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Published date: 18 May 2016

Screenwriter Heidi Thomas shares the process of transforming Jennifer Worth’s memoirs into the BBC period drama  ‘Call the Midwife’, a TV series about midwives working in the East End of London in the late 1950s.

Author: Carianne Whitworth (admin) Duration: 00:43:54

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I’m here, obviously as the writer and series producer of Call the Midwife. I’ve been working on the show for 8 years now because obviously we started 5 years ago on television and I was working on it for a couple of years beforehand.

I do a lot of talks about behind the scenes at Call the Midwife – this one’s slightly different. As you can see, it’s called researching Call the Midwife, so in a way it’s a bit more ‘before the scenes’. I’ll be talking about my research process, our process as a team, how we bring a very detailed accurate historical programme to the screens and obviously there’ll be other stuff as well.

We’ve got a long history now as a show so I won’t be able to cover everything and if there’s anything that you really do want to discuss do bring it up later because I’ll be delighted.

[Points to first image] So there we have our three lovely girls – now that’s what we call an iconic picture. We try and choose one for every series which will jump out at you from a newspaper, a magazine, a video stand, whatever.

And one of the iconic things, as you can see, is the red cardigan. It’s become a sort of instantly recognisable thing. I think it was my only sort of contribution to the costume line of Call the Midwife. I arrived very, very late for my first location meeting for Call the Midwife; there’d been a terrible accident on the M25 and I was 4 hours late, and when I arrived the costume designer and the set designer were at daggers drawn about the colour of uniforms.

You always have to have a palette for a television show. And that would be the colour of the walls in Nonnatus house, the colour of the costumes, there’s certain colours that would be forbidden and there are other colours that will really sing out against one another or work in sync with one another. The original uniforms, as you know, had a Peter Pan collar and no visible buttons and they’d sort of run their course so we refreshed them for this series. But on this particular day of the meeting the struggle was that we were trying with the nurses’ dresses to reflect history, but we also had to put those costumes on screen in a way that would work. It’s almost a metaphor for how you make history and fact work on television as drama.

The original uniforms were grey. They were worn with a grey coat and a navy hat and you can imagine it would look dingy on screen, the actors would look mouselike, they would feel uncomfortable and I actually said, coming into the room where they’d reached a dead end, wear red. They decided on the pale blue and I said red hats and red cardigans – the dresses will feel authentic but we’ll have that pop of colour that will make it worthwhile on screen. And that’s what happened, so as I say that’s a metaphor for the kind of process I’ll be describing to you as we go through these slides.

Call the Midwife, the book: where it all began. I was first approached by Pippa Harris of Neal Street productions in 2008 about this book. It was newly published, it had been published by small medical press about 2 or 3 years previously. Jennifer Worth was a retired nurse and midwife. She only practiced midwifery for a very short time in the 1950s, she nursed throughout the 60s – mainly in hospice care and cancer care – and then she had retrained as a music teacher and concert pianist. She was a very, very gifted woman with very diverse talents. Her first book was actually a book about how she cured her own eczema through diet, which became a sort of cult hit. Her publishers had suggested there might be another book in her and this was it, which is incredible really when you think about it.

It was offered to me in this form as hardback before it was on the open market. It was in development for BBC TV for about two years, which is not unusual, and during that period of time it became quite a bestseller. It had a huge word of mouth popularity… women were saying to each other ‘read this book!’ It was doing the rounds of book groups, mothers were giving it to daughters and vice versa. But when I was first given it, I had never heard of it or of Jennifer Worth, but my husband said he always remembers me going upstairs to read it and I came down and I said, ‘I think I can do something with this,’ which is possibly the greatest understatement of my life because it’s become, in our house at least (because I don’t know if any of you know, but my husband plays Doctor Turner) it’s become our sort of family business really! I worry for our son, who’s at university, that when he comes home it’s a bit like, I don’t know, being a member of the Clarks family and coming home and all your parents are talking about is shoes! But he bears it quite well.

