‘Call the Midwife’ is a TV series based in the UK, but has now become an international treasure. Relating the story of midwives based in the Poplar area of London it traces the history of midwifery from the 1950s, now reaching the 1970s. Samuel Todd, Consultant Midwife, Sherwood Forest Hospitals NHS Foundation Trust, reflects on the comparisons of the practice during that time in relation to those of now, including the use of more senior midwives as advice and support.
Introduction
On Christmas Day, my wife and I (both midwives) settled down to watch the Call the Midwife Christmas special, along with 3.44 million others across the UK.1 The year is 1970 and, within the first six minutes, we learn from Sister Julienne that things are currently “remarkably quiet”. By 16 minutes, Trixie is told her offer of midwifery duty is unlikely to be needed, and by 31 minutes a long-retired Sister Monica Joan is called upon for advice on how to manage a multiparous woman in obstructed labour (who is being cared for by Rosalind), as the locum doctor does not know how to use forceps. Earlier in the episode, it had been identified that the baby was in a right occiput transverse position.
What struck me while watching this episode was how familiar these scenes felt. Since the series first began in 2012, I have observed increasing parallels between the world portrayed in Call the Midwife and the contemporary landscape of midwifery and maternity care in 2025. The gradual loss of practical skills, declining confidence in supporting physiological birth, and reliance on a diminishing number of experienced practitioners felt uncomfortably close to current professional realities.
This article uses the 2025 Christmas special as a starting point to reflect on these parallels, exploring how historical shifts in maternity care continue to influence practice today, and what this may mean for the future of midwifery.
The influence of Call the Midwife on perceptions of midwifery
When I started my midwifery education in 2009, within the first few months I was given copies of the Call the Midwife trilogy, the memoirs of nurse and midwife Jennifer Worth, describing her work in the East End of London during the 1950s.2 I quickly read all three books and was inspired by the stories of human experience and midwifery practice from this period. News that a television series was in development added to this interest, as I was keen to see how the characters would be portrayed and how the stories would be told.
Sadly, Jennifer Worth died before the series aired, but the programme went on to have a notable impact on the landscape of midwifery. Midwifery graduates in the United Kingdom rose from 1,291 in 2009 to 1,636 in 2012, and in the three years following the release of the Call the Midwife television series, numbers increased further from 1,792 in 2013 to 2,805 in 2017.3 Although it is impossible to attribute the decision to pursue a career in midwifery solely to the programme, it is likely that it acted as a contributing influence for many, alongside other television series such as One Born Every Minute.
For some, the portrayal of midwifery in Call the Midwife, and home birth in particular, sparked interest within both the public and the profession to explore and promote this place of birth option.
Home birth: from norm to exception
The television series Call the Midwife begins in 1957, at which time approximately 33% of all births occurred at home; in 1955, 33.4% of births took place in this setting.4 The publication of the Peel Report in 1970 was the single biggest contributor to changing the culture of home birth in the UK, stating that “the resources of modern medicine should be available to all mothers and babies” and recommending that sufficient facilities be provided to allow for 100% hospital delivery.5 By the time I commenced my midwifery training in 2009, only 2.7% of births occurred at home in England and Wales, decreasing further to 2.3% by 2012 when I qualified.6
Home birth rates remained relatively stable at 2.3% in 2013, with a further slight reduction to 2.1% in 2017.7 As Call the Midwife progresses chronologically from 1957 to 1970, this decline in home birth becomes increasingly apparent, with more women admitted to the maternity home or requiring hospital birth. In parallel, although home birth rates in the UK have remained relatively stable in recent years, there has been a similar reduction in midwifery unit births, with an increasing proportion of women requiring obstetric input. This trend has been particularly marked since the COVID-19 pandemic,8 with many midwifery units struggling to return to pre-pandemic activity levels.
During the same period, the evidence base supporting home birth as a place of birth option has continued to grow,9,10,11 alongside the development of dedicated home birth teams, continuing professional development focused on managing childbirth emergencies in the community, and the publication of home birth-focused clinical textbooks. Despite this, many midwives appear to feel less confident in supporting home birth, for reasons that are likely multifactorial, including burnout, staffing pressures, and fear of litigation. Current midwifery students now have a greater exposure to caring for women within an obstetric unit, it is important to acknowledge that this is important for developing and gaining skills to support complex care and being able to respond appropriately to urgent and immediate care. However, this means that midwifery students are generally having less exposure to birth outside of an obstetric unit (either at home births or in a midwifery unit) which means they are not developing the skills and confidence to understand physiological labour and birth, these are important foundations that support midwives in recognising when birth is becoming complex and being able to identify and escalate for further medical support. Upon qualification, newly qualified midwives assigned to care for women who are “low-risk” may be fearful and anxious as they have not had the exposure and consolidation of key skills such as intermittent auscultation, waterbirths and being able to facilitate birth in a position other than semi-recumbent. This raises the question of whether, alongside supporting women and families, we also need to identify ways to better support midwives newly qualified and early-career midwives and identify appropriate opportunities to “midwife the midwives”.
Passing on knowledge: lessons from Sister Monica Joan
In the Christmas special of Call the Midwife, it is Sister Monica Joan who is called upon to provide a management plan to support the woman described above, recommending positional techniques to assist labour progress. These are relatively simple skills that, as midwives, we should be confident in advising. However, as exposure to physiological birth continues to decrease, there is a risk that midwives become less confident in implementing such measures, due to limited experience, reduced opportunities for observation, and staffing models that do not always enable a second birth attendant during the second stage of labour.
