How Call the Midwife smuggled radical social issues into Britain's living rooms

One in six people in the United Kingdom now watch the moving BBC drama on the midwives and nuns of East London's Nonnatus House.

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Try to pretend it’s anything but snobbery,” says Stephen McGann. “But it is snobbery. I’ve been a cultural snob myself. ‘Oh, theatre, daaaarling!’” he drawls, laughing. “It’s the same in science. Scientists will talk about ‘the general public’, and there’s an implicit cultural snobbery. But out there, in the real world, where real people live their real lives, people respond to actual stuff that’s crafted well and crafted with sincerity.”

I have discovered how right he is, for I was such a snob myself, once upon a time. We’re sitting in a cramped, old-fashioned trailer – on cracked red vinyl seats – on the set of Call the Midwife in Virginia Water, Surrey, doubling for Poplar in London’s East End. I’ve been allowed into the show’s new community centre to watch the filming of Sister Monica Joan’s birthday party. Over and over again, the candles on the cake are lit; over and over, midwives, nuns and extras sing “Happy Birthday” – but never with quite enough swing, it seems, which is why the candles on the cake have to be lit and relit and Judy Parfitt, who plays Sister MJ, must look delighted again and again. (Regular viewers of Call the Midwife will recall her character’s abiding passion for cake.) The show has reached 1963, and I find myself coveting the mid-century modern lamps that adorn the set. Goodbye to the postwar drabness of the first series – set in 1957, when the Second World War was still casting its long shadow.

This is series seven, with another two yet to come. The stories of the midwives and nuns of Nonnatus House have topped the ratings chart since they were first broadcast in 2012, regularly attracting more than ten million viewers a week. To put that another way: one in six people in the United Kingdom watch Call the Midwife.

McGann plays Dr Patrick Turner, the resident physician to the Nonnatus House crew, one of the many cast members who have been with the show since the beginning. He has an additional loyalty: he is married to the show’s creator, Heidi Thomas. But those ten million viewers feel just as loyal, it seems.

I never thought I’d be one of them. When Call the Midwife first aired, I dismissed it as just the sort of thing I wouldn’t like. Seeing stills of the smiling cast, I imagined a saccharine portrait of a postwar world, full of gorblimey cheeky chappies and plucky young gels. I probably also thought: nuns?

And then – around the time of the third series – I found myself far from home and pining for the East End of London that I have come to love: I have made my home here for more than 20 years. I was in the battered industrial town of Troy, in upstate New York, and staying in a former funeral home that retained rather too much of its original character to facilitate a good night’s sleep. Call the Midwife was being streamed by the American public broadcaster PBS – it has been sold in over 200 territories, and while the show hasn’t quite had the same effect on Americans as Downton Abbey, each of the past seasons was among the yearly top ten viewed programmes on public television.

By the banks of the Hudson River, I thought I’d at least get to glimpse a stage-set version of my home ground. Almost immediately, I was hooked. Just as Stephen McGann put it, here was actual stuff, crafted well and with sincerity.

Here, too, was a robust defence of the welfare state, needed now more than ever. Here was a reminder of what it meant not to be able to afford to see a doctor (a recent memory for the characters in Call the Midwife). And here were women’s lives – messy, difficult, beautiful, glorious. In 2012, Caitlin Moran called the first episode “off-the-scale ballsy”. “Good on you, Call the Midwife,” she wrote. “You dilate those cervixes without the help of pethidine on prime-time BBC One. You freak out viewers with the reality of the female reproductive burden. I raise my glass… to you.”

Yet one of the early doubters was Heidi Thomas. Thomas is one of Britain’s most successful writers for television, a master of literary adaptation who has brought Madame Bovary and Elizabeth Gaskell’s Cranford to the screen; her three-part adaptation of Louisa May Alcott’s Little Women followed hard on the heels of the Call the Midwife Christmas special this winter. The executive producer Pippa Harris had come across Jennifer Worth’s memoir – published in 2002, when Worth was well into her sixties – and thought that an adaptation of the book could replicate the success of All Creatures Great and Small, James Herriot’s tales of life as a Yorkshire vet that had run for 90 episodes from 1978 to 1990.

