The Many Lessons of “Call the Midwife”

The popular BBC series, set in mid-century London, continues to instruct and inspire modern nurses

Nurses and a nun from TV show Call the Midwife care for a woman in labor.

First aired in 2012, “Call the Midwife” is a BBC period drama, shown in the U.S. on PBS, that follows groups of newly qualified nurse midwives living at Nonnatus House, an Anglican convent in London’s East End in the late 1950s.

The storyline of “Call the Midwife” was originally based on the memoirs of the late Jennifer Worth, RN, RM, about her early career as a nurse midwife. However, the show has continued beyond the period described in Worth’s books, showing the transition to the ‘60s and modern medicine.

The setting, Nonnatus House, is a fictionalized version of the real-life Sisters of St. John the Divine convent where Worth worked, which was established in 1849. According to my London friend, having secular nurse midwives living and working alongside Anglican nuns was an unusual arrangement.

Since the show begins less than 10 years after the establishment of the English National Health Service (NHS) in 1948, it may have been an early way of providing services in the poorer areas of the country.

Accommodations are made on both sides. New nurse midwives must mind their manners in the convent, while the sisters must learn to tolerate discussions about jazz, smoking, alcohol, and men.

Healthcare in the Poplar District

Poplar, the district the midwives cover, is a poor area of London’s East End, near the docks. At this time, it was unusual for residents of this area to see a physician because of cost, so infectious diseases were common, and diphtheria was endemic. The poor had low expectations of the healthcare system and did not expect comfort or good treatment.

In the show, in-hospital delivery is viewed with suspicion, so nearly all births are at home, attended by midwives who arrive on bicycles. During a delivery, husbands and other children circle around outside the tenement with friends and neighbors, listening for the arrival of the new baby.

These young nurse midwives, together with the convent sisters and a newly widowed physician, deliver 80 to 100 babies each month, an amazing total. (The suburban hospital I worked at in the 1990s also delivered 100 babies a month, but the patients came to us, and we had a large staff that included multiple obstetricians and specialists.)

Besides attending deliveries, the nurses at Nonnatus House also staff a weekly maternity clinic, and organize classes and clubs for the other children. My British friend explained that during this time, school nurses and school dentists delivered much of the medical care for English schoolchildren, also giving out nutritional supplements during rationing.

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In the process of attending to patients in their own homes, these nurses learn to practice a kind of public health. They’re attentive to the needs of the entire family, noticing when other children or the elderly require care. They answer various cries for help, dealing with diabetes, alcoholism, incest, domestic violence, racism, and poverty. The series shows the midwives in the observer’s position, noting the details of a situation and then leaping into action in whatever way they can.

Nursing Instincts

I wasn’t prepared to learn anything from a TV show. Current U.S. medical television often seems overwrought, devoted to romance, rare diseases, and uncommon surgeries. “Call the Midwife,” with its earnest, hardworking characters, shines by comparison.

Each episode features simple stories about everyday people and how they’re able to face and overcome their hardships — not by winning the lottery or being selected by a foundation, but by being nurtured and cared for by a group of excellent nurses doing their jobs well. Not all episodes end happily, but each offers an important lesson, whether it’s about healthcare, nursing technique, or human values and relationships.

Watching “Call the Midwife” reinforced for me how important it is to develop our nursing instincts. The show’s nurse midwives are out in the field by themselves, without cellphones to call for advice. If a delivery gets difficult and the characters truly need help, all they can do is stick their heads out the window and ask someone to go get another nurse for them

Many plotlines emphasize the nurse midwives’ resourcefulness and courage. In one episode, Chummy (played by Miranda Hart) is forced to deliver triplets by flashlight in an apartment without power. In another episode, when gas anesthesia is introduced to the Poplar district for the first time, Chummy tests the new anesthetic herself before any patients can use it. This is really nursing at its best.

“Call the Midwife” also shows the advantages of women living in a community. The young midwives gain wisdom from the sisters, in more areas than just nursing. Sister Julienne, the sister-in-charge (played by Jenny Agutter), uses a soft voice and empathy to rule the convent, but when necessary, she stands up for a pregnant patient in jail. The elderly Sister Monica Joan (played by Judy Parfitt), who is retired, has visions and speaks in riddles, but when she has a complete breakdown, the others gather together to help her back to health.

Nursing Education

Early on, the nurses pitch in to make Chummy, a large and not very self-confident nurse, feel at home, including teaching her how to ride a bicycle. Later, when Sister Bernadette (played by Laura Main) falls in love with the widowed Dr. Turner (played by Stephen McGann) and wonders if she should ask to be relieved of her vows, everyone gives her the support she needs to make her choice.

Filming the Birth Scenes

After watching a few seasons of “Call the Midwife,” I found myself wondering where the show found all the newborn babies who “star” in the episodes. I learned that for the first season, a call went out to practicing midwives, asking for suggestions, but later seasons use newborns provided through licensed agencies. Prop babies are used for the rehearsals. During the actual filming, the real infant is held in place between the mother’s legs, shielded by her thighs, and then handed off. The real mother may either be in attendance or watch the filming on a monitor.

Many of the young actresses playing mothers on the show have not yet had children, so their rehearsals include coaching in what labor should look like. All in all, filming a birth scene usually runs about five hours.

One actress reported in an interview that the babies are really the divas of the show: They work for 15 minutes and then get a 15-minute break!

Passionately Human

The first three seasons of “Call the Midwife” are based directly on Worth’s three-volume memoirs, which conclude with her departure from the East End in 1959. Because of the show’s great popularity, the storyline has continued with the writers trying to stay true to the tone of Worth’s storytelling and the culture and history of the time period.

Actress Jessica Raine, who plays the young Worth (called “Jenny Lee,” Worth’s maiden name), leaves after the third season, but each episode continues to begin and end with a voiceover by an older Jenny (voiced by award-winning actress Vanessa Redgrave), looking back on her career and reflecting upon what all her relationships with colleagues and patients have meant to her. It boils down to love, compassion, and professionalism.

Redgrave said in an interview that the narration she delivers on the show is about the “rights and dignity of the poorest and least regarded.” She called the show “passionately human.” For me, it’s a reminder of something I already knew: Nurses are heroes.

If you haven’t seen “Call the Midwife,” there’s plenty to catch up on. Like many British shows, each season (or “series”) is fairly short — most have eight one-hour episodes, plus a 90-minute Christmas special — but with 12 complete seasons to date, there are currently 104 episodes.

Season 13 will be seen in spring 2024, and the BBC has already renewed the show for Seasons 14 and 15, which will carry the storyline into the 1970s. Older episodes are available on Netflix, and newer ones can be viewed through the PBS Passport service.

CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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