Jennifer Worth – wonderful woman, I’m going to talk about her more. Call the Midwife is a true story of the East End in the 1950s and again, that’s part of the theme I’m going to talk about this evening because as most of you know, BBC TV has very strong rules about compliance and truth, particularly in documentary. Around about this time when I was first given the book there’d been quite a hoo-ha in the press about a polar bear documentary. Footage of a polar bear in the wild had been supplemented by footage of a polar bear in a zoo and the viewing public felt very cheated because that hadn’t been made clear.
There are other rules at the BBC, all of which I believe are good ones – including if you’re telling a story of somebody’s life and you’re using their real name you have to be absolutely accurate: you can’t change the facts, you can’t manipulate them, you can’t tie them in a bow, you can’t separate them from one another. Facts are facts are facts. And as a dramatist, that presented me with a very significant problem because this book was an unputdownable read, it really was. But in places, half a page of Jennifer’s writing would give you something that can give you an hour of drama. In other places, she might give you three chapters that give you half an hour. And that’s the way with all adaptation.

l’ve come to this fresh from Cranford by Elizabeth Gaskell, which is actually based on Gaskell’s own memoirs, her own memories of her youth and childhood in Cheshire, heavily fictionalised. I wanted to be able to do the same with Call the Midwife, but I knew if this was true, if this was a documentary piece of work, there were going to be real constraints. I was concerned about this. One of the first things you do when you’re adapting a book for the screen is you start to break it down, you go through it, you make a lot of notes and I was also looking for things that I could research more deeply and look into and get more information. And there were two things that jumped out at me.

The first was the mention of Sister Evangelina, who ultimately was going to be played by Pam Ferris and I didn’t know that then. If I had known that I would have been very thrilled because I have worked with her before. It [the book] said that during World War One, Sister Evangelina had been parachuted down behind enemy lines to look after wounded soldiers. Now I don’t know much about aviation history, but I know that parachutes weren’t widely used in warfare until Operation Market Garden in World War Two and a little bit more research confirmed my suspicions. They were first used en masse by the Soviet Army in 1933, so I immediately thought that [the fact about Sister Evangelina] was not quite correct.

Then there was another thing: the character of Chummy played by Miranda Hart. It said her father had been the governor of Rajasthan and when I looked into that further, Rajasthan did not exist as a state until after Partition and thereafter all the governors were in fact Sikhs. Here I thought a novelist’s imagination has been at work here! There it was proved and it was actually an incredible liberation.

I went to meet Jennifer Worth – this picture was taken in her home, and as you can see by that time she was an elderly lady. I met her in her 70s and music was the defining thing of her life. She always said midwifery and nursing was a dim memory, it was many years ago.
She confirmed that they [the books] were memoirs, it wasn’t a documentary, and she and I worked together to make sure that the book itself – in fact it was part of a trilogy – but it was two books in particular in the trilogy we expanded and embellished to round out the characters.

Sister Julienne, for example, was very liminal, she hardly had a role to play at all, although she was a character you couldn’t miss. Jennifer gave me her blessing, if you will, as a novelist cum historian to do my job as a dramatist, and my job as a dramatist was to make that work sing on the page: the characters have to feel fully rounded, the stories have to feel compelling. It had to be structured over six episodes and therefore one had to create a sort of serial strand: Chummy’s love story with the policeman.

And everything I did that could count as an alteration in inverted commas was actually shoring up that material to make sure it was historically watertight and not just based on Jennifer’s own memories. And also to make sure it was medically watertight: one thing Jennifer had done that was actually a genius move is she had asked a then practising midwife of her acquaintance, Terri Coates, to go through all of the medical passages which in the original book were really to do with midwifery to make sure they were clinically watertight, because as Jennifer said, ‘I haven’t practised as a midwife for fifty years, I’m very rusty.’

So this lovely lady, Terri Coates, is here pictured on the set with a newborn baby and I think this tells you so much about Terri who is indispensable to our show – and that is a real newborn baby. She’s talking to it, she’s making it feel comfortable – can you see the trust? It’s absolutely slumped into her hands, little hands and feet are against her body. She is on set on any occasion when we have a newborn or indeed any baby under the age of about one, Terri is always there.

Sometimes she’s literally under the bed cause she doesn’t like to be more than arm’s length from a newborn. The mum is often a very newly delivered mother so we have her comfortable just a few feet away watching on a monitor so she knows her baby’s safe, and Terri will often give the new mum breastfeeding advice. You know we’re often waiting to do a take because the mum’s feeding and Terri’s like, ‘no don’t stop the mother – new baby!’ What Terri says goes – she went through all of Jennifer’s books and she does that with all of my scripts.

