Heidi Thomas Prepares To ‘Call The Midwife,’ Again


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For six years and six seasons of television, screenwriter Heidi Thomas has explored the challenges of 1950s-era British midwifery. Now, as the seventh season of her PBS drama Call the Midwife heads to air just ahead of her upcoming MASTERPIECE adaptation of Louisa May Alcott’s Little Women, Thomas explores how a charming midwife’s memoirs became an unlikely global success story.

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Jace Lacob: I’m Jace Lacob, and you’re listening to a special edition of MASTERPIECE Studio.

While we wait for the upcoming MASTERPIECE broadcast of Heidi Thomas’ adaptation of Louisa May Alcott’s Little Women, we turn today to another of the prolific British screenwriter’s popular series.

For the last six years, PBS has been home to a particular strain of unsung heroine: that of the mid-20th century British midwife.

Since its premiere in the spring of 2012, Call the Midwife has been a wild and unexpected success. A debut audience of more than 10 million in the UK carried over into a successful American broadcast that continues on into the seventh season of the series. And it all started with a midwife’s memoirs.

Heidi Thomas: I just thought It was the most beautiful, compelling story of a woman’s experience in which she interconnected with different women, different lives, at a time of history I knew very little about. And yet, it was so vivid and felt so relevant to the present day.

Jace: It’s 1963, and change is in the air — both in Poplar and around the world. For the last six seasons, Call the Midwife creator Heidi Thomas has closely traced out the lives, loves, and losses of the midwives of Nonnatus House. Thomas joined us for a special conversation on how an unlikely show about childbirth in post-war England turned into a global success story.

Jace: We are joined this week by a Call the Midwife creator Heidi Thomas. Welcome.

Heidi: Thank you for having me, Jace.

Jace: Now, take us back to the beginning. What was your experience first reading Jennifer Worth’s memoirs?

Heidi: My first experience of reading Jennifer Worth’s memoirs was that I refused to read Jennifer Worth’s memoirs. It was sent to me as an adaptation project, and I didn’t like the cover. I thought,  “This isn’t me. I’ve just done Cranford. I do 19th century literature.” Pippa Harris, with whom I’d worked on previous projects, had sent the book to me and she said, “Look Heidi I really think if you read it, you would love it.” She intuited that there would be a connection between me and the material. I said, “I’ll tell you tomorrow, I’ll have a look at it tonight.” I was still there turning the pages at 3:00 in the morning. So rather shamefacedly I rang Pippa up and said, “Please let adapt this book for the screen!” And that was the beginning of it.

Jace: Now this is ultimately a show about those major road markers in life: birth, marriage, death and everything in between. How does it feel to be responsible for making so many people sob on a weekly basis? It’s almost Pavlovian.

Heidi: I mean what an epitaph: “The Woman Who Made Everybody Cry.” And I cry when I’m writing it and sometimes it’s just the moment of truth in a story, or something in research that I come across. And sometimes I cry watching it because I’m so moved by the actors’ performances, often if it’s just a guest actor that we haven’t seen before. I love the fact that people engage emotionally with it. But my challenge is not to cynically be trying to turn tears out of them with a handle, because that’s just reprehensible. And I think it would lead the whole of the series completely the wrong way. I think it’s almost incidental that people cry. What I’m out to do is tell them really good stories that they feel invested in. And I feel as though it’s honorable to do that deliberately; it’s not honorable to try to upset people deliberately. Do you cry?

Jace: Every time. Every time.

Heidi: I’m sorry.

Jace: Without fail.

Heidi: Yeah.

Jace: There are very few shows that can that can actually do that. Call the Midwife is one that on a weekly basis I am sobbing.

Heidi: Yeah.

Jace: And not always sort of nice polite sobbing but…

Heidi: Ugly crying.

Jace: …ugly crying.

Heidi: It happens, yeah.

Jace: It’s upsetting. You’ve tackled everything on Call The Midwife from female genital mutilation and thalidomide to Down Syndrome and abortion, alcoholism, domestic violence. Is there a hot-button topic that you haven’t been able to cover, or that you’d like to tackle?

