'I ran down the street to find a drain for slops'

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By Caroline Parkinson Health editor, BBC News website

Home birth, natural childbirth, midwife-led care. It is a very modern approach to having a baby - but it's also how things were done in the 1950s.

The experiences of midwives then have been brought to life in Call the Midwife, the BBC One dramatisation of the memoirs of Jenny Worth, who worked as a midwife in London in the early years of the NHS.

It depicts the experiences of a young nurse Jenny Lee, who arrives in the East End to work as a midwife alongside an order of nuns.

For Mary Cronk, the series brought back many memories.

She too worked as a midwife in the 1950s, doing her rounds on a bike, just like the characters in Jenny Worth's memoirs - and took part in her last birth just three years ago.

"I have memories of working in Paisley when I was qualifying as a midwife in the mid-50s. We were visiting women in totally unsuitable, unsanitary homes", she said.

"But if they had running water and a fire, that was OK. I do remember running down the street to find a drain to pour the slops down though.

"The astonishing thing is that the outcomes were good. We were at the women's homes. We were just visiting. They did their own thing. They didn't expect anything else.

"The kind of cases we saw in Paisley were very similar to the social deprivation that we see in Call the Midwife. Women who were stunted in growth, very deprived, who were having huge families and who were married to men who drank heavily - or who were not married to them.

"They were in appalling social circumstances - but they were judged suitable for home birth."

Hospital move

Mary met Jenny Worth once, and compared notes.

"I had visited the nuns she worked with, as at one point I was going to do my training there. It was very interesting, because it's a very clear portrayal of some of the things that happened."

By the 1970s, birth had moved into hospitals. There had been the Peel report in 1970, which said all women should have access to hospital care when giving birth. And midwives were employed by the NHS instead of local authorities, as they had been previously.

But giving birth to a baby at home, in a natural birth guided by a midwife, is an option which women are increasingly returning to now.

Sue Macdonald, education and research manager at the Royal College of Midwives, said: "When you look at the history of midwifery, it does go in cycles.

"In the 1950s, it was before the move into hospital care - that came with the Peel report.

"Prior to that, most women gave birth at home and care was mainly in the community.

"Now we are trying to recapture the intimacy and individuality of the care that was provided then.

"But the difference is that we have a lot more evidence. For example, in relation to home birth at that time we didn't have the research into midwifery practice that we have now, or the understanding of risk factors for maternal mortality."

The other difference, she says, is that modern women are much healthier than their 1950s counterparts.

"Women were coming through the aftermath of World War II, and in general health wasn't as good.

"Women also had more babies. Having seven or eight children is much different to having one or two, where women want each of their births to be special."

"There weren't the same facilities then, but midwives were very much of the community. That's very important. And at that time, women knew their midwife and where to go.

"I don't know that women always know now."

The final episode of the first series of Call the Midwife is on BBC One at 20:30 GMT on Sunday 19 February.