Now I know enough about the nuts and bolts of midwifery that I have midwifery textbooks at home on Terri’s recommendation and I create the stories about the birth. Now I must add at this point that Jennifer’s books only gave us one and a half series of Call the Midwife: the first series and about half of series two. Now all of series three, four and five have had to be created from scratch, both on a medical and a historical level, and dramatically obviously I bring a lot into the mix as a creative writer. Nothing happens without Terri’s say so: I sketch out the scenes in the script and Terri reads them, sends them back covered in red pen – all I can say is five years later there’s a bit less red pen!

Quite recently, there was one book where she actually wrote – I was so happy – she wrote on my script, ‘I have no comments to make on this delivery,’ and I thought, ‘yes I’ve done it!’ I think it’s very, very important for us as a show to know that we are absolutely anchored in what is correct.

When we’re filming births, obviously part of Terri’s role is using a prosthetic baby. We have two or three at our disposal. They’re made of medical grade silicon so when you touch them they actually do feel like human skin and they’re the same grade of silicon that’s used perhaps as a cover for an artificial limb. It’s very convincing both to look at and to touch. It will take make up because the prosthetic baby is made up to match the real baby.
[Points to screen] As you can see that baby has had its head slicked with a little bit of oil as babies are born wet – we’re wetting the baby with a little organic grapeseed oil which is tested on the baby at home a couple of days before by the mum. Terri will manoeuvre the prosthetic baby and then manoeuvre the real baby as gently as possible in the same way and so what you will see on screen is the combination of prosthetic baby footage and real baby.

This even extends to having a drawer dull of umbilical cords of varying thicknesses. Again they’re beautifully done by medical artists but Terri will have a newborn in her arm like that and a real baby and she’ll be going through the umbilical cord drawer saying, ‘this one!’ because different sizes of baby have different sizes of umbilical cord and that was something I didn’t know and I’m constantly learning. As an executive producer on the show its part of my job to ensure all the visuals are just right and I know Terri will get it just perfect.

We use a lot of resources like this [points to screen] as part of our research component. This was a study taken in the early part of the 1950s of a midwife tending to a baby during a home delivery, so we can see a midwife… manky wallpaper with headboard… mum looking harrowed and at least ten years too old to be having a baby, which is something we find in these archive pictures.

One of the interesting things is, again when you think back to the red cardigan moment, to make things work on television: midwives would always wear a mask (the rule was at any point where the genitals of the mother are exposed) so sometimes, even in the clinic situation, the midwife would always wear a mask when handling a newborn for an extended period of time. We did some test shots and it wasn’t going to work on TV because you can’t distinguish the characters or hear them speaking and there was a sort of emotional barrier, so we did sit down and discuss it at great length because authenticity is so important to us. But we decided that we would dispense with the masks, so we’ve changed that now. We have occasionally once or twice seen caesarean sections and in an operating theatre we do have all of our characters masked because we just feel that that would be an accommodation too far, but as you can see this vintage photograph forms a real bedrock to our research – you get so much information from a still photograph.

What’s quite interesting is whenever a director joins the show. Most new directors come and do two episodes so we usually have new faces each series. A director will always work with a mood board. They carry them in, or sometimes two people carry them in, and it’ll be covered with photographic images they’ve cut out of newspapers or downloaded from the internet – we’ve always used pictures of this type, they will always go back to journalistic photography for their visual references, and obviously we encourage that.

So here we have Jenny Agutter as a nun midwife and this is one of our mums wearing a prosthetic belly – again it’s proper medical grade silicon. We have three or four of these in constant use and we usually replace them once every other series and we have them in different skin colours. And again they take make up but they’re fitted in such a way that – on one occasion, for example we had a breech baby that had to be turned in delivery – we can actually get a baby doll underneath so that the actress actually knows what she’s doing. You don’t just go and pretend, you actually move that baby around.

I wanted to show this picture because it reminds us that Jennifer Worth worked with nuns in the East End. It’s very important to remember that. These women did extraordinary work and part of my research when I first met Jennifer was trying to find out who the real nuns were because she had made them a promise that she would not reveal their identity and that was for a specific reason. Jennifer developed a very deep religious faith when she was in the East End and she kept up the relationship with the nuns throughout her life, right up until – in fact I first met one of the nuns at her funeral service – one of the sisters came along to do a reading.