Harris – now Dame Pippa – has a nose for a hit. Before forming her company, Neal Street Productions, with her partners Sam Mendes and Caro Newling in 2003, she was the head of drama commissioning for the BBC. With Neal Street, she has produced Jarhead, Revolutionary Road, Stuart: A Life Backwards and The Hollow Crown. But Thomas had just finished Cranford and didn’t think that adapting Worth’s book would be her cup of tea. “I thought, ooh, this isn’t me – this isn’t 19th-century classic literature! But Pippa urged me to give it a try, and then I couldn’t put it down. So I rang Pippa and said yes. I thought the material was utterly compelling.”

Thomas’s script strikes a remarkable emotional balance between heart-warming encounters and human frailty and existential struggle. You may be unable to think of Call the Midwife without conjuring an image of Miranda Hart – as the redoubtable midwife Chummy – wobbling about on her bike to great comedic effect, and comedy has always been part of the show. While Hart had to leave after the fourth series, her scrapes on London’s streets have been nicely replaced by Victoria Yeates’s Sister Winifred attempting to learn to drive (spoiler: she’s a menace).

But comedy isn’t the show’s true heart. Without access to birth control, women attempt kitchen table abortions; there have been clear-eyed depictions of what life was like for gay men and women when homosexuality was illegal (“A lot of the crew, who are quite young, really hadn’t believed that it could have been illegal,” Pippa Harris says). A character with Down’s syndrome has a major role (the actor playing him, Daniel Laurie, also has the condition) and, perhaps most strikingly, Call the Midwife devoted a long storyline to the discovery that a drug – thalidomide – prescribed for morning sickness was causing terrible birth defects. The midwife Trixie (Helen George) confronted her alcoholism and Sister Mary Cynthia (Bryony Hannah) was institutionalised for depression and underwent electroconvulsive therapy. Over the coming months, viewers will meet a new midwife, Lucille Anderson, played by Leonie Elliott, the show’s first West Indian midwife. No doubt not everyone in 1960s Poplar will be pleased with this development.

Thomas – whose late brother David had Down’s syndrome, and whose family has been impacted by suicide – bridles at the idea that the show is merely a cosy treat. She is still annoyed by a review that claimed Midwife presented an “alternative universe of sunshine and lollipops”. The review, she notes, was written by a woman. “I think some critics perceive it as soft-centred, as something female and therefore less worthy of their attention. That’s a huge issue in our society today, borne out by recent events. What sort of patriarchy do we live in that a woman on a kitchen table being scraped out with a scalpel by a neighbour is ‘comforting’? If you think Call the Midwife is comforting, you are not watching the show.”

Worth’s books have long been exhausted. Storylines come from research (Terri Coates, a midwife for nearly 40 years and the person who inspired Worth to write her memoirs, has advised the series from the beginning) and, sometimes, from the thousands of letters the producers of the show receive.

Louise Silverton is the director of midwifery for the Royal College of Midwives; she confirms the show’s accurate reflection of the work that midwives still do. She started her training in inner-city Leeds in 1974 and saw levels of poverty that reminded her of London Labour and the London Poor, Henry Mayhew’s portrait of 19th-century deprivation. “Even though we’d had the welfare state for some time, people were still locked in a cycle of being hand to mouth. And health outcomes are still stratified by levels of poverty, levels of education.” This experience is reflected, again and again, in Call the Midwife, as are the personal relationships and refusal to pass judgement on which the profession depends. “As a midwife,” Silverton says, “I’m going to take women as they are. What you see is relationship-based care. Knowing the woman, knowing that the advice and suggestions you give are in the context of her circumstances.”

Surely it’s important, in what we might call the post-Weinstein era, to pay attention to a show whose central theme is listening to women and taking what they say seriously? If the show ever errs on the side of uplift, I’m inclined to make allowances: that’s the warmth that leads to conversations that can alter people’s lives. The Christmas special is a notable example. One of its storylines is astonishingly bleak: a charming old chap dies, after which it is revealed that he beat and imprisoned his wife (a marvellous Anita Dobson) for years and also impregnated his 15-year-old daughter, who aborted the baby after the father kicked her out of the house. The warmth finally comes when the mother and daughter are reunited at the end – it is Christmas, after all.

