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Real Life History of Call the Midwife

Dr. Dina Copelman

We asked Dr. Dina Copelman, a British history professor at George Mason University, to preview the second season of Call the Midwife and give us her thoughts on how well it captured the time and place of early 1950s East End, London. Read below and learn a little something!



First impressions

Welcome back to Sunday night TV!

Hello and greetings to any Downton Abbey fans who may be following me on my journeys with the Midwives—I hope many are, especially since we are rewarded with such a rich and different view of British life. We are now in London, in the East End, to be precise.

The series is set in the 1950s. Does that mean the world depicted in the shows will be more familiar to viewers in the US?

Shown from L-R: Jessica Raine as Jenny Lee and Helen George as Trixie Franklin.It’s been interesting to watch the most recent shows of Midwife right around the time of Margaret Thatcher’s death. The 1950s seem so very long ago, whereas, as witnessed by the strong feelings aroused by Thatcher’s death, the 1980s seem like they were just a few minutes ago. Midwife presents us with a sepia toned view of what for many was a heroic time in British history. Britain had won the Second World War and, in contrast to what followed World War I, tried to make good on wartime promises to improve the lives of its citizens—all of them.

How did the government improve people’s lives after World War II?

By creating what we have come to call the welfare state. Some forms of “welfare” go back to the early twentieth century, but it is only after World War II that a comprehensive set of programs were instituted to provide a safety net for all—through such things as health care, unemployment benefits, pensions, access to affordable housing and education. Vision and reality may not have matched and there were significant political disagreements over what people should be entitled to. But the welfare state—in Britain and other West European countries—became an essential aspect of postwar life. Americans think of these programs as serving the poor—which they did, as they should—but actually everyone benefitted. The National Health Service (NHS) was used by all classes. Educational benefits, especially increased access to higher education, which expanded greatly during the 1960s and 70s, allowed some families to send their daughters and sons to college for the first time. But middle-class people benefitted as well, disproportionally in fact, from university grants. Pensions helped everyone. As we see in the show, class divisions remained, but these programs were welcome and popular. And there’s still a lot of pride in these accomplishments, as was made clear in the opening ceremonies of the recent London Olympics. Director Danny Boyle put on a multi-media extravaganza recounting the history of the British Isles; prominently featured was a loving depiction of the NHS, complete with oversize dancing hospital beds!

What about the series’ location in London’s famous—or should I say infamous—East End?  People may be nostalgic about the creation of the welfare state, but is the East End considered a national jewel?

The East End has always been home to London’s working class and its new immigrants. It is where the unmistakable Cockney accent was born and flourished (midwife unknown, but location is: within the range of St. Mary-le-Bow’s church bells). It’s where Jack the Ripper left an indelible signature of violence and misogyny. It’s where prostitutes served sailors and locals; where native British dockworkers, shop owners and working-class mothers lived alongside Huguenots, Irish, Jews and Bangladeshis. Those newcomers were often made to feel unwelcome, but the area always served as a reminder of Britain’s diversity. And it is among the nation’s jewels because it bore the brunt of the Blitz; it was the face of the unity and pluck of the British in the face of Nazi bombing.

How much of this do we see in Call the Midwife?

Quite a lot. Postwar migration is there, as we see in an episode that has a recent West Indian immigrant as a central character. The docks and the prostitutes are there. We see that notwithstanding considerable poverty, there is a strong sense of community. Community is always multi-faceted, so we are shown both the deep ties and cooperation between working-class families, as well as the tensions, the small rivalries and feuds that arise. The show captures all this well.

The work of reformers, benevolent societies and varieties of middle-class providers of services aimed at combating poverty was an important, complex part of East End history. Nonnatus House fits into this tradition and its nuns are presented as an established part of the community. They have a deep understanding of the East End, enormous personal knowledge of the families, as well as a very tolerant, non-judgmental respect for them. Their distance from the families they serve is evident in every frame, starting with their dress, the traditional nuns’ habits that we don't see anymore. Yet they do not condescend or moralize, practices that the many outside philanthropists and other service providers (as well as, later, local government workers) were often guilty of. The nurses are presented as at first shocked and put-off by the East End; quickly, they learn their way about and become, to a person, a beloved part of the community. This seems to me romanticized, though it echoes Jenny Worth’s Call the Midwife (a mostly autobiographical account upon which the series is based). At the very least, I assume that there were nurses who came to the East End but were never able to adapt. If they stayed they may have remained judgmental and were probably not a part of the local fabric; others probably left for more comfortable neighborhoods.

