Co.Create

Blood, Prosthetic Babies, And The Birth Of National Health Care: Behind Hit Brit Series 'Call the Midwife'

British screenwriter Heidi Thomas talks about adapting Jennifer Worth’s memoir for the small screen, the challenges of depicting childbirth realistically on television, and the show’s collection of prosthetic newborns.

British screenwriter Heidi Thomas didn’t think Call the Midwife, premiering on PBS September 30 at 8 p.m. EST, would be her "cup of tea" when executive producer Pippa Harris approached her about writing and co-executive producing the television adaptation of the late Jennifer Worth’s memoir, which chronicles the author’s years as a midwife in London’s East End in the 1950s. "I thought, ‘It’s set in the 1950s, and that’s not really my century,' " says Thomas, who is known for bringing heavyweight nineteenth-century novels like Cranford to television. "But when I read Jennifer’s book, I just couldn’t put it down. It’s an incredibly readable and evocative account of the female experience and quite captivating."

Inspired, Thomas went to work creating Call the Midwife, crafting a six-part series focusing on a young Jenny (played by Jessica Raine) and the other midwives of her day who made their rounds in the poorest area of London by bicycle, bringing medical care to women—thanks to the then newly formed National Health Service (NHS)—who, otherwise, would have had to deliver their babies on their own.

Produced by Neal Street Productions, which was founded by Harris, Sam Mendes, and Caro Newling, Call the Midwife became a ratings smash in the U.K. for BBC One earlier this year, and season two is currently in production.

Beyond being entertaining, the show’s depiction of the benefits provided by the NHS resonated with those who are currently fighting cuts being made to the publicly funded health care system. In fact, over the summer, modern-day midwives gathered in London and rallied outside Parliament to highlight the need for more midwives, donning cornflower blue uniforms like the ones worn on Call the Midwife and pedaling vintage bicycles. "I know in America there’s been moves to get free health care underway, but in the U.K., they’re starting to dismantle it," Thomas says, "and I think we all felt quite surprised but then very gratified that a story we set out to tell that’s set in another time actually became quite relevant with what’s going on today."

Thomas, whose credits also include the BBC period drama Lilies and a recent revival of Upstairs, Downstairs for the BBC, had to tinker with Worth’s story in translating it for television. "The better a book is on the page, the more you’re going to have to change it to make it work onscreen," Thomas says, explaining, "When you have memoirs, they tend to be quite fragmentary, and with Jennifer’s memoirs, you might get half a page of memories that give you a whole episode, or you might find three or four chapters that are very, very slight and won’t give you half an episode. So it was a case of mixing and matching material and changing story order, and then, of course, we did a great deal of medical research and that led to new dramatic pathways, new characters, and new situations."

The screenwriter notes that she was fortunate enough to meet and get to know Worth, who gave Thomas the gift of trusting her. But the author, who also wrote the memoirs Shadows of the Workhouse and Farewell to the East End, never got to see her tale portrayed on television because she died of cancer in May 2011, just a few weeks before Call the Midwife went into production. "The very last time I saw her, I sat by her bed on the most beautiful day in late spring. I remember the sun streaming through the window, and she was so ill she couldn’t get up. I just sort of sat by and said, 'I promise you I will make it the best thing I can,' " Thomas says. "I just wish she had been there to see it. I really do."

An elder incarnation of Worth narrates the show via a voiceover recorded by Vanessa Redgrave. "Very, very few shows earn that kind of narrative voice, but it was important to me," Thomas says, noting that the older woman looking back at her younger self enhances the emotional tone of the material, and it is also a way to keep Worth’s voice alive.

As we see in the premiere episode of Call the Midwife, Jenny, fresh from her training course, reports for duty at an East End convent inhabited by the endearingly eccentric Sister Monica Joan (Judy Parfitt) and the cranky Sister Evangelina (Pam Ferris) as well as Cynthia (Bryony Hannah), a shy midwife, and another midwife named Trixie (Helen George), a fun loving girl. (The second episode sees the arrival of yet another midwife, a tall, clumsy sweetheart named Chummy, portrayed by actress and comedian Miranda Hart.)

Immediately thrust out into the field, Jenny’s first patient is a Spanish woman who doesn’t speak a word of English and is pregnant for the 25th time. The birth is not routine.

Call the Midwife does not shy away from realistic depictions of childbirth. "We want it to be graphic because we feel as though we’re telling a story that has never been told, and if we’re too coy and too shy, I think we will lose the essential realism that does give the drama a bit of muscle," Thomas says. "You know, there’s no point of seeing a woman lying down with her hair all done and then cutting away to a cot where there’s this three-month-old baby."

That said, there isn’t a ton of blood. "We do go light on the blood. We’ve had a lot of beating about the blood. Everything gets checked by the BBC, and they would say ‘No blood,’ and I’d think ‘But it’s childbirth. When they have a murder program, there’s blood sliding down the walls.’ I pointed this out, and I said, ‘When they have blood, there’s blood everywhere,’ and they said ‘Oh, that’s crime. That’s all right,’ " Thomas says. "I found that quite strange because God knows how many more babies are born every day in the world than people get murdered. But that’s TV for you."

While the show does work with real newborns under the supervision of a nurse, the Call the Midwife production team also has an entire cast of prosthetic babies to call upon. "We keep them on a shelf, and it looks quite creepy if you walk past and see all the babies that we’ve got," Thomas says with a laugh. "We’ve got a little preemie one, which is quite small, and then we’ve a bigger, more robust one, and we have a mixed-race one, and they all have interchangeable genitalia, which we never show. I don’t really know why we have that embellishment, but they’re quite anatomically correct."

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