Midwifery is the very stuff of drama,” wrote Jennifer Worth. “Every child is conceived either in love or lust, is born in pain, followed by joy or sometimes remorse. A midwife is in the thick of it, she sees it all.”
When Worth set down what she had seen during her training as a midwife in the 1950s, her memoir, Call the Midwife (2002), was a word-of-mouth publishing phenomenon. Two more bestsellers, Shadows of the Workhouse and Farewell to the East End, each sold more than a million copies and cemented Worth’s reputation as a remarkable social historian.
Now a major new BBC adaptation is set to bring Worth’s life-and-death drama to a wider audience. With a script by award-winning Heidi Thomas (Cranford, I Capture the Castle) and a stellar line-up (Jenny Agutter, Miranda Hart and Pam Ferris, with Vanessa Redgrave narrating), Call the Midwife was produced in close association with Worth, who died last year, aged 75, only days before filming began.
Yet until the book was first published, her daughters Suzannah and Juliette knew nothing of their mother’s work as a midwife in the ruins of postwar London. “Proof-reading Call the Midwife was the first I’d ever heard of Mother’s experience in the East End,” says Suzannah. “I think she’d put that part of her life behind her.”
Worth, who’s played by newcomer Jessica Raine, was 22 when she took up her position with the Sisters of St John the Divine (called St Raymund Nonnatus in the book), an order of Anglican nuns who were qualified nurses and worked as midwives in London’s Docklands.
“She didn’t know she was going into a convent, she thought she was just going into a small midwifery practice,” reveals Worth’s husband, Philip, a retired schoolteacher. “She was not a religious person at that stage in her life, and I think she contemplated running a mile. Eventually, she came to really admire the nuns; their work and their faith. I’m sure working with sisters shaped the person she became. In later life she was very devout. She never talked about it to anybody – it was something she recognised she couldn’t impose on other people – but I think that sense of faith pervades the book.”
Worth was raised in Buckinghamshire and trained to be a nurse in Reading. “She was quite a gently bred girl,” says Philip. “She came from a rural, middle-class background, so what she found in the East End came as rather a shock.”
There is nothing of the shrinking ingénue in Worth’s humane, often humorous account of East End life. The tight-knit community that had survived the Depression and the Blitz now faced the implacable threat of postwar slum clearance. Living conditions in the condemned tenements were grim, but spirits were high.
“In the immediate aftermath of the Second World War, people were just so thankful to have survived,” Philip points out. “There was a real sense of being glad to be in a position to rebuild society, and I think that is an important background to what Jenny was writing about.”
In an era before the Pill, there was no shortage of work for a midwife. When Worth was practising, she could expect to attend around 100 deliveries per month. In the East End of the 1950s, families of 13 or 14 children, housed in two or three bedrooms, weren’t uncommon. Sanitation was rudimentary – few tenement flats had hot running water – and infectious diseases spread easily. Pests such as body lice, bed bugs, scabies, mice, rats and cockroaches were also rife.
The vast majority of babies were delivered at home (doctors were only called in for emergencies), so Worth and her colleagues were effectively obstetric practitioners, health visitors and social workers rolled into one. Obstetric practice was, by today’s standards, regimented – women were routinely shaved and dosed with an enema before giving birth and encouraged to adopt the standard “delivery position” (lying on their left side).
The drugs administered in childbirth were limited and of dubious efficacy – chloral hydrate, a mild sedative and analgesic traditionally used in the early stages of labour, had the unfortunate side effect of making the patient vomit – and complications such as a breech birth, where the baby is delivered bottom first – were potentially life-threatening.
On the positive side, however, a prolonged “lying-in” period of 14 days when mothers were confined to bed after delivery meant midwives had the opportunity to build close personal relationships with their charges. For Worth, one such friendship extended beyond the hospital ward. Later, when working as a midwife in an East End hospital, she met the brother of one of her patients – Philip, then a young legal assistant.
Worth’s character studies of the women she attended – the pregnant child prostitute, the glamorous mother of 25, the white married woman forced to give up her mixed-race child for adoption – are no less compelling on screen.
“Jenny told it as it was, without any kind of false sentiment,” Philip explains. “The sympathy was always there, but she was entirely objective. She was very strict on herself. I think what comes through is just how much Jenny learnt from her patients. She took real joy in her work. Nothing made her happier than delivering a new human being and watching that wonderful new relationship between mother and baby.”
Worth pursued her nursing career until 1973, when she retired to look after Suzannah and Juliette, and to pursue a lifelong interest in music. She went on to gain her licentiate from the London College of Music and taught piano and singing at home in Hemel Hempstead.
“I think Jenny left nursing at least partly because she had become disillusioned,” says Philip. “She felt that when they introduced degrees in nursing, the profession became very high-powered, but somehow less caring. She recognised this was an inevitable development because of the way medical science had advanced, but she also had the feeling that the close connection of nurse with patient had gone.” Concerns that are still voiced loudly in the NHS today.
In her 60s, she was leafing through a magazine on midwifery when inspiration struck. “She was very impressed by an article by a leading midwife, Terri Coates, who made the point that it was a great pity there wasn’t someone who could do for midwifery what James Herriot had done for vets,” says Philip. “Something just clicked and she thought: ‘Why not? I’ll go for it!’”
For Philip and Suzannah, the books were a revelation. “Mother was a very surprising person with strong ideas,” says Suzannah. “My sister and I had no idea about the time she’d spent nursing with the nuns. We’ve seen the first episode and it’s been fascinating and moving. I’m sure Jessica Raine has captured my mother as she really was.
“When the order moved to Hastings, we used to stay sometimes in a caravan in the grounds, but we didn’t know the whole story, although we met some of the characters,” Suzannah recalls. “I remember meeting Sister Julienne there, played by Jenny Agutter in the series. And Cynthia, one of my mother’s young colleagues, played by Bryony Hannah, was my godmother.
“Mother died at the end of May 2011, and filming started in June,” says Suzannah. “She had visited the set and given it her approval, and she was very involved in the early stages of the script – there’s a lot of her personality in there.”
Now, as Worth’s story is broadcast, her family takes comfort and huge pride in her memory. “The final scene brought tears to my eyes,” reveals Suzannah. “In some ways, having the series has helped me to cope with the loss. It’s a way of keeping Mother’s memory alive.” “It is a lovely tribute,” says Philip. “A lovely tribute to a remarkable woman.”