In relation to home birth, I have witnessed effective workforce models, including midwife–maternity support worker (MSW) pairings for uncomplicated pregnancies, and on-call systems where the first midwife has significant home birth experience and is supported by a second, less experienced midwife to enable succession planning. To support physiological birth and improve experiences and outcomes for women and families, there may be value in identifying experienced midwives who have capacity to work in a supernumerary or mentorship role, providing guidance and support to colleagues delivering intrapartum care.
Like Rosalind, I have sought advice from experienced colleagues when caring for women in labour, and more often than not this has contributed to positive outcomes, regardless of the eventual mode of birth. What is important is that, as a profession, we do not lose essential knowledge and skills but instead create opportunities to share and pass on the experience that underpins safe, woman-centred midwifery care.
From reflection to action: supporting midwives and midwifery
The themes explored through the 2025 Call the Midwife Christmas special highlight the importance of protecting midwifery knowledge, supporting professional confidence, and addressing the systemic pressures that affect how care is delivered. While no single intervention will resolve these challenges, there are collective actions that can help to support midwives, women, and safe, evidence-based practice.
Suggested actions/recommendations
- Consider adding your support by signing the following letter “An Open Letter on Birth: In Defence of Midwives, Mothers, and the Truth”, which seeks to challenge misinformation and advocate for respectful, evidence-informed maternity care.
- Consider adding your support by signing the following petition “Establish legal limits on midwives’ working hours”, recognising the impact of fatigue, burnout, and unsafe working patterns on both staff wellbeing and quality of care.
- Support and advocate for mentorship and knowledge-sharing models, particularly those that enable experienced midwives to work alongside and support colleagues in labour care, including home birth and midwifery-led settings.
- Value and retain experienced midwives, by promoting roles and working arrangements that recognise clinical expertise, enable succession planning, and protect the transmission of skills that underpin physiological, woman-centred care.
Conclusion
The enduring appeal of Call the Midwife lies not only in its storytelling, but in its ability to reflect wider truths about midwifery, care, and the systems within which we practise. Watching the 2025 Christmas special, set at a time of significant transition in maternity care, prompted reflection on how far the profession has travelled, and what may be at risk of being lost along the way.
Despite advances in evidence, education, and service design, many midwives now practise in environments where opportunities to observe and support physiological birth are limited, confidence is challenged, and experienced voices are increasingly stretched or sidelined. The parallels between the gradual shift depicted in Call the Midwife and contemporary maternity services are difficult to ignore.
If midwifery is to continue to offer safe, compassionate, and woman-centred care, there is a need not only to support women and families, but also to support midwives themselves. This includes valuing experience, enabling mentorship, protecting safe working conditions, and creating space for skills and knowledge to be shared across generations of the workforce. Examples of models that could be further promoted and recommended by trade unions representing midwives is the role of ‘Legacy Midwives’. This role is aimed at midwives at the point of retirement following significant experience in midwifery to supervise, support and hand over their career insights and experiences to newly qualified and early career midwives and includes pre and post registration clinical teaching.
Like Sister Monica Joan, whose wisdom remains relevant despite her distance from frontline practice, experienced midwives still have much to offer. The challenge for the profession is to ensure that this knowledge is not lost, but actively retained, shared, and nurtured for the benefit of those who give and receive care.
References
1. Turner L. The King’s message tops Christmas Day TV ratings. BBC News. Published December 26, 2025. Accessed December 29, 2025. https://www.bbc.co.uk/news
2. Park E. Jennifer Worth obituary. The Guardian. Published January 2011. Accessed December 29, 2025. https://www.theguardian.com
3. Yang J. Midwifery graduates in the United Kingdom (UK) 2008–2022. Statista. Published 2023. Accessed December 29, 2025. https://www.statista.com
4. Nove A, Berrington A, Matthews Z. Home births in the UK, 1955 to 2006. J R Stat Soc A Stat Soc. 2008;171(3):537-555. Accessed December 29, 2025. https://pubmed.ncbi.nlm.nih.gov
5. Ministry of Health. Domiciliary Midwifery and Maternity Bed Needs: Report of the Standing Maternity and Midwifery Advisory Committee. HMSO; 1970.
6. Office for National Statistics. Births in England and Wales by Characteristics of Birth 2: 2013. ONS; 2014. Accessed December 29, 2025. https://www.ons.gov.uk
7. Office for National Statistics. Birth Characteristics in England and Wales: 2017. ONS; 2019. Accessed December 29, 2025. https://www.ons.gov.uk
8. Brigante L, Morelli A, Jokinen M, Plachcinski R, Rowe R. Impact of the COVID-19 pandemic on midwifery-led service provision in the United Kingdom in 2020–21: findings of three national surveys. Midwifery. 2022;112:103399. doi:10.1016/j.midw.2022.103399
9. Birthplace in England Collaborative Group; Brocklehurst P, Hardy P, Hollowell J, et al. Perinatal and maternal outcomes by planned place of birth for healthy women with low-risk pregnancies: the Birthplace in England national prospective cohort study. BMJ. 2011;343:d7400. doi:10.1136/bmj.d7400
10. Hutton EK, Reitsma A, Simioni J, Brunton G, Kaufman K. Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared with women of low obstetrical risk who intend to give birth in hospital: a systematic review and meta-analysis. eClinicalMedicine. 2019;14:59-70. doi:10.1016/j.eclinm.2019.07.005
11. Reitsma A, Simioni J, Brunton G, Kaufman K, Hutton EK. Maternal outcomes and birth interventions among women who begin labour intending to give birth at home compared with women of low obstetrical risk who intend to give birth in hospital: a systematic review and meta-analysis. eClinicalMedicine. 2020;21:100319. doi:10.1016/j.eclinm.2020.100319
Samuel Todd, Consultant Midwife, Sherwood Forest Hospitals NHS Foundation Trust
Email: Samuel.Todd1@nhs.net
February 2026