As Call the Midwife comes to the end of its 10th season, I’m closing in on 16 years of clinical practice as a nurse-midwife. When I think of my work through those years, memories cascade much like the scenes in this anniversary episode: former colleagues reappear, emergencies and tragedies and hilarious moments stand out among foggy recollections of normal births.
I don’t remember every birth I’ve attended, but I certainly remember Allison’s grace while delivering a stillborn daughter. I remember Rebekah giving birth to a son while her delighted little girls watched by my side. I remember Gwen arriving to the labor unit at the end of a precipitous labor, standing in the elevator with her newborn baby suspended in her pants. Like Dr. Turner’s thalidomide prescriptions, my own clinical errors haunt me. But mostly I’m lucky to remember resilient families working hard, then welcoming beautiful babies.
As I reflect on my own professional life and these dozens of Call the Midwife episodes, I wonder if the Nonnatus midwives would recognize themselves in me the way I see myself in them. A television show featuring modern nurse-midwives at work would be very different! Birth remains the same 60 years on from Call the Midwife’s time, but midwifery and midwives have changed. Modern midwives exercise far more control over labor and birth: we induce labor, augment labor when it’s not effective, and offer very effective pain relief. While induction of labor was practiced at the time of CTM, it became more widely offered in the 1970s. Today about a quarter of all U.S. births are induced.
My own practice induces labor when medically indicated, protecting the well-being of mother and baby by controlling the timing of the birth. It’s a common, marvelous way to solve problems at the end of pregnancy, helping families avoid some of the tragedies that we witness on Call the Midwife: stillbirth, eclamptic seizure, intrauterine infection. When labor starts on its own, we can use medications and techniques to boost the power of spontaneous labor when the contractions aren’t effective. We offer labor support, yes, but we can also nearly eliminate labor pain with epidural anesthesia.
Our practice outside the labor room is different too: We use imaging and genetic screening to gather information about baby before the birth. We offer so many more contraceptive options; we attend to perinatal and postpartum mental health. We work as a team with physical therapists, perinatologists and nutritionists and genetic counselors to care for mom and baby. Medical science has advanced fast in 60 years, and midwifery has incorporated modern obstetrics into our traditional approach.
The lives of all women have dramatically changed since the 1960s, midwives included. The Nonnatus House midwives all live as nuns, even the lay women; they live in a “family” of midwives, fully absorbed in and dedicated to their shared work. Shelagh Turner leaves midwifery when she marries and has children, working part-time as a nurse for her husband.
Today’s midwives balance their work with full, modern lives. My 16 years of practice run parallel to 15 years of marriage and motherhood. My own televised drama would include scenes from life as a midwife and a mother: my husband struggling to bottle feed my breastfed newborn while I attended an overnight labor, my pager waking the whole family from sleep, my toddler clinging to my leg as I threw on scrubs to race out the door.
My kids know which of their friends I “caught,” they roll their eyes when I triage labor calls during dinner, and they are a reliable source of accurate reproductive information for their friends at school! Midwifery is a vocation that impacts and shapes a midwife’s marriage and family, which we rarely see on screen through Call the Midwife.
Over 10 seasons we’ve seen enormous change for the Nonnatus House midwives. As they move through the 1960s, we know some of what the future holds: induction of labor, ultrasound, genetic testing, career options for married women. The future promises progress and challenges for all of us, the fictional midwives of the past and my colleagues practicing alongside me. I’ve got at least 16 more years in me — dare I hope for another 10 seasons of Call the Midwife?
Kate Virostko, MSN, CNM, is a member of the Vanderbilt Nurse-Midwives & Primary Care for Women at West End, the clinical practice of the Vanderbilt University School of Nursing.