Um, but obviously, if if you want to tag me um to see it, that's fine. Um, and yeah, there's a link on there to the to the e-survey. So if anybody is eligible who's listening, or if you know people who are eligible, please feel free to pass it on because as many people as we can get because people are so different. Looking at all corners of the population will be the most beneficial.
Florence
Yeah. How many people are you hoping to get after have a kind of mind?
SPEAKER_00
Yeah, we were kind of going for about 500.
unknown
Yeah.
SPEAKER_00
So the the papers we released um before had about 800, nearly 900. Yeah. Um, we're hoping about 500 for mine. Um, I think we're currently around the 220 mark, so yeah.
Florence
It takes a bit of time. Excellent. Well, that's that's really good. Um, and I can definitely put that link in the in the programme next for people to share. Um, that'd be really, really good, I guess. Um, yeah, anything you think um that we haven't talked about that would be good to to discuss?
SPEAKER_00
Yeah, it's just it's just about getting that word out to everyone, I suppose, as you were saying, and you know, working together with um clinicians and academics. Like um, when we published these papers, we had Grania Donley on our team member Brockwell, Joe Perkins, who are all kind of physiotherapists, pelvic health physiotherapists. Yeah, it really helped that because you know, my background isn't I'm not a physiotherapist, I don't pretend to be one. Um, there are people who know a lot more than me about pregnancy and things like that. Um, but it's about like working together to kind of you know use each other's knowledge and bridge those gaps. Just hopefully it'll it'll start putting us on the right track, and um it's just quite an exciting area to be working in, so and rewarding as well.
Florence
Yeah, no, it sounds like it, and it sounds like you know, it it's work that's really needed, and that I accept, you know, within your PhD, you might not, you know, it might just be the foundation and the stepping stone, but you know, my goodness, it could bring really big change or benefit in the long run, couldn't it? If actually more women were able to safely get back to running or encouraged to be running both during pregnancy and after having their babies.
SPEAKER_00
Yeah, exactly. And it's it's you know, it's one of those sports as well that it's accessible, but it's also what a lot of people do to keep fit for their main sports if they're not runners. Yes. If you're like a netball player, hockey player, you'll you'll go running to keep fit. So it's all yeah, it's and it's you know, it's a bit of a I think a lot of people would make sure they're back running before they went back to those sports.
Florence
Totally. My daughter plays football and she she runs to keep fit, and also in the off season, so that when it's pre-season and she's getting back into it, she's ready because she's been running all through the summer.
SPEAKER_00
Yeah.
Florence
Um, so yeah, very much it it's kind of something that people use to maintain their fitness for something else as well, isn't it?
SPEAKER_00
Yeah, definitely, yeah.
Florence
Yeah. Oh well, thank you very much. That's been really interesting. Uh, and I wish you lots of luck with it, and um and I look forward to seeing amazing things happen. But but that's really great, thank you.
SPEAKER_00
No problem, thank you so much for having me on.
Florence
Let's think, what's the zesty bit from that fabulous conversation with Megan? I guess a couple of things. One would be please, please, please, if you fit her criteria, you're over 18 and you've had a baby in the last couple of years and you're a runner, fill up her survey. And if you're a maternity professional, try and disseminate it to women who might be able to fill up the survey. But on a practical note, if you look in the show notes, I've put the guidance that she mentioned, and there's some really great information in it, both for women themselves and for physios, GPs, midwives, health professionals caring for women in the postnatal period. There's a really great appendix flowchart on how to assess women and whether they're ready to resume running, as well as an appendix on exercise progression for those first few months postnatal that would help you build up and get ready to restart running. So check out the guidance, check out Megan's links and answer her survey if you possibly can so that we can help progress this fascinating area and support women's health and women's exercise in the future with better quality information and advice. I very much hope you found this episode of the Obspod interesting. If you have, it'd be fantastic if you could subscribe, rate and review on whatever platform you find your podcasts, as well as recommending the ObsPod to anyone you think might find it interesting. There's also tons of episodes to explore in my back catalogue from clinical topics, my career and journey as an obstetrician, and life in the NHS more generally. I'd like to assure women I care for that I take confidentiality very seriously and take great care not to use any patient-identifiable information unless I have expressly asked the permission of the person involved on that rare occasion when it's been absolutely necessary. If you found this episode interesting and want to explore the subject a little more deeply, don't forget to take a look at the programme notes where I've attached some links. If you want to get in touch to suggest topics for future episodes, you can find me at the Obspod on Twitter and Instagram, and you can email me at the Obspod at gmail.com. Thank you for listening.
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