In the 1950s, most mums gave birth at home, says Call the Midwife’s expert adviser Terri Coates.
As around 9 million of us witness every Sunday night, in the 1950s women in London’s East End generally went through childbirth at home with little more help than a puff of gas and air. “Now so few women give birth at home, there is no knowledge that this was once normal,” says Terri Coates, who collaborated with Jennifer Worth on her memoirs of life as a trainee midwife in Poplar, which inspired the TV series. “These days they hear about friends having a bad time and want an epidural.”
A midwife and lecturer of 30 years’ standing, currently based at a West Country district hospital, Coates has been involved with Call the Midwife from the start. On the set she is charged with keeping an eye on the new-born extras, a job she does so effectively that she has been christened “the Baby Whisperer”.
But it’s Coates’s experience and knowledge of childbirth – which she now shares with young actresses to whom it is a mystery – that give her a unique insight into the ups and downs of bringing new life into the world over the past half-century.
While the act of giving birth is universal, Coates says, attitudes today are very different. “A lot of young women in the 1950s didn’t even know where babies came from. They were happy to have someone lead them and were more deferential. Now women are far more savvy, have apps on their phones, mum-and-baby books, better education. They know what they want and how to get it.”
Too savvy perhaps? “Managing their expectations is like walking a tightrope,” says Coates. “They expect the perfect birth, the kind they see in magazine pictures. Some feel that if they have anything but a drug-free birth, they’ve failed. But if they end up with a healthy baby, they’ve done extremely well.”
While Coates welcomes the arrival of fathers in the hospital delivery room, she’s not so sure about the wisdom of allowing several “birth partners” to attend at once. “Men used to be left at the door, but now women come with Uncle Tom Cobley and all – the most I’ve had was 15 extended family members! Sometimes the mother can feel she has to play to an audience, which is sad.”
Nowadays, hospitals try to offer women in labour cushions, comfy beds and birthing pools. Working on Call the Midwife couldn’t be more different. Coates calls the disused seminary in north London where the indoor sets have been built “seriously unpleasant”.
St Joseph’s has no running water, electricity or heating, but Coates has to make it safe for infants who are under five days old. Real babies are only used momentarily, mainly they are prosthetics, but either way an invisible Coates is sliding them around, usually saying, “Other way up!”
“I usually end up kneeling in a puddle or underneath the bed in damp jeans with something dripping on me as the bed gets progressively wetter while they film from different angles,” she says. She gets very cold, wears a lot of clothes and makes sure her “on-set” bag contains a raincoat, umbrella – and chocolate.
During her training in rural Warwickshire in the 1980s she lived “over the shop” with the other trainees, where, as at Midwife’s Nonnatus House, they had a cook and even a porter like Fred. The lightweight scrubs she wears for her day job today are a huge relief compared with that period as a young midwife when aprons and cuffs were worn over dresses. “There was a lot of faff and it took all night to starch and iron your cap and sew seven pleats at the back.
“We saw life in a small rural community, but also in the bigger hospital at Nuneaton. That was what made me think it was like James Herriot, but for midwives.”
Years later the idea that midwives needed a TV series that would raise their profile just as Herriot’s had done for vets resurfaced in an article Coates wrote for the Midwives’ Journal – and sowed the seeds for Call the Midwife. Jennifer Worth rose to the challenge.
“Midwifery and childbirth have all the ingredients of a blockbuster,” was how Coates summed up the appeal of a midwife’s story in that article. “Sex, love, anticipation, excitement, pain, the new arrival of life.”
It’s a powerful combination – and it seems everyone has noticed. Watching women giving birth on TV would have been unthinkable in the 1950s, but now it’s commonplace – US reality TV star Kourtney Kardashian did it on air, surrounded by her entire family. New mums even post videos of themselves in labour on YouTube.
And while Channel 4’s hugely popular fly-on- the-wall hospital series One Born Every Minute shows how birth has become medicalised, it also highlights the boom in baby programming. The latest addition? One called Home Delivery, an upcoming documentary about women giving birth at home, supported by midwives. Whoever gave them that idea?
Kerry Mahoney gets on her electric bike to deliver babies in Poplar.
I work for the Barts Health Trust at the Barkantine Birth Centre on the Isle of Dogs, in the area where Call the Midwife was filmed. We deliver about 40 babies a month. The centre is midwife-led, with five birthing rooms with pools.
We try to promote a home-from-home environment where women feel relaxed, all on the NHS.
In Call the Midwife women are on their backs and midwives are seen as the authority figures, but we don’t see ourselves like that and we encourage women to walk around, or get down on all fours. I like the uniforms in the TV series, they’re quite smart, but we wear our own clothes to try to keep things informal.
If women choose home births, we go out to them. We also go round and about in the community on bikes, like the midwives in the series. Some of us drive, but it’s easier to get around on a bike because of parking restrictions.
We’ve got a really big cultural mix – third-generation east Londoners whose grandparents would have been born in the days of Call the Midwife and who have lived here for years and seen all the changes, and a lot of migrants. The class divide is apparent with the business district around Canary Wharf, though regeneration has brought improved services for women who don’t have so much.
You don’t know what to expect at the start of each day and you have to be resilient. There’s more of a language barrier now. Some Bengali women don’t speak English and that can be difficult, especially during labour – you have to try to communicate with them without speaking. We have advocates who can come and translate, but some families prefer just the husband and a female family member to be there.
The population is much denser now and a lot of people live in high-rise buildings. We see a lot less of the women than the midwives in the series. Women don’t always see the same midwife twice; it would be nice to go back to that sense of continuity and get to know the women better.
You can tell a midwife has been involved in making Call the Midwife because it’s accurate in the things the characters do and say. In the episode where a baby died, you saw the support that the midwife got and what it’s like to go through the investigation afterwards. It shows the humanity better than the labour-ward scenes you see in some programmes.
My colleagues and I like the way the series goes back to the old days when everyone was at home. It’s nice to see that home births are safe, but it’s a shame to see as well how things started to move away from that.
Now childbirth has become medicalised. We are trying to encourage women to understand that it’s safe to stay at home or come to a birth centre if your pregnancy is low risk, but last year we only had six or seven births at home in our area. Yet for inner-city London, that’s actually quite a lot.
I don’t watch One Born Every Minute because I don’t think it’s very well done and it works by scaring people. People watch it and think all midwives do is sit around and drink tea and eat cake and leave women in labour on their own. That really isn’t the case. Call the Midwife captures the essence of being a midwife – we really strive to be with a woman when she needs us, and support her.
Call the Midwife continues on Sundays at 8:00pm on BBC1