00:00Joined by the consultant obstetrician, Bryony Jones.
00:03And Bryony, of course, is the woman behind.
00:05I'm not going to shy away from this, Bryony.
00:07You have played such a significant part in this story,
00:11which is on the front page of the papers today.
00:13You're working this morning, working as normal, gone back to work.
00:17But tell us, this couple came to you or had the transplant
00:21and you were brought in to be the obstetrician to lead their care.
00:26Why was this case so special?
00:28Good morning, Bev.
00:30Good morning.
00:30No, this was a really honour and a privilege to be part of this amazing team
00:34that have made this amazing pregnancy
00:37and had this lovely baby Amy into the world.
00:43It's a difficult journey and actually I met,
00:45been part of the team which precedes the pregnancy.
00:47So it's really important that there's a whole team behind
00:50making sure that the transplant is safe,
00:53that the patient remains safe whilst they're trying to get pregnant.
00:56And obviously once they're pregnant, looking after the pregnancy
01:00and monitoring both the mum and the baby.
01:04And so you delivered this baby by caesarean section.
01:08Just explain to us why she would have to be born by caesarean.
01:11So because of the uterine transplant,
01:16it's really important that the woman doesn't experience any contractions
01:20because that could jeopardise the transplant,
01:23the blood supply to the womb.
01:25And so the only way of delivering the baby safely is by caesarean section.
01:29Because Amy, the mother, sorry, Grace, was born with ovaries but no womb.
01:33So this baby is biologically hers, using her own eggs and her husband's sperm.
01:39That's right.
01:41How is it different as a carer of this couple
01:44to manage that pregnancy journey with them
01:47compared to a normal couple, if you like?
01:49There are lots of women who have complicated pregnancies.
01:53So clearly as doctors, many obstetricians have experience
01:56in looking after complexity and our job is to make keep mums and babies safe.
02:00Clearly this is the first time we've looked after a woman
02:03who's had a transplant.
02:05But a lot of the same principles apply
02:07and there's a whole team behind me
02:09ensuring that both the mum and the baby were safe
02:14and monitored throughout the pregnancy.
02:16But yes, it was joyous.
02:17It's an incredible opportunity.
02:19It was deeply rewarding
02:21and an absolute joy to be part of the team.
02:24How nervous were you that it was all going to work out OK?
02:28Because this is a major step.
02:29That's why it's international news.
02:31It's on every front page.
02:32We're all talking about it.
02:33Because first of all, you've got to remove the wound from her sister.
02:37Big, big surgery.
02:38Then you've got to be implanted in the mum.
02:41And then you've got the cesarean.
02:43I mean, big, big surgical steps.
02:45I guess so.
02:46Perhaps naively, you look after her as you would do anyone else.
02:51I mean, I think you've just got to look at the medical issues.
02:54You're caring for the patient.
02:56You're doing the things that are needed.
02:58The day was special.
02:59It felt special because it was the accumulation of years of work
03:03from the Womb Transplant UK team.
03:05And I was incredibly honoured to be part of that team.
03:08The surgery was complex, but actually it had a really good outcome.
03:13And it was just, it was a great experience.
03:15I have to say, I'm going to admit,
03:17a little bit of a watery eye looking at the baby being held by the mummy afterwards.
03:20There were 16 of you in that surgery.
03:23Was there quite a lot of people crying?
03:25I think we all held it together.
03:27I think we just, there was a lot of joy.
03:29There was a lot of joy.
03:30And remembering that this was a special day for us,
03:34but it was a super special day for Grace and her baby.
03:38And it was the birth of their beautiful baby.
03:40And so we were trying to keep that as normal as a special for them.
03:43Now, critics or cynics or sceptics might say,
03:47well, this couple could have adopted a baby or they could have used a surrogate.
03:52Why would she put her own health at risk?
03:54And of course, at some point,
03:56she will have to have the uterus removed as well for the remainder of her life.
03:59So she's not on immunosuppressants.
04:01Can you explain, having got to know the couple,
04:03why that was so important to them?
04:06I think you probably have to speak to an individual woman.
04:09But I can reassure you that she went into this with a full knowledge of the issues that might arise.
04:16But also, we are used to looking after women who have other organ transplants.
04:20And to me, probably having a uterus transplant or a womb transplant
04:23is no real difference than someone having other organs that are transplanted.
04:28And I think medical research does push boundaries, but I think in a positive way.
04:34And I think it's given her the opportunity.
04:36And for many women who, like Grace, were born without a womb,
04:40to give the opportunity to have a baby.
