By Hannah Diaz, MSN, CNM
Vanderbilt Nurse-Midwives & Primary Care for Women at Melrose
Call the Midwife is back for its eighth season and so are the faculty of the Vanderbilt University School of Nursing with a weekly guest blog. Watch the show Sundays at 7 p.m. through May 19, then read our blog each Monday morning for historical and contemporary context about the previous night’s episode. SPOILER ALERT: Some posts may contain spoilers.
After an emotional and dramatic first episode of the season, Call the Midwife continues to highlight heart-wrenching storylines in both physical and mental health. Episode 2 opens on a loving Ghanaian family that has recently gained British citizenship. As the episode progresses, we learn that the Aidoo family all suffer from a genetic condition known as sickle cell disease (SCD). For Flora Aidoo (Jessica Kennedy), this is a serious concern during pregnancy and labor.
Even today with our knowledge of the disease, Flora would have been considered a high-risk pregnancy. Among several other concerns, we midwives worry about anemia and blood loss – both of which Flora experiences. Trixie (Helen George) and Dr. Turner (Stephen McGann) work through their limited knowledge of SCD and Flora receives a life-saving blood transfusion. It was nice to see this familiar collaboration between a midwife and a physician. Today, this is a common occurrence – midwives communicate closely with our physician colleagues to treat higher risk patients.
I was also struck by Dr. Turner’s frustration when he realized there wasn’t adequate information to help him care for the Aidoo family. As a medical provider, it can be maddening to recognize a problem and not know how to solve it. In 1964, little was known about sickle cell disease in the medical community. The first formal description of SCD was published by James Herrick in 1910; sadly, it would take decades for progress to be made. It wasn’t until 1995 before the FDA approved a medication, called Hydroxyurea, to treat the painful complications of the disease.
At first, SCD was thought to affect the African population only; it was many years later that researchers determined that while people of African heritage are at greater risk, any ethnicity could be a carrier of this molecular disease. Thankfully today we can screen patients for sickle cell disease and provide them with helpful management and treatment.
We are always learning in medicine. As midwives, we strive to keep up with the latest evidence and ensure we are using the most current guidelines to give our patients the absolute best care we can. We also have a great resource in our collaborating physicians for high-risk issues. While it took far too long to make any advances in our understanding of SCD, the disease is now recognized as a public health challenge and there are ongoing efforts to improve palliative care and seek a cure.
Hannah Diaz, MSN, CNM, is a member of the Vanderbilt Nurse-Midwives & Primary Care for Women at Melrose, the clinical practice of the Vanderbilt University School of Nursing.