Editor’s Note: The opinions expressed in this blog post are solely those of the author.

Our return to Nonnatus House in the Spring of 1967 brought the feeling of fresh new starts, and hope seemed to be hanging in the air. Nancy Corrigan, now a qualified midwife, was joining the staff at Nonnatus. The financial strain of wondering how Nonnatus House would continue their important work had been solved by the generous annual donations from Mr. Matthew Aylward. Mr. And Mrs. Fleming returned to Poplar, expecting their second baby. Along with all of these joyful moments, comes grief. Nancy grieves the time she didn’t get to spend with her daughter Colette, and Colette’s childhood experiences that she has no knowledge of. Matthew’s wife, Fiona, passed away the year prior, shortly after the birth of their son Jonathan. His generous donations to Nonnatus are given in her name, because of the care she was provided by Trixie. The Flemings are overjoyed to be expecting their second baby, however, the loss of their first son, Christopher, has compounded their worries as they await their new baby. Christopher’s pregnancy had been relatively straightforward, however, he died shortly after birth. He had several severe birth defects, likely caused by Derek Fleming’s radiation exposure from an H-bomb test in “Operation Grapple.” In this episode, we also met Marigold Nyall, whose grief over losing two babies more than 30 years prior had changed her life forever.

Despite the passage of time, grief never goes away. It might be quieted in moments, moved from the forefront of one’s mind, over to the side, or tucked away in a corner, but it is always there. Sometimes, those who have lived with significant grief might find it hard to feel hopeful or joyful, because they know the depths of sorrow. Other times, they may savor the joy, relishing in each moment, acutely aware of how this feeling is never promised forever. There is no “right way” to experience or express one’s grief, and grief will evolve over time.

In the profession of midwifery, I have been present with people through periods of grief and joy, and sometimes those moments are intertwining. We are there for our patients through all of the complex emotions surrounding their health, their pregnancies, and their postpartum experiences. I have attended the births of many “rainbow babies,” a special term for babies born after loss. “After the storm, comes the rainbow.”

One part of my job that never gets easier is being with someone as they learn that their baby no longer has a heartbeat. These people are in the thick of that storm. I had to tell someone recently that their early pregnancy ultrasound revealed a baby with no heartbeat. My heart broke for her, especially because she was sent up to my office to talk to me without having any idea what our impromptu meeting was going to be about. Many times, when people have ultrasounds done, the ultrasound technician is remotely sending images over to a radiologist, who reads them, but it is out of the technician’s scope of practice to actually tell the patient any results or findings. In these cases, a midwife or doctor (generally, whichever provider is available) will be the one to tell the patient.

While I know that miscarriage occurs in 1 out of every 5 pregnancies, this doesn’t make the news any easier for the person going through the loss. I know that this may not have any impact on this person’s ability to get pregnant again and have a healthy, term pregnancy, but their next pregnancy might seem to have a shadow cast over. I notice this especially in the early days of pregnancy, where there is nothing to do except to wait. Wait for the first ultrasound. Wait until they surpass the gestation they had made it to in the previous pregnancy. Wait until they feel the baby kicking regularly. And finally, wait until they hold that baby in their arms. As their midwife, I will do my best to provide reassurance, sometimes offering to see someone in the office more frequently than our usually timed appointments, in order to hear the heartbeat more frequently. I’ll listen if they need to express any worries or fears. I’ll hold space for them as they navigate pregnancy after loss.

I loved watching the staff on Call the Midwife come together to support Audrey and Derek Fleming during the last few weeks of their pregnancy. Their first prenatal visit was a “double appointment” with Dr. Turner. Despite his very busy and often overbooked schedule, they were able to secure two appointment slots in order to have enough time for a thorough check up, while also reserving time for answering questions and providing whatever reassurance they could. Unfortunately, so much was unknown in the 1960s regarding exposure to radiation, and the government was not being forthcoming about the risks that these men were exposed to. Dr. Turner couldn’t guarantee that their baby would be born healthy. Ultrasound was not used until the early 1970s to identify fetal anomalies, and wasn’t routinely used to screen pregnancies until the mid- to late-1970s. While ultrasound findings cannot guarantee that someone will have a healthy child, it could have reassured the Flemings that their baby appeared to have normal anatomy. I held my breath all through Audrey’s labor, hoping and praying for a good outcome, and breathed a sigh of relief (maybe with a few tears in my eyes!) when I saw 10 little fingers and 10 little toes, and heard that strong cry. This was truly their rainbow after the storm.

While there are still so many uncertainties about baby Elizabeth’s future, for today, we bask in the joy. Of course, the grief is still there. There will probably never be a day when the Flemings don’t think about Christopher, but for today, they hold onto the joy that their new daughter brings. As a midwife, I will take those difficult moments, the hard conversations, and the worries about my patients and their babies, in exchange for all of the beautiful moments. The times when we make our patients feel heard, the times when we hold their hands through labor and reassure them, like Lucille did, that all is well, and the moment when we place their babies into their arms. Midwifery truly fills my cup; the connections made with the people I care for, along with the shared moments of joy keep my passion for midwifery alive.