Heidi: At the moment, I can’t think of anything that I have very specifically within my sights. I think in a way, the early 60s—Series 7, which is about to go out, is set in 1963—a lot of accounts had been opened in terms of the way society was going to deal with things, notably through the prism of women’s experience, that’s very much the way we look at things. We’ve started to talk about domestic violence because women were starting to talk about domestic violence; we’ve started to talk about the pill because women were starting to take the pill, but none of these journeys were simple. I see, going ahead—we already know we’re going to be making Series Eight and Series Nine—I think what we’re going to see is returning to the same subjects, but looking at them in a different way, or seeing how experience has changed over the 1960s. Genital mutilation, domestic violence, disabled children being born—none of these are one-off incidents in human history. They happen again, and again, and again, and sometimes the outcome is better and sometimes it’s worse. I think part of our remit as a series is to look at how experience evolved. Did things change for the better, or did they change for the worse? I think that’s more the way we’re going to go, rather than always looking for the new. We’re going to be looking at the lived experience, because we still haven’t used the word “feminism.” We are a feminist show. We look at feminist issues from a feminist perspective, but the word has not been coined for everyday usage. I feel as though we’re still building up to that.

Jace: Now, despite the fact that the show is set in the 1950s and 60s, issues about healthcare and female reproductive rights feel especially relevant and timely today. Do you feel the show arrived at the right time to talk about the NHS and conversations about women and reproductive health?

Heidi: I think these are conversations which are always relevant. I think that were relevant then— they weren’t necessarily happening then—and in Britain, I have loved the opportunity to show the NHS when it was up and running in the most spectacular way. But it was always flawed. I think some people who don’t follow the show closely think we just blindly celebrate the NHS. But what we’re actually saying is, “Look what can be accomplished when the reach exceeds the grasp, when you’re always trying to do something better, when you’re trying to live up to an ideal.” Yes, mistakes are made; yes, it’s imperfect. Yes, the holding maternity clinics in the parish hall are a room above a pub, but just because something isn’t perfect is no reason to dismantle it. And certainly in Britain at the moment, the common thesis is, “The NHS is a disaster. Close it down. Privatize it. This is no good.” Whereas what we should be saying is, “It’s always been held together by chewing gum, and string, and goodwill—the goodwill of the patients, the goodwill of the medical caregivers.” I think if we lose our goodwill towards the National Health Service we are undone. What we have is a jewel. It is a jewel in British history. I think it is a jewel with a finite life. I don’t know where we will be in ten years’ time but I’m very glad that we will have had a chance to say, “Look how it was doing in 1963, when it was 16 years old.” The National Health Service is a teenager in Call The Midwife, and like a teenager it has its problems. It has its flaws. It’s sometimes a bit chaotic, but it’s ultimately well-meaning, and I think that remains the case today. That has been a very important thing. I think what’s been interesting is women’s issues have actually risen up the agenda in the past seven years. In Britain, abortion is legal and it has been for quite a long time. We are doing a drama that’s set in a time when it was illegal, when the practitioners could go to prison. The women themselves could go to prison, and certainly would have felt the long hand of the law. I think it’s worth remembering that this is recent history. It’s within my living lifetime. We as a society, and I mean as a global society, cannot afford to be complacent. I think young women nowadays, in their sort of late-teens/early 20s, have no idea how lucky they are. If all we’re doing is showing them how lucky they are, I think that’s a good thing. Sometimes just showing the way things used to be is an education for the younger generation, and the older generation of women in particular feel validated by seeing their experiences on screen.

Jace: Now childbirth is always miraculous and always perilous. How important was it to you that Call The Midwife be truthful to the difficulties and realities of childbirth?

