Call the Midwife

In the mid-1950s, Jennifer Worth, a young nurse in her early twenties, arrived at Nonnatus House in London's East End expecting a small hospital. Instead she found a Victorian convent run by the Midwives of St Raymund Nonnatus, an Anglican religious order of nuns who were also qualified nurses and midwives. The order had served the Docklands for decades, delivering babies through epidemics, two world wars, and the Blitz. Worth came not out of religious calling but to train as a midwife, driven partly by a broken heart and the need for a fresh start. What she discovered among the nuns and the people of Poplar, Stepney, Limehouse, and the Isle of Dogs turned out to be, she reflects, the most important experience of her life.

Worth sets the scene by describing the densely populated Docklands, where families had lived for generations within a few streets of their birthplace. Men worked brutal hours in the docks; women managed enormous households with minimal facilities, washing everything by hand, often in homes with only cold running water and an outdoor lavatory. Families were large, contraception was unreliable, and early marriage was the norm. The area was rough, with common street fights and domestic violence, yet there was an unwritten code of respect for children, the elderly, and especially the district midwives, who traveled alone at all hours without fear. Worth identifies three forces that ended centuries of Docklands tradition within a single decade: slum clearance beginning in the late 1950s, the introduction of the contraceptive pill in the early 1960s, and the gradual closure of the docks by about 1980.

On her first evening, Worth was greeted at the convent door by Sister Monica Joan, a very elderly nun whose mind wandered brilliantly between cosmology, poetry, and nonsense. The two consumed an entire cake intended for the household, earning the fury of Sister Evangelina, a blunt, heavy-set nun with no patience for such antics. Sister Julienne, the small, warm, radiant Sister-in-Charge, smoothed the incident over. Two other young lay midwives, Cynthia and Trixie, convinced Worth to stay rather than flee what she initially perceived as an absurd situation.

Worth recounts her early deliveries in vivid clinical detail. Cycling alone through dark, rain-soaked streets at 2:30 a.m. to attend Muriel, a 25-year-old having her fourth baby on the Isle of Dogs, she delivered the baby and placenta safely while managing the anxiety of being a first-year practitioner without telephone access. She reflects on the immense responsibility midwives carried and their lack of public recognition, noting that all medical students and general practitioners in the 1950s were trained by midwives. Throughout the memoir, Worth weaves in historical background on the fight for proper midwife training and the 1902 Midwives Act, which addressed devastating maternal and infant mortality rates that prevailed when untrained "handywomen" attended births.

A series of patients and neighbors populate the memoir, each illuminating a different facet of Docklands life. Chummy, born Camilla Fortescue-Cholmeley-Browne, was a six-foot-two upper-class woman who found her vocation in nursing and God after a lifetime of social awkwardness. She arrived at Nonnatus House unable to ride a bicycle, essential for district work, and her determined efforts to learn, aided by Jack, a tough 13-year-old Cockney boy who became her devoted protector, provide some of the memoir's most comic passages. Fred, the convent's boilerman and odd-jobber, is another beloved figure whose entrepreneurial schemes, from breeding quail under his bed to manufacturing fireworks in his kitchen, offer comic relief and a vivid portrait of Cockney resourcefulness.

Worth describes the weekly antenatal clinic, where she examined patients in a converted church hall. Through Lil Hoskin, a woman on her 13th pregnancy, she discovered a syphilitic chancre, a hard lesion indicating infection, during a routine exam. Her initial revulsion softened when she visited Lil's home and recognized her as a heroine keeping a large family together in appalling conditions. Brenda, a 46-year-old woman whose body was severely affected by rickets, a bone disease caused by vitamin D deficiency, illustrates how the condition deformed poor women's pelvises and made natural childbirth impossible. Brenda had lost four babies in obstructed labors during the 1930s, possibly because she could not afford a Cesarean section before the National Health Service existed. Now pregnant again, she was radiantly grateful, and a successful Cesarean delivered a healthy daughter she named Grace Miracle.

On Christmas Day, Worth assisted Sister Bernadette, a gifted young nun, in delivering a breech baby, one coming bottom-first rather than head-first, for Betty Smith. Sister Bernadette performed the complex delivery with calm expertise while a raucous family Christmas party continued downstairs. Worth watched her read her breviary, a book of daily prayers, by firelight and was deeply moved, beginning to question her own dismissal of faith.

Mary, a teenage Irish girl Worth encountered at a bus stop, represents the memoir's darkest thread. Mary had fled abuse in Dublin, arrived alone in London, and been lured by a pimp named Zakir into prostitution at the Full Moon Café in Cable Street, one of several establishments that operated as brothels. Worth provides a harrowing account of the violence Mary endured and the death of her friend Nelly from a botched abortion. When Mary became pregnant, she escaped by stealing five pounds and running. Worth arranged refuge through Father Joe Williamson, a priest devoted to helping women leave prostitution. Mary gave birth to a daughter, Kathleen, but the Roman Catholic home where she was staying placed the baby for anonymous adoption without Mary's consent, reasoning that a teenager with no family could not raise a child. Mary was devastated. Years later, Worth reads that Mary was arrested for abducting a baby from a pram and sentenced to three years in prison.

Mrs Jenkins, a mysterious old woman who appeared outside every delivery asking about the baby, is gradually revealed to have one of the memoir's most tragic histories. Through Sister Evangelina's patient relationship-building, Worth learned that Mrs Jenkins had entered the workhouse, a dreaded institution where the destitute were confined, in 1916 as a widow with five children. Under the system of mandatory segregation, the children were torn from her and from each other. Over the following years, all five died. The last was a 14-year-old girl named Rosie, the "daughter" Mrs Jenkins still spoke of as though she visited regularly.

Len and Conchita Warren anchor the memoir's most life-affirming story. Len, a voluble Cockney painter, had brought Conchita home from the Spanish Civil War as a young peasant girl. She spoke no English; he spoke no Spanish. They had 24 children, all bilingual and harmonious. When Conchita fell during a dense London smog and went into premature labor at approximately 28 weeks, the baby, weighing roughly one and a half pounds, was expelled so suddenly that Worth nearly lost it. When a pediatric team arrived with an incubator, Conchita clutched the child to her chest and refused to let go. She fed the baby drops of colostrum, the nutrient-rich first breast milk, from a glass rod every half hour and carried him in a silk sling against her skin for five months. The baby thrived. Worth concludes that modern medicine does not know it all.

The memoir's spiritual thread reaches its resolution through Sister Monica Joan. After the elderly nun wandered out of Nonnatus House in her nightgown on bleeding feet, believing she had to reach a patient, Worth was overwhelmed with love for her. During Sister Monica Joan's recovery from pneumonia, Worth discovered that she had written hundreds of poems since the 1890s, including verses that spoke to Worth's own heartbreak. When Worth asked what impelled her to leave a privileged life for the slums, Sister Monica Joan replied that one cannot love ignorance and brutishness, only God, "and through His grace come to love His people." She dismissed Worth with three words: "Go with God." For Worth, these words became a revelation of acceptance, the beginning of faith. That evening, she started to read the Gospels.