Even though this episode begins with the start of summer holiday, there is no “rest” from the drama in this episode! A LOT to unpack so let’s dig in. First, the focus on the move away from out of hospital birth that began to shape during this time was so fascinating in how they were suddenly portrayed as passe`, “primitive” and “not really cutting edge these days”. The move from birthing at home to hospital began in the 20th century. Because those who moved into the hospital setting first were women who had the means, birthing at home gained the reputation of something only poor women did. What the public did not know at the time – but we know from examining the birth statistics of the time – was that birth in the hospital was fraught with some higher risks than women who birthed at home had. Infection and certain complication rates, particularly those related to unnecessary interventions performed, were much higher for women who birthed in the hospital than they were for women who birthed in their homes. We have strong evidence demonstrating the safety of birth in the home for low-risk women who are attended by qualified caregivers, particularly when this occurs within a well-integrated setting – meaning there are existing protocols in place for seamless transfer and referral when necessary.

Ok moving on… how much did you love the storyline around Nurse Phyllis Crane (Linda Bassett) and ageism? When criticized by the pompous physician at the obstetrical ventouse (i.e., vacuum extractor) workshop when she had the audacity to question the use of a new device, Phyllis’ response of “I’ve seen more innovation in my 44 years and embraced and approached them all with caution and question which has served me well”. Brava Phyllis! Were EVERY practitioner to approach “the latest and greatest” with the same amount of healthy query, we may have averted some real medical misses that cost patient lives. Take, for example, the “miracle” that vaginal mesh was when it was introduced into the market for repair of female pelvic organ prolapse in 2002. Widespread use was swift and profitable but since that time literally thousands of malpractice suits have been filed by women who, since having the mesh placed, have had unrelenting pain, bleeding, and loss of sexual function. 

Another product that was found to be deleterious to women was the fallopian tube contraceptive implant that came out in 2002, meant to be an alternative to the surgical tubal ligation (“tube tying”). The device was basically a metal coil implanted into each fallopian tube, with the purpose of creating scar tissue at the site, which would then occlude the tube such that an egg could not pass. Maybe It’s just me but I remember first learning about this product and distinctively thinking “I don’t know how a method that works via the creation of scar tissue can be all that great and not cause pain and other problems…”. Indeed, a significant number of women needed follow up surgeries to remove or correct problems caused by the device. These are just a few of the many problematic examples throughout time.

And how about Sister Monica Joan (Judy Parfitt) to the rescue to support Phyllis? She has been my favorite character since the show’s inception, and never fails to deliver. I had to replay the scene a few times over where the pompous physician at the Council hearing begins his demeaning response to her “with all due respect sister…” where she cuts him off at the knees with “I hear no respect in your tone”. Then the way she makes the case for Phyllis’ calling and pledge as a midwife to be no less compelling than hers as a nun – and that neither comes with an expiration date. That was pure perfection. What has the council got up their sleeves for Nonnatus house? I’m not too worried knowing that Sister Monica Joan will be there to face them.