It was curious because when she had first written her first draft of her book she showed it as a first port of call to the sisters who said, ‘well we love it but it’s not factual, it’s not an accurate record of us and none of the characters are fictional. It is a brilliant depiction of the work we did and the way we lived but this isn’t our story.’ And they asked Jennifer to change the name of the order, which she did absolutely, and you know it took me about eighteen months to get the truth out of her. Because I wanted to make contact, as you would imagine. I wanted to meet the order, talk to them. The directors, the costume designers really felt that we could bring something more authentic to the screen if we had that conversation.

Anyway, she let slip one day that they were now based in Birmingham and by fortuitous coincidence, I have an uncle who is a vicar who’s been based in Birmingham for many years. So I rang him up and described this new fact that I had and I said, ‘Uncle Warwick, do you have any idea who they might be?’ And he said, ‘I know exactly who they are and I was with them two weeks ago on a retreat!’

It was just such a bullseye so he told me and I rang Jennifer and I said, ‘I have information!’ and when I said to her, ‘is it the order of Saint Raymond Nonnatus based on the community of Saint John the Divine of Alum Rock Birmingham?’ she said yes, and the relief in her voice to be honest sang down the telephone like an excerpt from Puccini! She was so relieved not to be bearing the burden of that secret.

And what was lovely was I didn’t actually go up on this particular day but I’d been to visit them many times since and the sisters who are all surviving have all become friends. They no longer wear the habit, but they brought out the habit that they kept in their own archive, which was exactly this outfit that you see Jenny wearing here and because of the beautiful quality of this screen you can see it’s made of quite a heavy linen. It has to be ironed a lot but it is very, very washable. The colour blue that people always used to call ‘Saxon blue’ is quite a vibrant blue and it was going to look harsh on screen so we took it down two tones, which they were happy with. They even let our seamstress unpick the habit – she reassembled everything, but just to see how the seams were put together, because obviously it’s all a very important way of looking at how it hangs. The wimpole and the cap are absolutely identical.

One of the funny things is the nuns no longer now wear the habit and Sister Christine said the reason why was that during the 1970s, although the sisters were still nursing (they stayed in the East End till ’76) was that they actually became NHS employees and were expected to wear NHS uniform. At that point they felt that that was incompatible with their Christian witness and their statement of who they were and why they were doing that work. They sort of came to a compromise where they wore white coats over their habits on the ward because most of them were working at quite a senior level in hospitals by that point. Sister Christine said at that point birth was becoming more active and she said when you’re coaching women for an active birth and you’re bouncing on a beach ball she said, ‘what you really want is a pair of slacks!’.

If I show you a picture of the nuns now, slacks to a woman, there you go! They work with the homeless and are just downsizing from their very big convent – it’s just too big for them now there’s only five of them. And as you can see they’re all ladies of a certain age but they’re at their best, very committed to their religious lives and they do a lot of work with the disadvantaged.

[Points to screen] Those are the slacks made by sister Margaret Angela, who you see in the middle there, who is a whizz on the sewing machine, but they all wear these large silver crosses and they’ve all had those since they first took their vows.

None of these ladies worked alongside Jennifer, although they knew her later because of her continued association with the order and they have been incredibly helpful to us. They’re not official advisors but when we have a query about, for example, how the nuns should be seated – when we moved chapels between series two and three, nuns would sit in choir, so facing each other, so we weren’t quite sure how far the chairs should be apart, etc, etc – we ring them up and they answer our questions, quite often on the same day with great thought and care and we’re very grateful to them.

They also benefit financially via a literary trust that was set up by Jennifer Worth. They do receive an income from the profits of the TV show so I think that’s quite nice, it means there’s a sort of two way stream of communication between us, which is lovely.

Now here we are in Nonnatus house. I just thought you might enjoy this picture because it really is a glimpse behind the scenes. You can see this is a check before a take. So, costume: you’ve got Nurse Barbara who’s in the middle, somebody’s adjusting her collar and somebody else is seeing to her hair. At the same time camera work is going on, lights are being looked at, someone’s up a ladder adjusting a light – busy busy, and particularly in the dining room it gets very crowded because you can have up to twelve people around that table and at least as many crew. But we do all enjoy these days because it gives all of the cast a chance to get together and work together and sometimes you know, working in twos and threes, they may not see each other.

