Jennifer Worth - Call The Midwife - A True Story Of The East End In The 1950S

The St Raymund midwives worked in the slums of the London Docklands amongst the poorest of the poor and for about half of the nineteenth century they were the only reliable midwives working there. They laboured tirelessly through epidemics of cholera, typhoid, polio, and tuberculosis. In the early twentieth century, they worked through two world wars. In the 1940s, they remained in London and endured the Blitz with its intensive bombing of the docks. They delivered babies in air-raid shelters, dugouts, church crypts and underground stations. This was the tireless, selfless work to which they had pledged their lives, and they were known, respected and admired throughout the Docklands by the people who lived there. Everyone spoke of them with sincere love.

Such were the Midwives of St Raymund Nonnatus when I first knew them: an order of nuns, fully professed and bound by the vows of poverty, chastity, and obedience, but also qualified nurses and midwives, which is how I came to be among them. I did not expect it, but it turned out to be the most important experience of my life.

Why did I ever start this? I must have been mad! There were dozens of other things I could have been - a model, air hostess, or a ship’s stewardess. The ideas run through my head, all glamorous, highly paid jobs. Only an idiot would choose to be a nurse. And now a midwife ...

Two-thirty in the morning! I struggle, half asleep, into my uniform. Only three hours sleep after a seventeen-hour working day. Who would do such a job? It is bitterly cold and raining outside. Nonnatus House itself is cold enough, and the bicycle shed even colder. In the dark I wrench at a bicycle and crack my shin. Through blind force of habit, I fit my delivery bag on to the bicycle, and push it out into the deserted street.

Round the corner, Leyland Street, across the East India Dock Road and then on to the Isle of Dogs. The rain has woken me up and the steady pedalling calms my temper. Why did I ever go into nursing? My thoughts flit back five or six years. Certainly there had been no feeling of vocation, none of the burning desire to heal the sick that nurses are supposed to feel. What was it then? A broken heart certainly, the need to get away, a challenge, the sexy uniform with the cuffs and ruffs, the pinched-in waists and pert little caps. Were they reasons though? I can’t tell. As for the sexy uniform, that’s a laugh, I think as I pedal through the rain in my navy gabardine, with the cap pulled down well over my head. Sexy, indeed.

Over the first swing bridge that closes off the dry docks. All day they teem with noise and life, as the great vessels are loaded and unloaded. Thousands of men: dockers, stevedores, drivers, pilots, sailors, fitters, crane drivers, all toiling ceaselessly. Now the docks are silent, the only sound is the movement of water. The darkness is intense.

Past the tenements where countless thousands sleep, probably four or five to a bed, in their little two-room flats. Two rooms for a family of ten or twelve children. How do they manage it?

I cycle on, intent on getting to my patient. A couple of policemen wave and call out their greetings; the human contact raises my spirits no end. Nurses and policemen always have a rapport, especially in the East End. It’s interesting, I reflect, that they always go around in pairs for mutual protection. You never see a policeman alone. Yet we nurses and midwives are always alone, on foot or bicycle. We would never be touched. So deep is the respect, even reverence, of the roughest, toughest docker for the district midwives that we can go anywhere alone, day or night, without fear.

The dark unlit road lies before me. The road around the Isle is continuous, but narrow streets lead off it, criss-crossing each other, each containing thousands of terraced houses. The road has a romantic appeal because the sound of the moving river is always present.

Soon I turn off the West Ferry Road into the side streets. I can see my patient’s house at once - the only house with a light on.

It seems there is a deputation of women waiting inside to greet me. The patient’s mother, her grandmother (or were they two grandmothers?), two or three aunts, sisters, best friends, a neighbour. Well thank God Mrs Jenkins isn’t here this time, I think.

Lurking somewhere in the background of this powerful sisterhood is a solitary male, the origin of all the commotion. I always feel sorry for the men in this situation. They seemed so marginalised.

The noise and the chatter of the women engulfs me like a blanket.

“Hello luvvy, how’s yerself? You got ’ere nice an’ quick, ven.”

“Let’s ’ave yer coat and yer ’at.”

“Nasty night. Come on in an’ get warm, ven.”

“How about a nice cup o’ tea? That’ll warm the cockles, eh, luvvy?”

“She’s upstairs, where you left ’er. Pains about every five minutes. She’s been asleep since you left, just afore midnight. Then she woke up, about two-ish, pains gettin’ worse, an’ faster, so we reckons as ’ow we ought ’a call the midwife, eh, Mum?”

Mum agrees, and bustles forth authoritatively.

“We got the water hot, an’ a load o’ nice clean towels, an’ got the fire goin’, so it’s all nice an’ warm for the new baby.”

I have never been able to talk much, and in this situation I don’t need to. I give them my coat and hat, but decline their tea, as experience has taught me that, in general, Poplar tea is revolting: strong enough to creosote a fence, stewed for hours, and laced with sticky sweet condensed milk.

I am glad that I shaved Muriel earlier in the day when the light was good enough to do it without risk of cutting her. I also gave the required enema at the same time. It’s a job I hate, so thankfully it is over; besides which, who would want to give a two-pint soap-and-water enema (especially if there was no lavatory in the house), with all the resultant mess and smell, at two-thirty in the morning?

I go upstairs to Muriel, a buxom girl of twenty-five who is having her fourth baby. The gaslight sheds a soft warm glow over the room. The fire blazes fiercely, and the heat is almost suffocating. A quick glance tells me that Muriel is nearing the second stage of labour - the sweating, the slight panting, the curious in-turned look that a woman has at this time as she concentrates every ounce of her mental and physical strength on her body, and on the miracle she is about to bring forth. She doesn’t say anything, just squeezes my hand and gives a preoccupied smile. I left her three hours earlier, in the first stage of labour. She had been niggling in false labour all day and was very tired, so I gave chloral hydrate at about 10 p.m., in the hope that she would sleep all night and wake in the morning refreshed. It hasn’t worked. Does labour ever go the way you want it to?

I have to be sure how far on she is, so prepare to do a vaginal examination. As I scrub up, another pain comes on - you can see it building in strength until it seems her poor body will break apart. It has been estimated that, at the height of labour, each uterine contraction exerts the same pressure as the closing of the doors of an underground tube train. I can well believe it as I watch Muriel’s labour. Her mother and sister are sitting with her. She clings to them in speechless, gasping agony, a breathless moan escaping her throat until it passes, then sinks back exhausted, to gather her strength for the next contraction.

I put on my gloves and lubricate my hand. I ask Muriel to draw her knees up, as I wanted to examine her. She knows exactly what I am going to do, and why. I put a sterile sheet under her buttocks and slip two fingers into her vagina. The head well down, anterior presentation, only a thin rim of cervix remaining, but waters apparently not yet broken. I listen to the foetal heart, a steady 130. Good. That is all I need to know. I tell her everything is normal, and that she hasn’t far to go now. Then another pain starts, and all words and actions have to be suspended in the enormous intensity of labour.