Did the nuns and nurses make a difference in the community?

Shown: Jessica Raine as Jenny Lee and supporting actors as the Teddy Boys.The nuns were, according to Worth, welcome and trusted by East End families. The services they offered were important, though they had not changed a great deal over time—home births and minimal medical intervention were still the norm, especially in Season 1. The availability and acceptance of the prenatal care provided at the clinic was a newer development. But what was really different in the 1950s was that the midwives, in a sense, belonged to the community because they were employed by the NHS—all the services we see in the show were part of the NHS system.

The show convincingly argues that, compared to the interwar period and before, conditions had improved significantly. For instance, there are frequent references to the workhouse—the dreaded, centuries old institutional system where destitute families were sent to as a last resort. There families were separated (by sex and age) and life was physically hard and emotionally devastating. Mention of the workhouse usually occurs in exchanges between the nuns and the nurses, with the nuns educating the naïve nurses about the importance of their work and how conditions, even in the recent past, were significantly worse.

What’s distinct about this season, compared to what we saw in Season 1?

Shown: Helen George as Trixie Franklin.First, we want to see what’s happened to the people. Will Jenny get over the heartbreak of loving a married man? Will Chummy return? Can Jane, Chummy’s replacement, fit in? What about Trixie’s flirtatious behavior—will she find the right man or get in trouble? As aging continues to debilitate Sister Monica Joan, will the nurses and nuns continue to care for her? The list goes on… We also see, slowly, postwar improvements in standards of living. Some families have more room and modern conveniences; old housing is being demolished though arrangements to relocate tenants were inadequate. There’s personal mobility too: later in the season we see children who benefitted from education, left the East End and were acquiring middle-class status along with middle-class possessions.

Nurses and nuns still travel by bicycle, but will consider other options later in the season. Nurses keep up with the latest fashions and working-class women were also able to enjoy new, fashionable clothes a bit more. The show uses music extensively and effectively. It always starts with its orchestral theme song, but popular music—often American—is used to mark time and highlights the greater integration of the East End into postwar culture. The nuns don't have a television set, but everyone is aware of the new stars launched by the small screen.

More central to the subject of the show are changes in medical practices. The midwives’ work continued to be prenatal clinic care and assistance at home births. But hospital care is becoming more familiar, the East End starts to benefit from new screening technology, even birth control is referred to. These are all presented as positive changes, but, as Jenny Worth notes in her memoirs, these changes are also signs of the midwives eventual irrelevance.

As usual, parting thoughts?

Yes, along two different lines. First, connected to my last comments about the midwives eventually being displaced, I am struck that the tide may be turning back to the sort of care we see in the show, or at least some are suggesting that we reconsider how we provide care. That’s not offered as a prescription to return to lower, poorer standards. Rather, it’s a reaction against medical care that is too mechanized and remote (as well as too costly). Community clinics, nurse practitioners, alternatives to hospital births—all these have enjoyed popular attention. The search for savings figure into these proposals, but a major impetus is to return to medical care based more on human interaction.

Second, Call the Midwife is a huge success in Britain. On Christmas day it attracted nearly as many viewers as Downton Abbey (it’s a British tradition for popular shows to air Christmas themed specials; for the past two years the most popular was the long running soap Eastenders, set in… you guessed it, the East End!). In the US the series is appreciated, but compared to Downton, not nearly as successful. I have been pondering why that is so. One obvious reason is that the American mind more readily identifies country house life as quintessentially British. Poverty, the East End and the National Health Service are not as central to our Anglophile fantasies, nor as appealing. But also, maybe we have fewer parallel viewing experiences that would allow us to identify with the show. Reality TV provides some shows featuring working-class people, but the context is usually dysfunction—unprepared teenage mothers; people with a psychological problem, such as hoarding. Shows like All in the Family and Roseanne don't have many present day descendants. There are a few, but both in the past and the present our shows focus more on the inner dynamics of families, rather than the nature of community life. There’s a lot of Main Street nostalgia around, but our communal pasts (and present) don't seem to inspire our entertainment. I don’t know how to re-direct our viewing habits, but I really hope more viewers will give Call the Midwife a try.

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