Rosalind and Joyce are out on their own in their first week as newly qualified midwives! I remember my first solo days as a midwife and all of the excitement and nervousness that came along with it. This week, Rosalind and Phyllis are assigned to give a reproductive health presentation for women and girls at a factory. Right off the bat, Rosalind meets young Alison Casey, who she notices is quite pregnant but seems to be concealing it. At one point, Rosalind does try to pull Alison aside to answer any questions the girl might have, but Alison is too nervous to confide in her.

Later, Alison goes into labor. Since her mother doesn’t know she is pregnant, Alison ends up flagging down Miss Higgins for help. Miss Higgins helps her to the maternity home where at least Rosalind is scheduled for the day. I’m sure at that moment it was helpful for Alison to have one familiar face. Rosalind can tell right away that Alison is very fearful and uncertain about what is going to happen during birth, and she discloses that she has never had a boyfriend. My own “red flag” alarm was blaring at that moment, and I could see that Rosalind felt the same. She convened with Sister Julienne and Dr. Turner to come up with the best plan to support Alison through her birth.

When it came to light that Alison was positive for syphilis, I felt certain that her stepfather was likely responsible for her pregnancy. I was already getting that vibe from Alison’s reaction earlier when she learned her stepfather would be returning home soon, but this new piece of information really solidified it for me. My heart was broken for Alison. To have endured sexual abuse is already traumatizing, but then having to hide her pregnancy, all while being rather uncertain about how everything would happen, must have been terrifying. The midwives and Dr. Turner provided Alison with kind, patient, respectful care. They helped deliver the news about the pregnancy, the syphilis diagnosis, and their suspicion that Alison’s stepfather was responsible for her pregnancy to her mother. They were amazing advocates for Alison and quickly worked with social services to help place her in foster care where she would feel safe. They remained non-judgmental to both Alison and her mother, all while keeping Alison and her baby’s best interests and safety in mind.

As medical professionals, we are “mandated reporters.” This means that if we suspect child abuse or neglect, we have to report it to the appropriate authorities. Since Alison is still a minor, the Nonnatus team did report this to social services. I’m not sure how it worked in England in the 1960s, but today, the police would immediately be involved in a situation of abuse such as this. I sincerely hope that Alison’s stepfather will meet severe repercussions – and more than just not being allowed back in their family’s home.

Joyce also has a very eventful first week on the roster at Nonnatus House. From her estranged husband showing up to Nonnatus House unannounced, stating she was her “cousin,” to a birth emergency with Gerri Godfrey, Joyce has a lot on her plate. She first meets her patient, Gerri, during a tour of the maternity home. Gerri appears anxious about sharing space with so many other women, but later we learn this is because her husband had left her and she was nervous about experiencing judgment. Joyce again offers kind, non-judgmental care and even offers to evaluate Gerri’s home for a home birth. It would have been easy to write Gerri off as someone who felt entitled or just wanted a private room, but Joyce took the time to really understand where Gerri was coming from. This kind of patient-centered care and shared decision-making is a cornerstone of midwifery care even today. I think this relationship and trust built between Gerri and Joyce helped to keep Gerri calm during her placental abruption. Joyce also used her knowledge and skills to get help for Gerri right away, which helped prevent any serious complications. Midwives are experts in low-risk care, but we are trained to see when complications arise, how to manage them, and how to get all of the appropriate help. It was wonderful to see this midwifery expertise portrayed in Call the Midwife again this week.

With only one more episode to go this season, I’m waiting on the edge of my seat to see how Trixie is going to get through this separation with Matthew, and what trouble Sylvester, Joyce’s estranged husband, will try to get into. Both in the past and today, midwives and other healthcare professionals need to find a balance between their personal and professional lives. This reminds us again that even caregivers need care. The midwives of Nonnatus House consider each other like family, and I know they will rally around Trixie and Joyce for whatever support they need.