The possibility of real change in the real world is what keeps Heidi Thomas so attached to this project. “This is my chance to tell stories that matter to me in a form, in a medium, that will never happen to me again,” she says passionately. “Sometimes it’s really simple: you get a letter from someone who will say, ‘I’ve been able to talk to my husband about the birth of our children for the first time.’ I’ve had letters from the families of disabled people who had not been allowed to live in marital or romantic set-ups until they saw the Jacob and Sally story in series three.”

In that episode, Jacob, played by Colin Young, an actor with cerebral palsy, and Sally, played by Sarah Gordy, who has Down’s syndrome, form a romantic attachment and Sally falls pregnant. Two of the show’s midwives were in a lesbian relationship: “I’ve lost count of the letters I get from women saying, ‘I was able to come out to my parents because of Patsy and Delia,’” Thomas says. “Sometimes we’re changing people’s point of view; sometimes we’re enabling people to say, this is my story. And I don’t think I’ll get that chance again.”

Call the Midwife also offers a model of a production almost wholly run by women. Thomas is wryly blasé about her working environment. “A journalist at a literary festival asked me, ‘Is it very novel for you to work on a show where women are in charge?’ And I said: ‘Not really. There’s a woman in charge of every show I work on, and it’s me.’” The way to bring about change across the industry, as in any industry, is straightforward, if not simple, Pippa Harris says. “I suppose I feel that the more women are in positions of power, the less people like Harvey Weinstein can ever get any traction. There’s not going to be a Harvey Weinstein on this set! But it does need women to be working in every area and in senior roles, so they can ensure that young women coming through are not put in the path of a person like Weinstein.”

Part of the change involves breaking down received notions of what kinds of stories appeal to people. “When we developed the first series, people would ask, ‘Aren’t you worried that it’s not going to appeal to men because it’s all about babies?’” Harris says. “No one ever said that when I worked with Heidi on Soldier Soldier. No one ever said that women won’t be interested if it’s all about guns and warfare.”

Call the Midwife offers a portrait of a society that still believes in the idea of society. In austerity Britain, in Brexit Britain, in the age of Donald Trump, this Sunday-night viewing offers more than an excuse to curl up on the sofa with a glass of wine. “Call the Midwife works on many layers,” Thomas says. “If you want to watch the show and just scoop the top layer off and enjoy the frocks and the music and the relationships, if you just want to be cradled for an hour – join us on those terms. You are totally welcome. But if you want to dig a bit deeper into the stuff of life, you’ll find so much there. This is about women, about the disabled, about immigrants, about the elderly. At every turn, we strive to tell the stories of people whose stories are not often told and are even less often listened to. And that’s the challenge. Watch Call the Midwife and you will see something of your own experience reflected back.”

Jenny Agutter, who plays Sister Julienne, is sitting on those cracked vinyl seats in the trailer, taking a break from filming with a warm bowl of apple crumble. She says that the show offers a different kind of comfort from mere escapism. “I think we live in quite dangerous times, right now. It’s quite nice to see a society which sees where the dangers are – and that it’s human resolve that gets past those dangers. In the end, it’s the people that make the world that we live in, people making human connections.”

There’s a knock on the trailer door. A young assistant pokes his head in, apologises and says that Sister Julienne needs to get back on set. As he heads out the door, Agutter turns to me and smiles. “He’s great. He’ll make a wonderful producer some day.” Right now, however, it’s his job to call the midwife. 

The seventh series of “Call the Midwife” begins on BBC One this month

Erica Wagner is a New Statesman contributing writer. A former literary editor of the Times, she has twice judged the Man Booker Prize. Her books include Ariel's Gift: Ted Hughes, Sylvia Plath and the Story of “Birthday Letters”, the novel Seizure and, most recently, Chief Engineer: The Man Who Built the Brooklyn Bridge

This article first appeared in the 04 January 2018 issue of the New Statesman, Young vs Old