04:43So one in 5,000 women are born through no fault of their own without a womb.
04:47But it gives them hope to be able to, if they choose this pathway,
04:51not every woman will choose the same pathway,
04:54but at least it gives them hope and another choice.
04:56West Street and the Health Secretary, who was doing the rounds this morning,
04:58suggested that this could end up being on the NHS.
05:02I mean, certainly that is something we would like to explore.
05:05At the moment, this has been charity-funded for the transplants.
05:09But I certainly know that that's what a transplant in the UK
05:13would want to consider for the future.
05:16But clearly, that has to be political decisions.
05:18Yeah, because there's some people contacting the show this morning
05:21and saying, well, you know, I've been waiting two years for a knee operation.
05:24I've been waiting for a transplant that would save my life.
05:27Why should, that phrase, why should a couple like this
05:30be given this kind of treatment on the NHS?
05:31It does raise ethical questions, doesn't it?
05:35I can see that point of view.
05:36But just, again, to reassure you and your viewers,
05:40that the transplant itself was charity-funded.
05:45Doctors like myself gave up our time and our free time to care.
05:49And so it wasn't taking away any care from somebody else.
05:53So they didn't, it wasn't, someone else was delayed because of this.
05:57The other ethical dilemma, Brian, is this idea that maybe men transitioning
06:04to be a trans woman might want a womb.
06:07There's been some research of this in other countries.
06:09Can you picture a time, and the charity that's funded this
06:12has said categorically on their website,
06:14that is not something we endorse in the foreseeable future, they say.
06:16But can you see a time when men might be able to receive a womb
06:21and then give birth, biological male?
06:23I can't see that in any near future, both in the UK or worldwide.
06:30Yeah.
06:30The hormonal implications, you have to.
06:33You fancy it, Andrew.
06:35Look on his face.
06:36How, for the baby, just the same as any other baby,
06:43I mean, is she, is she, is she,
06:45what's it going to make a difference to her life, do you think,
06:47knowing that she's the first ever in this country to be born in this way?
06:52I mean, there have been other firsts, for example, the first IVF baby.
06:55And so I wouldn't imagine that she will,
06:58she will have a lovely, fulfilling life with great parents.
07:01And I wish only the very best for her.
07:03And maybe another baby?
07:04We have to wait and see.
07:06A little sister, a little brother?
07:07We have to wait and see.
07:08You're up for doing it again, if they're up for it?
07:10Absolutely.
07:11Absolutely.
07:12It was, did you know it was on the front page of the paper this morning?
07:16Like, when did you see this and realise what a big story it was?
07:18I have to say, as a doctor, probably not very, a bit naive,
07:21did not anticipate this was going to be such an enormous story,
07:24but obviously clearly delighted and very respectful
07:28that they've chosen to go public with their story.
07:31Because originally they wanted to remain anonymous, didn't they?
07:33Anyway, what do you think changed that decision on their part?
07:38Do you have any idea why they then said, we don't mind?
07:40Because it was a success story, presumably.
07:42I genuinely don't know.
07:44I genuinely don't know, but clearly supportive.
07:46Because I'm interested in the figure you gave,
07:48one in 5,000 women without a womb.
07:49This would be a great encouragement to those women who read this story
07:52and think that could potentially be me.
07:55That's a very good reason to go public with this story, I think.
07:58I think so, and I think that clearly there are some women
08:01who are born without a womb, but other women might have lost their womb
08:04due to cancer or other conditions.
08:06And this also gives them a hope of potentially carrying a pregnancy.
08:09Yeah.
08:10Just take me back to the moment then, when the caesarean was performed
08:13at Queen Charlotte's Hospital around the corner.
08:15And you have that quiet, don't you, in a delivery suite like that,
08:19in the ward, in the surgical room, when you're delivering the baby.
08:24What was that like when she emerged?
08:27It was really important that it was a quiet moment.
08:31And you can imagine in a big room where there were lots of people,
08:34actually noise control was really important, but it was really special.
08:38It was that special, magical moment, and it was really delightful.
08:42And did they know it was a girl or a boy, or did they not know?
08:45I can't remember, actually.
08:47Ah, I'd be fascinated to know.
08:48Yeah, I imagine they probably didn't mind either way.
08:51No.
08:51I don't think that was important.
08:52All they had been through, they would just be happy and grateful.
08:56Well, it is a miracle of modern medicine, Bryony.
08:59And you're part of it.
09:01I'm a very small part of a very large team.
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