I wanted to also draw your attention to the table, the famous Nonnatus house-type tea time. This is an ordinary weekday tea, so we don’t have flowers in vases, but you’ve got the boiled ham, ‘Webbs Wonderful lettuce’ – no iceberg lettuce on this show, thank you very much! The pork pie, the tea set – which actually has a bigger post bag than some of the actors! We’re getting so many letters from people saying, ‘my mum had that tea set,’ and they just want to share because it’s bought back a memory or, ‘my mum still has that tea set, but has broken the sugar basin,’ and we’re like, ‘well you can’t have ours!’ But often our art department buy a lot on eBay, so we will often say to one of our young ladies, ‘go on eBay and see if you can find a spare Royal Doulton Cascade sugar basin.’

This was a pattern that came out, I think it was 1953 or ‘54, but that’s the kind of thing… it’s not my research department but as an executive producer I will say ‘I don’t like the look of that cup,’ and heads roll. If it’s datelined for perhaps the ‘60s what you soon learn, if you work on a historic series, is people are passionate about their sphere of interest whether it’s pram flowers, perhaps, or china, you really have to get those details right because if you get something like that wrong somebody’s faith in the whole show will be undermined. At the back of their minds they’ll be thinking, ‘well they’re using the wrong kind of tea set,’ or ‘those shoes didn’t exist’ and they’ll sort of assume that everything is no good, so I always look at these small details as almost like our flagship. They go in getting those details absolutely right.

This is Easter tea at Nonnatus house and I’m partly showing it to show we have our Cascade tea set again, but our art deco cups that come out for our big events, and as you can see were en fete here, so we’ve got the butterfly cakes. I was very alarmed – if I can point just there – there were a bowl of black cherries, so I phoned the office and I said I think that’s a bowl of black cherries on the table for Easter, but it’s grapes so I think we’re all right.
But, for example, in an earlier series there was one scene where a family were eating a Sunday lunch. Our usual set dresser had a day off – she was actually expecting a baby and wasn’t feeling too well. The replacement person had put broccoli on the table. Nobody ate broccoli in 1959 so – I’m very proud of this, it’s pure Call the Midwife – we actually sent that footage (because it was an important scene that we filmed some weeks previously) into what’s called the grade, which is a process where you can adjust the photographic image. It’s a bit like Photoshop but you do it on a moving image, and we decolourised all the broccoli so it looked like cauliflower. If ever you think we’re slacking at the BBC, just think – broccoli-cauliflower! It is important to get those details right and that’s just on a visual level.

Those of you who are fans of the show, you might like to know about those lovely clothes. This is Easter Monday at Nonnatus house. We just had Easter, as you can see by the Simnel cake. Most of our costumes are vintage. Some of them are just hired and they’ll be altered to fit the actress; some are makes, but not many. As the writer I’m very keen that our costume designers take character into account, that’s very important. For example, you can see Delilah peeping out from behind the Call the Midwife clapper board. She’s dressed very conservatively because her mother is there. It’s very important that you acknowledge those things, whereas she’s actually got quite ‘autre’ taste in clothes – she’s even got this lurex t-shirt that she rocks when her mother’s not around, so there’s that sort of sense sometimes.
Like I said for Barbara, who’s completely invisible behind the other clapper board, wearing a lovely dress, but that cardigan that doesn’t quite go and sometimes I can put in a detail like that and that will help. Oh, this was at the beginning – we had a new costume designer, and those little character things are very important because when people invest in characters they expect them to behave in what I call this cohesive way… that there’s a little through line running through each personality. That’s not just expressed in my writing, it’s expressed in the way they’re dressed, how they associate with other characters, what we might see them doing in their spare time.

I mean, for example, those of you who follow the show now know that Trixie doesn’t drink alcohol and some people who are guesting on the show, perhaps as an actor or writer, struggle to get to grips with that and they’re like, ‘well, what does she do when everybody else is drinking?’ Well, she drinks tea, but you know she won’t drink alcohol again, unless there’s a very big story. I mean nothing like that is planned at present.

So again that’s the sort of detail. Another reason why I wanted to show this one to you is because we’re very conscious of the passing of time in Call the Midwife. In series five, which you will have just seen – that was particularly important because we were dealing with thalidomide, I’ll be talking about that in more detail – this was set at Easter (well, this was Easter Monday) so I know that’s April 3rd. One of the reasons why I was very distinct in my mind about that was because there was a lot of talk about the space race and the man on the moon and that’s because we’re ten days off Yuri Gagarin’s great adventure in space, so it’s something that’s very alive in the world of our characters. We don’t talk a lot about the news but there are some things so big in terms of affecting the human mindset that we like to reference them.

