Next, Nurse Trixie Franklin (Helen George) was devastated when her patient and fitness buddy Jeannie died after a botched abortion, leaving behind a widowed husband and a motherless son.
This careful plotting means that when the big reveal arrives in episode seven, the shock is all the more powerful.
We feel all of Val’s horror when she discovers that the grandmother she loves and admires, the kindly woman who insists on giving her ice-cream money and inviting her to bingo, has inflicted such harm.
Her operating table in the upstairs room of a pub is utterly filthy; her boils are infectious and lethal to expectant mothers; her instruments are unclean and inadequate; her towels and blankets are grimy. And yet she insists what she is doing is a service to womankind.
“I send them home to bed, usually,” she says as her patient’s blood spreads over a layer of dirty newspapers. “They lose it overnight or the next day. Never seen anything like this. I reckon there was something wrong with her already.”
But Val knows, and viewers know, that this is an utter evasion of responsibility; the women she sends home sometimes die of infection (like poor Jeannie Tennant), or sometimes are so damaged by her instruments that they will never be able to have children (like Cath Hindman).
“What you did in here was criminal, and I don’t just mean because it was against the law,” Val tells her grandmother, her voice wavering with anger.
Val’s fury is righteous and powerful – but Elsie too is given a voice. And when she shouts back at Val, what she’s really saying is: what is the alternative for these women when abortion is illegal?
Earlier in the series, Jeannie had visited her GP Dr Turner and begged him for an abortion. But as her life was not medically at risk, his hands were tied and he could offer no help. No wonder she sought Elsie out in desperation.
“I’ve seen them cry. I see it all the time,” Elsie tells Val. “The girls who are trying to feed five kids on a can of corned beef. Wives with black eyes covered in panstick, and a husband who drinks a skinful every night… I do it because they ask me to. Beg me too.”
This is the true message of the drama: backstreet abortionists were dangerous and irresponsible – but so were the laws that drove people into their arms.
Call the Midwife creator and writer Heidi Thomas has delivered a climax that rings true to the realities of the era and the emotions of a terrible situation.
The screenwriter has certainly dialled up the drama by adding a personal connection for Val, who must now decide whether to report her dear grandma and possibly condemn her to years in jail, or risk her own career by keeping quiet. But this dramatic narrative does not conceal the historical reality of the storyline: backstreet abortionists were often ordinary civilians like Elsie, using rudimentary knowledge and tools.
While abortion may have been legalised (with certain restrictions) in England, Scotland and Wales under the Abortion Act of 1967, the procedure remains illegal in Northern Ireland, where doctors may only act “to save the life of the mother” or if the pregnancy could result in the woman becoming a “physical or mental wreck.”
It is worth remembering too that Call the Midwife is a show with a huge international audience. The drama airs in countries from Spain to Greece, Norway to Australia and the United States. This story doesn’t just go out in the context of the UK’s national conversation about abortion; it also will encourage discussion in countries like the USA, where abortion rights are being challenged by “pro-life” politicians, the de-funding of clinics and new ‘foetal heartbeat’ bills. The world of 1964 is not so long ago, nor so very far away.
Call the Midwife is at its best when it puts a human face on important issues, telling historical stories with contemporary relevance. The drama has handled this important storyline with great care and skill. Now the question remains: what will Val do next?
This article was originally published on 24 February 2019