Tag Archives: midwifery

“Call the Midwife – A Memoir of Birth, Joy, and Hard Times” by Jennifer Worth

This well written memoir was published in 2002, the first of three books about practicing as a midwife in the poverty stricken East End area of London (the Docklands) in the 1950s. The BBC produced a television series based on these books, broadcast beginning in 2012. Having seen just one episode, I was expecting Call the Midwife to be humorous and exciting. Instead I found it to be gritty and very sad. I actually skipped one chapter (about the workhouse), not feeling up to it.

The first surprise for me was how BAD conditions were in postwar London. Wartime damage to buildings had not been repaired. Housing was limited, so poor people lived in overcrowded and unsanitary conditions. Not every apartment had a bathroom or hot water. Men readily found employment on the docks, but the work was hard and poorly paid. Women married young and had many children. If they worked, they were poorly paid.

Nonetheless, there were positive aspects to life in the Docklands. People knew their neighbors well, and extended families were very supportive. Nurses and doctors were so respected that they were safe even in violent neighborhoods, where the police worked in pairs. Worth also mentions in passing the richly expressive Cockney dialect, almost a distinct language. She understood it most of the time, but certainly never spoke it.

Having just read  Empty Planet – the Shock of Global Population Decline by Bricker and Ibbitson (see blog entry dated August 15, 2019), I found myself pondering the “demographic transition”, the shift of a community from high birthrate with high death rate to (eventually) low birthrate with low death rate. Sometimes countries at these two extremes are described as “third world” and “developed”.  East End London in the 1950s was in a transitional state, with high birthrate and low death rate. It was challenging and (inherently?) unstable. The conditions described were so bad, I had trouble remembering that I was NOT reading about, say, the year 1900.

The quality of obstetrical care provided in this teeming slum was amazingly high. Midwives and nurses were well trained. Doctors and hospitals could deal with a wide range of emergencies. Most babies were born at home, attended by a midwife. Follow up as extensive as three nursing visits PER DAY might continue for several weeks. Doctors also made home visits, and extreme emergencies were handled by an Obstetric Flying Squad which could transport mother and baby to a hospital quickly if necessary. The maternal and infant survival rates were high. Little was available by way of contraception, so families with more than 10 children were common.

Death rates also fell because antibiotics became available and communicable diseases were increasingly controlled.

In the introduction to Call the Midwife, Worth attributes the disappearance of the Docklands community to “the closure of the docks, slum clearance. and the Pill”. When oral contraception became available, women chose to have much smaller families. The midwifery practice in which Worth was employed saw births fall (over a few years) from 80-100 per month to four or five per month! One can only speculate about how things would have changed if this reproductive revolution had NOT been accompanied by job loss and the wholesale destruction of old (but potentially useful) housing.

This book should be read by urban planners. Some experts think that the most sustainable human future will arise from high density urbanization.

“The Chilbury Ladies’ Choir” by Jennifer Ryan AND Shakespeare’s “Twelfth Night”

This book reminded me of The Guernsey Literary and Potato Peel Pie Society by Shaffer and Barrows, published in 2009. Each novel consists of a series of letters, diary entries and notices. Ryan’s novel seemed less “spontaneous” than Guernsey. Would anyone really write such wildly uninhibited letters?? But both novels, each dealing with British civilian life during World War II, make good reading.

The church choir in the village of Chilbury is deactivated when too few men are left in town to sing tenor and bass. The Ladies Choir’ takes its place, at first tentatively and then with vigor. Chilbury is located next to a city named Litchfield Park, possibly meant to resemble Bletchley Park, where Britain’s crucially important code breakers were headquartered.

Yes, there’s a spy among the characters. He turns out NOT to be a villain. Ryan creates interesting villains. One is predictable, a military man (a brigadier) who bullies his family and neighbors. But another is a midwife! (See my blog entry of May 24, 2018 about midwives in fiction.) The brigadier and the midwife enter into a nefarious scheme to insure a male heir for the brigadier. Other plots unfold. Many important characters are children and adolescents. Ryan depicts the impact of war on their young lives very realistically.

Ryan’s plotting is uninhibited – she throws in complications fast and furious. I couldn’t stop reading! One of my favorite characters was Kitty, the third child of the brigadier. At 13, she’s full of energy and curiosity, headlong and rambunctious and confused by the War and it’s impacts. She reaches out to other children and also to adults as she struggles to cope. There are enough interesting characters in this book to make me hope for a sequel. After all, the Battle of Britain has barely started!

What’s this got to do with Shakespeare’s romantic comedy, “Twelfth Night”? I attended a discussion of the play recently. Remember the identical twins, Viola and Sebastian, who are separated after a shipwreck? Viola disguises herself as a man, and is mistaken for her brother, who she fears is dead. Love at first sight strikes several characters, and giddy confusions ensues. Our discussion leader pointed out that “Twelfth Night” has a subtitle, namely “What You Will”. Our starting discussion question was “Is love something you WILL, or is it something that happens to you?” Great question! We talked for over an hour. Do you choose to love? Does reason play any role in love? No, we didn’t reach a conclusion.

In The Chilbury Ladies Choir, Jennifer Ryan depicts characters to whom love “happened”. They weren’t “looking for love”, but were taken by surprise. There are two couples, one young but sophisticated, the other older and burdened with sorrows. For each of these four people, love is a dangerous path.

The person who recommended this book to me said it was about music. This aspect was handled lightly and deftly, with occasional references to hymns and choral performances. Two other themes are change and leadership.

This book rises well above the “chick lit” or “beach reading” category. I’d classify it as high quality historical fiction. The echoes of World War I are important. Read and enjoy, but remember, war is hell.

“The Mountain Midwife” by L. Eakes and “The Secrets of Midwives” by S. Hepworth

How did I end up reading two books about midwives in the same month? Better not to speculate…

The first of these books was not worth the time it took to read it. Eakes is described (by Wikipedia) as a “romance author”. She does not do well by the genre. Her characters are relatively one dimensional. She’s got some kind of Christian/family values “agenda” going on which I found annoying.

The Secrets of Midwives was better. There are two main themes:

  • The joy and wonder of birth
  • The power of secrets, both to protect and to injure

Carrying these threads through three generations, Hepworth writes a gripping tale. Some of the romance was a bit trite, but overall this was a good read.