So that was one thing, because normally a year goes by in every series and that’s because at the moment we’re locked into giving you a Christmas special every year, so if you see Christmas every year obviously a year has passed. But we would generally begin in March or April and would normally finish in October/November, in terms of screen passage of time.
This year we knew we were stretching things out because some of the thalidomide events are very specifically datelined to December of that year, particularly to December 6th, but I’ll talk about that later.

We get a lot of comments about our use of popular music in the show. We have a wonderful composer called Maurizio Malagnini, who provides all of our score, which is glorious. He’s been with us for a couple of series now, but from the very beginning I’ve chosen to use popular music of the period to just enhance the atmosphere to give us a taste of the experience that our characters were having. And for this reason, this is The Paris Sisters… we use this lovely track, ‘I love how you love me’ in episode seven of the most recent series, but to begin with we were set in 1957 and I was using a lot of vocal music that was coming from America at that time. It tended to be The Four Coins, the Four Tops, The Four Aces – they were all four men, but singing in a very mellifluous romantic music often based on standards from a previous era. What I say to people – often directors when they come on – is I don’t want to hear Buddy Holly because that was in the charts at the time, I want to hear the music that made women dream, I wanted the music that women fell in love to and then the music that they did the vacuuming to when the love story has sort of collapsed a bit like a soufflé. I wanted that romantic soundtrack to people’s lives something that, if you will, went beyond the East End. Then as each year has gone by, we’re now using Billy Fury and Helen Shapiro and I love that because time is moving on, but it still has to be romantic in some way and uplifting – essentially music that not many men would listen to.

I brought this up also because as part of my research process, YouTube is my friend. When I’m writing, I sit there thinking, ‘I need a song with the word baby in it from 1961.’ It’s a wide choice. But I will sit there, as Doctor Turner will testify, and he hears the most beautiful music coming out of my study. We do have a rule, because we know which era each series is set in: we never move from after that date, but it doesn’t have to be from the year in which that episode is set, it could be from 2 years beforehand or something. The exception to that is if you hear music coming out of the radio – we are very punctilious and it has to be something that could have been heard on the radio in March 1962 or July 1962. If it’s just used for the score or to cover a montage I say as long as it’s not later than that year then it’s fine, but presented in a real life way it has to be absolutely accurate. Going with the music – it’s very expensive to do, so we do it very sparingly. There will usually be a popular track in each episode, but we have to save up if we want to do it twice or three times so we try and make it justified.

Here’s Doctor Turner – the reason I’ve put this picture in here is, as I mentioned earlier, Jennifer Worth’s books only gave us one and a half series’ worth of stories and we had no idea at that point that the show would go on for five or six years, but we did know that the BBC wanted one more or two more series. It was in the scheme of things because it was so successful, so in series two for the first time I was looking at expanding on that material and, as Terri the midwife said, there’s only so many ways a baby can come out and I didn’t want to write a story where it was complication of the week – we nearly always lost our mother because that’s not the way birth works.

So on the one hand you can have an ordinary uncomplicated home or maternity home delivery where the story and the drama comes from the mother’s situation – you know, abusive relationship, or a baby that’s been longed for after several miscarriages… you can do that as well – but I instinctively knew if we wanted this show to have legs, to have depth, to have texture and to have resonance, we had to expand into the field of general medicine mainly seen through the eyes of our Nonnatus team who have always been district nurses as well as midwives.

The spotlight started to shine on Doctor Turner. This partly came about because I like to go as close to the source as possible when I’m researching and there’s two ways of doing that. One is oral testimony and after series one, we engaged the services of a professional journalist and researcher because we’d had so many letters from people saying, ‘my mum was a midwife in the East End,’ or possibly Glasgow or Liverpool, or ‘my mum was an urban midwife and it’s brought back so many wonderful memories and she just loves the show’ and we think, ‘ooh, would your mother agree to be interviewed?’ so we were sending Karen, our lovely researcher, out to visit a lot of quite old ladies. I mean some of them were in their eighties or nineties and we had a wonderful resource from which to draw, so that’s taking research right back to the most raw level you can. It was marvellous. I don’t think Karen ever had a wasted visit and you also have the satisfaction of knowing that you’re keeping people’s stories alive.

