‘Call the Midwife’ Recap: Season 12, Episode 5

Call the Midwife is back for its 12th season and so are the faculty of the Vanderbilt University School of Nursing to provide historical and contemporary context in a weekly recap blog. Watch the show Sundays at 7 p.m. through May 7. SPOILER ALERT: Some posts may contain plot details.

In practice, midwives help women avoid pregnancy as much as we help women during their pregnancies. We discuss contraceptive options with women, prescribe pills, place and remove IUDs and Nexplanon devices, encourage condom use, teach natural family planning and lactational amenorrhea – sometimes providing many of these methods for the same woman in different seasons. I refer women for tubal ligations and send their husbands to the urologist for vasectomies. But sadly, I’ve never teamed up with a nun to teach a family planning class just for men. In my favorite scene from this episode, Dr. Turner and spunky Sister Veronica list synonyms for condoms to encourage Poplar’s dads to prevent unplanned pregnancies.

From my 2023 vantage point, we haven’t made much progress since 1968. The experimental vasectomy described by Dr. Turner has become a safe, simple procedure. But we still have just two methods of pregnancy prevention for men. In 1968, women had the combined oral contraceptive pill and IUDs. Since then a few more methods have been invented, all used by women, all with significant side effects, all fallible. And despite Sister Veronica’s campaign, contraception is exclusively relegated to women’s health care. My husband has never been asked about our family planning practices by his primary care provider, whereas pregnancy or its prevention has been a major focus of nearly every health care encounter I’ve had in adulthood.

Every pregnancy in this episode is unplanned: the tiny girl born to a teenage mom in the first vivid scenes, a brief early pregnancy for Shelagh Turner, and a desired but dangerous term pregnancy for Annette Barkeley. Annette has rheumatic heart disease, a consequence of untreated strep throat. Worldwide, rheumatic heart disease is still the No. 1 cause of cardiac complications in pregnancy. Pregnancy, birth, and the immediate postpartum transition pose huge challenges to the cardiovascular system, and women with cardiac disease like Annette can develop arrhythmias, clots, heart failure, and cardiac arrest.

The fetus in utero relies on maternal circulation for oxygen and nutrition, so maternal cardiac disease can cause fetal growth restriction, preterm labor, or pregnancy loss. For all these reasons, women with rheumatic heart disease are often advised to avoid pregnancy – but in the United States, half of all pregnancies are unplanned. Annette’s story makes me want to post flyers and lead workshops like Sister Veronica, reminding men and women that contraception is life-saving, essential health care.