`Call The Midwife` The Morning-After Analysis: Season 2: Episode 1

Like they did last season, we are happy to have the faculty of the Vanderbilt School of Nursing back to guest blog for us each Monday morning about the previous night’s episode of Season 2 of Call the Midwife, airing on Sundays on NPT and PBS Stations nationwide at 7:00 p.m. Central, March 31-May 19. Check in here every Monday morning for the next six weeks for historical and contemporary context on the show, and some fun discussion.  SPOILER ALERT: Some may contain spoilers, so please be aware of that.

By Michelle Collins PhD, CNM

Are we not all loving that season 2 is here? It’s like reuniting with old friends to see Jenny Lee (Jessica Raine) and the crew again. If I could use one word to summarize the theme of this week’s episode, it would be vulnerability. We saw the all-too familiar scenario of the woman in the abusive relationship; misinterpreting pain for love, abuse for security, and control for protection. Unfortunately, and as too often happens, no good end came from that relationship. The story line involving the Swedish woman whose father offered her up to the sailors on his ship highlighted the strength of a woman at the height of vulnerability, despite the worst exploitation one could imagine. But like the proverbial phoenix, the young woman arose from the ashes to be a survivor. Such strength from such a vulnerable place.

The third example of vulnerability in the episode was much more subtle than the two prior examples. I think we can all agree that laboring and birthing women are perhaps at the height of vulnerability. The perception for them can seem like one’s position to negotiate needs and desires is somewhat limited, unfortunately. Often it is others who dictate “what is best,” as such is often the case when it comes to pain relief options. On that note, I was thrilled to see that nitrous oxide was highlighted this episode. “Gas and air,” as it is called in Britain, has been a mainstay of pain relief for labor and birth for many years in Europe, and more recently in the US at a handful of hospitals (one being Vanderbilt University Medical Center!). As the young midwife in this episode exclaims to Sister Evangelina (Pam Ferris), shortly after the Sister has placed a moratorium on nitrous oxide use, “women want pain relief!”

It is not new that women want access to all safe options when it comes to pain relief. This was as true in 1950’s east London as it is today. I know this may come as a shock to some, but not every woman wants epidural anesthesia for labor. In the 2006 Listening to Women II survey conducted by Childbirth Connection, 14% of the women surveyed gave birth without the use of pain medications or anesthesia – by choice. Additionally, an overwhelming number of women in the survey desired to have more safe pain relief options made available to them. The American College of Nurse-Midwives, in 2009, published a position statement advocating for the widespread availability of nitrous oxide. In the same vein as the young midwife in the episode who exclaimed “women want pain relief!” modern midwives know that women “still” want pain relief, and it’s just the right thing to do to make sure that all safe options are available to them. For women who choose and obtain relief from the use of “gas and air,” they enthusiastically join their voices to the woman who birthed her baby in this episode using nitrous oxide who said “I’ll be spreading the news about that gas…”

Michelle Collins PhD, CNM, is an Associate Professor of Nursing, Director Nurse-Midwifery Program, at Vanderbilt University School of Nursing

Missed our analysis of the Previous Season’s Episodes? Read them here.