But another resource that I’ve stumbled on in series 3 – I’ll show you this. This is in the Wellcome Trust: an annual report of the medical officer of health for the year 1960. And these reports were all carried out – I didn’t know until I started to do my research into how I might research – these were compiled every year from 1848 until 1978. A significant chunk is lodged at the Wellcome on facsimile and it was this sort of thing [points to image]. Now that looks like the driest read you can imagine, but for example if you look at the amount of vascular disease, lung disease… a lot of smoking related illness, so you only have to spend a few minutes scanning up and down these and you think, ‘my goodness this is like a snapshot of the health of people in urban Britain at this particular point in time.’

There are other things, it’s not just tables; there’s also a sort of prose report from the medical officer for health. It mentions the health problems posed by caravan dwellers… I thought that’s interesting. Because of the amount of building that was going on in the east end there were a lot of Irish traveller communities – as we would call them now – coming and living in London working on demolition road building doing other things, but living very much separately and apart. The children weren’t going to school, they were considered to be a sanitary risk and nowadays we would call some of those attitudes racism.

But I thought there was an episode to be gained from that and so it proved. When we did what we do with all of their stories when they involve a strong medical issue – when they involve a particular disease or a particular social group – we approach the Irish traveller community. They were fantastic. They were so happy at the thought of their community being represented that not only did they read our script and give us some comments, and they were positive comments, but there were some things that were helpful. I had read early on in my research about caravans being burned when somebody died, and they said, ‘oh well if you want to do that we’ll come and do it for you.’ When a community actually says ‘we will put ourselves out, we will bring our own matches and we will burn this in the ceremonial manner’, it’s like a gift from the gods! Not only did they come and do that and try to make sure that we represented their culture correctly, they introduced us to – I don’t know if people remember this episode, it was in series four – a wonderful singer called Thomas McCarthy, who came and actually sang our fictional character to her grave. It was one of the most moving moments I think we ever had on set. And yet it comes from something as dry as this document.

So, again [through the report] we found out about polio – I just thought, because we ended up with a very emotive story about Doctor Turner and Sister Bernadette, her stepson having polio – we did it. And when we were looking at those statistics I realised very quickly that we were running out of time to cover polio as an active disease, because by this point in our history and in British history we were rolling out the vaccinations and it was close to being stamped out. So we seized the opportunity to do a polio story in our Christmas special because we wanted to reflect history as it was and not lose our chance.

Again, the booklet alerted me towards social issues such as the neglect of children. This story, which was episode one in series four, was about children found living in squalor and it came from two sources. I’m mentioning it because I have a sister-in-law who works in the family courts as a solicitor, and she told me a particularly harrowing story about children being found in squalor. She works in the Midlands and in her area it will happen two or three times a year in the present day. In the booklet I’ve just shown you it mentions the cleansing station, which was actually a building set aside for people who were so verminous and dirty they had to be industrially cleansed – you may remember that sequence in episode one of series four.

If I flick quickly through the next couple of images – I told you about the directors coming in with photographs – there’s a whole sequence of pictures taken by Nick Hedges, a photographer in the late ‘60s, as part of a campaign run by Shelter, the homelessness charity. This picture is actually of a lady in Sheffield living in housing owned by the steelworks and if I just flick between the two you can see how these images play off one another.
This is another photograph from the same sequence: this is inner city Birmingham. If you can see by the lady’s beehive, this is later in the ‘60s – I think this was ‘66. And when people say to me – and they did in the early stages of Call the Midwife – ‘nobody lived in squalor like that’, excuse me yes they did! This was actually 10 years after our starting point and people are living like this. I’ve just used this because if any of you saw the last episode of the last series when Evangelina hears her last baby being born she’s in a landing stairwell with a sink and a gas ring and this was actually based on that photograph.

