(Bonus British Perspective) `Call the Midwife` Recaps: Season 3: Episode 7

In addition to the faculty of the Vanderbilt School of Nursing guest blogging for us each Monday morning about the previous night’s episode of Call the Midwife — airing on Sundays on NPT and PBS Stations nationwide at 7:00 p.m. Central, March 30-May 18 — we are thrilled to have a bonus blogger. Rachel Sykes, who did a practicum at the Vanderbilt School of Nursing in the summer 0f 2013, is a registered midwife and graduate from the University of Manchester, United Kingdom. She’s watched the show on the BBC and will provide a unique UK-perspective. She currently practices in a busy maternity unit in the Northwest of England. SPOILER ALERT: Some posts may contain spoilers, so please be aware of that.

By Rachel Sykes 

The opening to this episode sees Pamela Saint’s baby being born ‘in the caul.’ On rare occasions, the membranes do not rupture prior to birth and the baby ventures into the world in the bag of amniotic fluid. There is an old wives tale that a baby which is born in the membranes is good luck and was believed to protect the child from drowning. It was often sold at auction to nervous sailors who perceived it as a welcome shield from the unforgiving ocean. This probably would not translate well to modern times, and may seem a little far-fetched. ‘I would like to buy some caul please, as I am going on a Caribbean cruise next week.’ You could only imagine the look you would receive!

Pamela (Sophie Rundle) captures our attention this week with her sudden onset of extreme paranoia shortly after the birth of her baby. Puerperal psychosis is a rare, but a serious psychiatric condition which is rapid in onset, usually within the first 14 days postpartum. You may be surprised to learn that in the late 1990s, suicide was the overall leading cause of maternal death in the UK. This thankfully declined in the years to follow and may be viewed as a positive reflection of our ability to identify women at risk of psychiatric illness and to provide them with the care and support they need.

Jenny Lee (Jessica Raine) is back to the grindstone after compassionate leave and finds herself working at The London, a hospital which originated in the 1700s and still operates within the National Health Service (NHS). Her new role on the hospital ward is similar to how modern day British midwives work. The majority of midwives in the UK are employed by the NHS, in the hospital or the community. Hospital midwives generally rotate between the antepartum, postpartum and labour wards (or ‘labour and delivery’ in US hospitals), usually working for a period of 6 months on each area.As an attempt to teach Jenny a lesson, the stern matron in charge says ‘Nurse Lee, your shift is at an end.’ This, I found pretty harsh! I am sure that it would have been completely appropriate for Jenny to stay with Mrs Rawle (Emily Taafe), given her previous history and the emergency cord prolapse situation. Even though hospital midwives in the UK work shift patterns, we try our best to give women continuity of care and many midwives will care for women on subsequent shifts, if they are already known to them. I do find this works well and is a fulfilling way to provide care. It allows you to become familiar with someone’s history and build a trusting relationship.

Jenny’s increasing unease with the flow of hospital life eventually gets the better of her. She reflects as she says ‘how did care become so lightly valued?’ This is a question many nurses and midwives all over the world may ask themselves during a busy shift, when they are banging their heads against the nearest available brick wall. In response, our old friend Sister Monica Joan (Judy Parfitt) answers ‘swift machines, build for the future, the world passes in a blur, but we can always walk, Nurse Lee, should we prefer to see what we are missing.’ The thought-provoking words of the elderly nun inspires her retreat back to Nonnatus, a place she can provide the continuity of care in harmony with her own ethos. Those wise words are an inspiration for us all. If you don’t like something, change it. No one wants to be taking their last breath with a multitude of regrets. Her old friends Trixie, Chummy and Cynthia are only glad to see her face again (and they are probably relieved they have another midwife to make the numbers up, phew!).

Rachel Sykes is a registered midwife and graduate from the University of Manchester, United Kingdom.

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