Birth of a prof

Arriving for an appointment with Lesley Regan at St Mary's Hospital, Paddington, the first thing you notice is the home-made poster on her office door. It depicts a fire-breathing dragon, menacingly poised above the legend "I'm 51 per cent sweetheart, 49 per cent bitch. Don't push it." Warning acknowledged, you step inside and are immediately confronted by at least 25 framed photographs of her identical four-year-old twins, Clare and Jenny.

The poster - an "entirely appropriate" gift from a former medical colleague - testifies to the drive and occasionally fierce temper which, alongside her outstanding clinical record and pioneering research into multiple miscarriages, have helped her to become the first woman in England to be appointed as a professor and head of department of obstetrics and gynaecology (O&G). The picture gallery celebrates the daughters whose fragile first four weeks of life transformed her approach to caring for sometimes "terrified and vulnerable" mothers of premature babies.

When she took office as head of O&G at the Imperial College School of Medicine at St Mary's in October, Prof Regan, 40, was astonished to find that, in the one medical field where every patient is female, she was the first woman south of the Scottish border to have reached the top of the academic tree.

"When the excitement had died down, the fact that I was the first, and the significance of the responsibilities, began to sink in. I found myself rather awed," she recalls. "I have to offer a specialised clinical service, teach undergraduates and post-graduates, and head a research programme. I just hope I can get the balance right."

One in six of the 1,230 consultant obstetricians and gynaecologists in the UK is a woman, a considerably higher proportion than the number of female consultants across other surgical specialties. None the less, Regan has frequently been the only woman at hospital meetings. Discussions with the other 50 male university O&G professors will not, therefore, come as a shock. In any case, such under-representation has never bothered her.

"I don't pay much attention to it, partly because of my refusal to recognise that it is a problem and partly because of my father's influence when I was a child." A journalist-turned-distribution manager for The Daily Mirror, he convinced his daughter that "You are who you are and you do what you want to do", regardless of your sex.

"Women of my generation who were practical got very annoyed by Germaine Greer and co and the whole business of feminism," she says. "If you said something sensible the reaction from the men would be `Feminist! She's burned her bra.'" She declines to "toe the party line and give a great spiel" about the prevalence - real or imagined - of male chauvinism in medicine, because she feels she has not been on the receiving end. However, she volunteers one personal example which shows male doctors in an unflattering light.

"When I worked at a hospital in the East End of London, the three male consultants had never had a female senior house officer before. One of them bet 20 quid I would never be able to pass the primary surgical fellowship. Twenty pounds was still quite a lot in 1981, but I passed the exam and won the money."

Regan believes her new post offers "a unique opportunity" to act as a role model, encouraging female medical students and junior women doctors to stay in the profession, and in O&G in particular. "Medicine is losing a lot of women because they don't plan for their children. Saying `Oh, I'll be able to sort that out later' is unrealistic. Being on call one night in three is a crippling workload for people without kids. With them, it's virtually impossible. Since I was appointed I've had umpteen women doctors ask me for advice about combining children and career. If you plan ahead and take advantage of the part-time training arrangements, which allow women to take time out while their children are young, there can be a happy medium."

That Prof Regan did not become a mother until she was 36 was because she was "fortunate enough not to meet the right person" until she had finished her up-all-night training. She married Professor John Summerfield, a liver specialist at St Mary's, in 1990, with Regan becoming step-mother to four children (now aged 12 to 24). Their twins were born six weeks premature at St Mary's in December 1992, and spent the next month in the special care baby unit. "It was the most humbling month of my life," Regan recalls. "I felt so very dependent. The girls were never actually very sick, just small. But even with all my knowledge it was still desperately frightening.

"To see your baby on a ventilator when you have no obstetric knowledge must be absolutely terrifying. Having experienced those emotions, I now make absolutely sure mothers know exactly what's going on at every stage. Since I've had children my patients seem to be much more reassured by the advice I offer them."

Clare and Jenny are now "a couple of complete bruisers and an absolute joy. They have inherited my determination, which will stand them in good stead later in life."

Throughout our meeting, Regan talks 19 to the dozen in long, articulate bursts. When she discusses her work on multiple miscarriage - the 1 per cent of women who lose babies on three or more occasions - the disarming energy and commitment in her voice reach their peak.

"I chose O&G as a specialty because it is a happy and positive area where seriously ill patients are relatively few and far between. In general, patients are pleased to see you," she says. "But when I was training I encountered the most heart-rending miscarriage stories. Whenever I saw a woman or a couple who'd lost a child I didn't know what to say. The dry stuff in textbooks didn't help. It was my feeling of complete impotence which directed me towards research."

Over the past six years, her work at St Mary's, which has the largest recurrent miscarriage clinic in the Western world, has revealed that some women carry antibodies that make their blood more likely to clot during pregnancy. Clots in the placenta obstruct the blood supply to the unborn child, often causing miscarriage. But by screening women for these antibodies and then, as soon as they conceive, giving them daily doses of aspirin or heparin injections to inhibit clotting, Regan and her colleagues have achieved an "enormous" success rate. Allan Templeton, professor of O&G at Aberdeen University and a member of the committee which appointed Regan, says she has made "a major contribution to clinical practice".

The desire to remain at the forefront of what she calls a "revolution" in the use of molecular science within O&G and to persuade junior doctors to pursue research are the two things that are going to get Regan out of bed every Monday morning in 15 years' time. "The infertility and miscarriage patients I work with often feel lost and vulnerable. But when you see your research moving things forward, and when you succeed with individual mothers - that is quite, quite wonderful"