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

Muriel is cooing and kissing her baby while her mother tidies up. The fire crackles. I sit quietly waiting, pondering.

Why aren’t midwives the heroines of society that they should be? Why do they have such a low profile? They ought to be lauded to the skies, by everyone. But they are not. The responsibility they carry is immeasurable. Their skill and knowledge are matchless, yet they are completely taken for granted, and usually overlooked.

All medical students in the 1950s were trained by midwives. They had classroom lectures from an obstetrician, certainly, but without clinical practice lectures are meaningless. So in all teaching hospitals, medical students were attached to a teacher midwife, and would go out with her in the district to learn the skill of practical midwifery. All GPs had been trained by a midwife. But these facts seemed to be barely known.

The fundus tightens and rises a little in the abdomen as a contraction grips the muscles. Perhaps this is it, I think. But no. It doesn’t feel right. Too soft after the contraction.

Another wait.

I reflect upon the incredible advance in midwifery practice over the century; the struggle dedicated women have had to obtain a proper training, and to train others. There has been recognised training for less than fifty years. My mother and all her siblings were delivered by an untrained woman, usually called the “goodwife” or the “handywoman”. No doctor was present, I was told.

Another contraction coming. The fundus rises under my hand and remains hard. At the same time the forceps that I had clamped to the cord move a little. I test them. Yes, another four to six inches of cord comes out easily. The placenta has separated.

I ask Muriel to hand the baby over to her mother. She knows what I am going to do. I massage the fundus in my hand until it is hard and round and mobile. Then I grasp it firmly, and push downwards and backwards into the pelvis. As I push, the placenta appears at the vulva, and I lift it out with my other hand. The membranes slide out, followed by a gush of fresh blood and some clotted blood.

I feel weak with relief. It is accomplished. I put the kidney dish on the dresser, to await my inspection, and sit beside Muriel for a further ten minutes massaging the fundus, to ensure that it remains hard and round, which will expel residual blood clots.

In later years oxytocics would be routinely given after the birth of the baby, causing immediate and vigorous uterine contraction, so that the placenta is expelled within three to five minutes of the baby’s birth. Medical science marches on! But in the 1950s, we had no such aids to delivery.

All that remains is to clean up. While Mrs Hawkin is washing and changing her daughter, I examine the placenta. It seems complete, and the membranes intact. Then I examine the baby, who appears healthy and normal. I bathe and dress him, in clothes that are ridiculously too big, and reflect upon Muriel’s joy and happiness, her relaxed easy countenance. She looks tired, I think, but no sign of stress or strain. There never is! There must be an in-built system of total forgetfulness in a woman; some chemical or hormone that immediately enters the memory part of the brain after delivery, so that there is absolutely no recall of the agony that has gone before. If this were not so, no woman would ever have a second baby.

When everything is shipshape, the proud father is permitted to enter. These days, most fathers are with their wives throughout labour, and attend the birth. But this is a recent fashion. Throughout history, as far as I know, it was unheard of. Certainly in the 1950s, everyone would have been profoundly shocked at such an idea. Childbirth was considered to be a woman’s business. Even the presence of doctors (all men until the late nineteenth century) was resisted, and it was not until obstetrics became recognised as a medical science that men attended childbirth.

Jim is a little man, probably less than thirty but he looks nearer forty. He sidles into the room looking sheepish and confused. Probably my presence makes him tongue-tied, but I doubt if he has ever had a great command of the English language. He mutters, “All right then, girl?” and gives Muriel a peck on the cheek. He looks even tinier beside his buxom wife, who could give him a good five stone in weight. Her flushed pink, newly washed skin makes him look even more grey, pinched and dried out. All the result of a sixty-hour working week in the docks, I think to myself.

Then he looks at the baby, hums a bit - he is obviously thinking deeply about a suitable epithet - clears his throat, and says, “Gaw, he aint ’alf a bit of all right, then.” And then he leaves.

I regret that I have not been able to get to know the men of the East End. But it is quite impossible. I belong to the women’s world, to the taboo subject of childbirth. The men are polite and respectful to us midwives, but completely withdrawn from any familiarity, let alone friendship. There is a total divide between what is called men’s work and women’s work. So, like Jane Austen, who in all her writing never recorded a conversation between two men alone, because as a woman she could not know what exclusively male conversation would be like, I cannot record much about the men of Poplar, beyond superficial observation.

I am about ready to leave. It has been a long day and night, but a profound sense of fulfilment and satisfaction lighten my step and lift my heart. Muriel and baby are both asleep as I creep out of the room. The good people downstairs offer me more tea, which again I decline as gracefully as I can, saying that breakfast will be waiting for me at Nonnatus House. I give instructions to call us if there seems to be any cause for worry, but say that I will be back again around lunch time, and again in the evening.

I entered the house in the rain and the dark. There had been a fever of excitement and anticipation, and the anxiety of a woman in labour, on the brink of bringing forth new life. I leave a calm, sleeping household, with the new soul in their midst, and step out into morning sunlight.

I cycled through the dark deserted streets, the silent docks, past the locked gates, the empty ports. Now I cycle through bright early morning, the sun just rising over the river, the gates open or opening, men streaming through the streets, calling to each other; engines beginning to sound, the cranes to move; lorries turning in through the huge gates; the sounds of a ship as it moved. A dockyard is not really a glamorous place, but to a young girl with only three hours sleep on twenty-four hours of work, after the quiet thrill of a safe delivery of a healthy baby, it is intoxicating. I don’t even feel tired.

The swing bridge is open now, which means that the road is closed. A great ocean-going cargo boat is slowly and majestically entering the waters, her bows and funnels within inches of the houses on either side. I wait, dreamily watching the pilots and navigators guide her to her berth. I would love to know how they do it. Their skill is immense, taking years to learn, and is passed on from father to son, or uncle to nephew so they say. They are the princes of the docklands, and the casual labourers treat them with the deepest respect.

It takes about fifteen minutes for a boat to go through the bridge. Time to think. Strange how my life has developed, from a childhood disrupted by the war, a passionate love affair when I was only sixteen, and the knowledge three years later that I had to get away. So, for purely pragmatic reasons, my choice was nursing. Do I regret it?

A sharp piercing sound wakes me from my reverie, and the swing bridge begins to close. The road is open again, and the traffic begins to move. I cycle close to the kerb, as the lorries around me are a bit intimidating. A huge man with muscles like steel pulls off his cap and shouts, “Mornin’ narse.”