Heidi: Oh, it’s absolutely imperative. There is always a degree of difficulty the degree of pain, but most natural childbirths end well. I think we’re showing midwifery at a very interesting period when we began in Series One. There wasn’t even domestic pain relief available, so we were sharing natural, unmedicated births in a home setting, which nowadays is perceived as a revolutionary act. It was happening every day of the week in Britain, at that period. In Series Two, as was historically appropriate, we introduced the gas and air machine, and the births became a bit less screamy a bit more relaxed, and probably a bit more encouraging to viewers at home. Nobody has ever told us that they’ve been frightened out of having babies by Call the Midwife. A lot of them have said it’s given them courage. We’re very popular with midwives because we show normal labor. We have a midwife consultant on set at all times, and I go through my scripts with her and we discuss story ideas. And at different times, we’ve show, for example: A long, slow labor, where the woman’s biggest problem is she’s bored to tears, and she’s done about six crosswords, and it’s kind of grinding on…It’s also normal—as Terry, our midwife consultant says—when Sheila had her baby at the end of the last series, she’s grizzling, “It’s like a nightmare!” Terry said, ‘This is brilliant. This is normal labor. You’re showing that it’s going on all day. It has its ups and its downs, and ultimately ends at the desired and positive result.” I think it was very important from an early stage not to make every birth a story of peril. We’re trying to derive the drama around the birth from the woman’s circumstances. Has she been recently bereaved? Does she have an interfering mother in the room? Is she hoping for a girl after four boys? All of these things are the warp and the weft of our drama. It’s not necessarily medical peril.

Jace: Before this next question, a brief word from our sponsors…

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Jace: My son was delivered by midwife, and I will never forget the woman who kept us calm during a very difficult delivery, and she reminded me more than a little bit of Sister Evangelina, if I’m being honest. Do you think that the show has helped to bolster the image of midwifery, especially in the States?

Heidi: It’s very interesting the difference between midwifery in the States and the United Kingdom. The most recent statistics that I saw: In Britain, 82% of babies are delivered by midwives, the vast majority in a hospital setting. In America the equivalent statistic is 8% of babies are delivered by midwives, the vast majority in a home setting, because it’s perceived as radical and alternative. The obstetrician still rules, and in Britain, you see an obstetrician if there’s a complication. My baby was delivered by forceps, so in came the worryingly-young looking student obstetrician with the forceps. On either side of the Atlantic I think the experience is very different. Anecdotally, we have been told by very senior American midwives that we are really changing the image of midwifery. We are reminding people that it’s a profession; we are reminding people that midwives have very highly trained and have huge biological and scientific knowledge. I think in America there’s a slight problem: some midwives are lay midwives, they don’t have full medical training. In Britain, you do a degree in midwifery, or you can train as a nurse and then do a year’s midwifery training. In Britain what happened was applications to midwifery courses went up tenfold. It meant that midwifery schools who’d struggled to attract candidates were now getting enormous numbers, and that meant that the midwifery schools were able to choose the very best candidates, so the quality of qualified midwives has gone up, as well as there being many more midwives out there. I’ve actually got an honorary doctorate for services to nursing and midwifery from a wonderful university called Edge Hill University near my home city in the northwest of England and I think that’s my proudest possession. The idea that by doing the thing I do, I’ve made it more attractive for people to do something better. That’s amazing. I’ll never have a writing job that will have that sort of impact again.

Jace: Now going into the seventh season of Call the Midwife, with two more already commissioned, what are the challenges for you in terms of keeping the show fresh after so many years, and what are the opportunities?