This is when the internet is not your friend. I’m just drawing your attention to this because on the BBC homepage it says Enoch Powell made an announcement that the Pill was coming on the 4th December. It actually says: ‘On this day 4th of December 1961’ – this is not true, everything that I was learning about the Pill while I was researching the previous series suggests that it was something that crept up on the British population. Yes, there was a point where it was licensed, but take up wasn’t immediate: partly because they were very high in oestrogen and therefore difficult to take; there were a lot of side effects and women didn’t actually enjoy them; and husbands didn’t trust them, so it was a slower burn than they we’re led to suppose. But I wanted to check this out, so what I actually did is the kind of research I do to keep us on point: I went to Hansard to see what had been said in Parliament on the 4th of December 1961, and it was nothing like that. What happened was one person asked Enoch Powell about the cost of the Pill, and it was no great thing – it was literally a four-line exchange, and I thought that was very interesting. And I’ve looked up Hansard in the past to do with when I wanted to understand why in the late ‘50s it wasn’t easier for gas and air to be distributed to labouring mothers at home and it was because the machines couldn’t be made fast enough and questions were asked about that in Parliament in 1955 so if anybody here wants any tips about researching everything I always say, ‘my motto is trust no one, you’re a screenwriter!’ Always go one source further back than the source you have in front of you.

I’m moving onto thalidomide now because there are a few more things to say about research in depth and hopefully for those of you who’ve seen our most recent series there’s a story that we told… Distaval, thalidomide: we think we know everything about it. What became obvious to me when I decided to tackle this story was people much younger than myself – I was born in 1962 and don’t know very much about it. It’s a story that remains ongoing because of the struggles of the people who were impaired by the drug, and the younger generation – by which I mean people perhaps in their 30s, members of our own cast – are forgetting what happened.

My own research also pointed out to me that it [thalidomide] wasn’t just given for morning sickness. It was a sedative, so it was prescribed as a sleeping pill. It was in cough mixture. A lot of women took it before they even knew they were pregnant and one of the things I was keen to do was actually set the record straight so that people were reacquainted with what it was and that was out of respect for thalidomide survivors, many of whom I met as part of my research process.

We created a family. This is going back to BBC rules about fact and integrity. Baby Susan Mullucks is not based on any one thalidomider. We wanted to be able to tell the story as expansively as possible, therefore I wanted to create a situation where the parents had divergent attitudes – the mother in this case being instantly accepting and the father being very challenged by it – that was a very common pattern, although there are many instances of it being the father who accepted the baby and the mother rejecting it.

Here you’ve got the older sister Belinda and the older brother Perry – when I finally saw this still I realised that up to a point I’d told my own story because I had a severely disabled brother (not through thalidomide, through other reasons) born in 1970, and in many ways that experience is the experience of my family’s, so concomitant with my science research was the human story. This is the father looking at the baby and as you can see here, he’s holding a very severely impaired baby who has shortened arms – not the full complement of fingers. The baby also has deformed feet. I have brought a prosthetic model along with me. This is the same prosthetic model – what you saw on screen was a combination of our prosthetic model, who I will show you very briefly because it’s the size of a newborn. We created the deformities based on a medical photograph, all of which are housed in the Wellcome Trust. Again, it’s a slight hybrid in that we took the hands from one child and the feet of another. Of the 400 plus babies born in Britain, 10 percent or more than 40 were what were then termed ‘four limb deficient’ and therefore we had a very strong historic model for it. We weren’t plundering one child’s life and I’m very glad we took that approach because having met many thalidomiders since as part of the research and afterwards, you realise you’re telling a very important story on their behalf.

I’m just going to finish with this image now. I saw this image in a newspaper and it was actually published with some screen grabs from the first episode. This is Rhoda, the mum being told the news, looking at her baby, introducing the baby to her siblings, and a picture of this child was used in the same article. I’d seen this picture during my research and when I looked at that picture I didn’t think, ‘oh my god, that child is grotesquely deformed,’ I thought ‘that child is so loved’. And do you know how I know that? Because of his hand knitted clothes. My grandma always used to say in the early ‘60s, ‘I like to see a baby in hand knits because they look loved.’ And somebody had knitted that child’s clothes so that his hands could come out of the sleeves. He’s got little shoes on his feet, and those hand knits are well bobbly – that means that baby has been cuddled and loved and adored.

Almost the first thing that happened when this publicity piece went out is we had a letter from that child grown up. He’s called Ed Freeman – he’s the most delightful person. He wrote to us and said, ‘oh that little chap in that photo is me.’ He told us something of his own experience, and then we’ve been in correspondence since and met him and he’s met baby Susan. He said: ‘thank you for telling our story with such dignity and sensitivity.’ That brings me full circle to Call the Midwife: a true story. Is a true story a story that just replicates the facts that they were or is it a story that you shape and hand it back to the people that inspired it and they say that is my story?

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