Heidi: I think the thing that I thought would be a problem has actually become our biggest advantage, which is we have a very loyal cast. You can almost divide it down the middle: young cast, older cast. Every so often someone wants to leave. It’s usually the younger actors, but Pam Ferris, who plays Sister Evangelina, opted for semi-retirement. She’s very keen on her garden, and we always film in the summer and she’s said, “I’ve got to retire. My carrots are running to seed.” She was making a life choice. The younger ones come to our show, they haven’t done much television usually, and they want to see what else is out there. You think, “Oh my goodness Patsy is leaving,” or, “Sister Evangelina’s leaving.” You bring in a new character to fill the void and it becomes a new engine, and it constantly refreshes our brand. It’s a different equation between the nuns and the midwives themselves and they interact with their patients in a different way. So that feels like the biggest challenge; it’s usually the biggest advantage and a great excitement. I mean yesterday I was starting my research for Series Eight, which will be filming this summer and I was just reading London County Council’s medical report for 1964. What’s really exciting, going back to my earlier reference to the National Health Service, is things were starting to change. They brought in a new profession which was health visitor, which was a qualified nurse who was trained to work with problem families, because social problems were on the rise with high divorce rate, great inequality…even within the working class, some people were actually destitute. This was leading to problems in terms of housing. I’m just thinking, the further we get into the 1960s, the more complicated and revolutionary society is becoming, and that’s impacting on the medical world. The pill, by 1964 having been newly introduced in 1962, was so popular that health visitors were targeting problem families where there were too many children—or the children were juvenile delinquents—and offering the mother the pill. That smacks of eugenics to me and I can’t think it went down very well. If you’re sitting there in your council flat with your eleven kids for somebody to come round and say, “Have you ever thought of taking pills to stop this happening?” It’s an assault on someone’s personhood. So there’s instantly an episode for me there. I think because we’re set in a very fast-moving and dynamic decade, society itself is providing story opportunity. Within the Nonnatus House family there will always be opportunity for new relationships. I mean, Nurse Crane, I don’t ever want Nurse Crane to marry or have a romance, but I felt she lacked a sparring partner, so I’ve introduced a new policeman, and they kind of go at it hammer and tongs. It’s just brilliant watching two actors of that caliber working together. People keep saying, “Is it a romance?” I’m like, “It’s a very slow burn, if it’s a romance at all.” From within that sort of core cast of characters, the way they interact with each other always sparks off something new as well.

Jace: The dialogue on Call the Midwife is superb, but one character often walks away with the very best lines. How much fun is it to write for her Sister Monica Joan, played by the amazing Judy Parfitt?

Heidi: I really do think Judy Parfitt is the best actress working today. She is an actress, when you say, of the old school—I mean she trained as an actress in the 1940s. Her diction is impeccable. She’s very experienced in Shakespeare, and she quotes Shakespeare, and indeed Keats, which I felt was appropriate for the character. You cannot give Judy a sentence that she doesn’t burnish and turn into a jewel. Every time I write a scene for Monica Joan I think, “Do your best work, because Judy will give you the best performance you will ever get.” I mean she’s a lovely character to work for because of the way her mind works. She’s so incredibly well-read, so she’s influenced by the classics, but she’s also influenced by the Bible. If you think of someone who’s read the King James Bible every day of their lives, several times a day, those beautiful, 17th Century cadences will creep into their speech. She just really knows how to rollout a sentence. Monica Joan knows it as a character and Judy knows how to play it. The other thing about Judy, which I can take no responsibility for, is her impeccable attention to detail. If Judy’s in a scene threading the needle while everybody else is talking you’re just like, “Wow, look at Monica Joan threading a needle.” She never stops working. Even the big group scenes we have around the table. she’s utterly focused on her own run. Sometimes you can see her over the shoulder of somebody else’s close up, or whatever. She’s working constantly. Like a lot of senior actors, she doesn’t like the younger ones bringing their phones on set. She said, ‘They shouldn’t be on their phone between takes. When you are between takes that is when you are thinking about your next take, and what you can do with it, and how you can allow your character to shine.” From the minute she arrives on set, she works, and she works, and she works, and that’s that. It sounds like a trope but they just don’t make them like that anymore.

Jace: In a broad sense, where are we going this season on Call the Midwife, in the very broadest of terms?

Heidi: In the broadest of terms, we very much bed in Valerie—who was new last series—and we also have our first midwife of color, who is Lucille, who arrives from Jamaica. She’s trained in Britain, but she’s still a relative newcomer. We are looking at Britain becoming more multicultural. She’s not just a midwife of color; we don’t only look at her from a race perspective, she has other attributes and she’s very funny and elegant and charming. I think we’re looking at British society broadening out and becoming more inclusive, or in some ways, less inclusive. I think individual characters go on different journeys. I think one thing that seemed to emerge as a theme throughout this series is family, and the way families are shaping up differently. Fathers get a bit more looking. They’re being encouraged to come into the room and they’re not very keen, in some instances. Yes, it’s about family—family ties, what they mean. How is family defined in a Britain which is changing and looking more at relationships between women and men, which is obviously a key part of the female experience?

Jace: We get a Eastern European au pair for the Turners.

Heidi: Yes we do, Magda. The glorious Magda we look at as well, it’s quite nice.

Jace: And we find Trixie in the midst of what seems like a personal crisis.

Heidi: We do, and we’re not spoiling this very heavily, because we feel alcoholism shouldn’t be treated as a sensational plot point. For some people it’s a daily battle. Trixie has done very well since Series Four, when she first confronted her problem with alcohol. In Series Five, she coped with it by taking up exercise to an almost obsessive degree. We felt that was important to acknowledge. Then in Series Six, she starts to find her feet romantically again and we were becoming increasingly aware that it wasn’t very realistic to show her battle as effectively being over. We realized it would be realistic to see Trixie backsliding at some point. So we wove that into the fabric of Series Seven. Then—as has been widely publicized—Helen became an expectant mother. A great many swing coats and clipboards were brought into service. We did have to give her a couple of episodes off. It was actually perfect. We give her a little break to go and cope with her problems, but we explore those very fully. I’m hoping that people will find her journey authentic and valuable and also encouraging as well.

Jace: It was happy families for Tom and Barbara when they set off for Birmingham. Are they still quite happy when they return to Poplar?

Heidi: They are. They are returning with great happiness. Life throws challenges at them along the way, but I think the key challenge with Call the Midwife for all these years has always been not to let it become a soap. We’re a medical drama, and when our characters marry or have an emotional storyline, we never really allow it to dominate. It’s something that became necessary because our audience are invested week by week in these characters. If we’d followed the structure of the original books permanently, the spotlight would always be on the stories of the week. Our regular characters would be very peripheral and we don’t feel that’s right either. We had a struggle to get people to believe in Tom and Barbara, because he’d been involved with Trixie, but the minute they got married everyone just loved it. We will never be a soap, but we will always acknowledge the private lives of our caregivers, because I think that’s a good balance.

Jace: What is the most unlikely fan encounter that you’ve had?

Heidi: We’ve had a few. One that really worried me was when I used to be on Twitter. Somebody tweeted me a picture of her Patsy tattoo, and I had just find out that Emerald Fennel wanted to leave. I thought about tweeting, “Don’t do it! Don’t get the tattoo!” Most unlikely…I think we always used to be very surprised when men came up to us and said how much they enjoyed it. But that is quite the commonplace now. That no longer seems unusual. The nicest one, and we were very delighted by this, was just after Christmas, we had the “baby in the bag” story, and an old man of eighty four rang the office and said he’d been put to one side and assumed stillborn, but he’d been left just near enough to the fire to survive. He said, “Thank you for telling my story.” That was probably the most recent, direct fan encounter and I think it’s one of my favorite of all time.

Jace: Heidi Thomas, thank you so much.

Heidi: Thank you very much, Jace.

Jace: Shifting from the Midwives to the Marches, Heidi Thomas’ brand new MASTERPIECE adaptation of Louisa May Alcott’s Little Women debuts Sunday, May 13th, 2018.

In two weeks on MASTERPIECE, Benedict Cumberbatch and Kelly MacDonald star in a brand new adaptation of Ian McEwan’s captivating novel, The Child in Time.


Julie: Where is she?

Stephen: She was there. She was there.

Julie: Stephen where is she?

Stephen: She was just there, she was right there.

Julie: What do you mean?

Stephen: I don’t know.

Julie: What do you mean? Where is she? Where is she now?

Jace: A modern married couple struggles to cope with the lingering trauma of their missing four-year-old child. Actor Kelly MacDonald joins us to discuss the difficulties—and unexpected joys—of filming this emotional drama with Benedict Cumberbatch.

That’s April 1st in your podcast feeds, following the U.S. television broadcast of The Child In Time.

MASTERPIECE Studio is hosted by me, Jace Lacob and produced by Nick Andersen. Elisheba Ittoop is our editor. Susanne Simpson is our executive producer. The executive producer of MASTERPIECE is Rebecca Eaton.

Sponsors for MASTERPIECE on PBS are Viking Cruises and The MASTERPIECE Trust.




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