Honest labour

Stephen McGann discusses accuracy and engagement in the BBC’s Call the Midwife.

 

Clinical adviser and midwife Terri Coates (centre) on the set of Call the Midwife with Director Philippa Lowthorpe (left) and actress Jessica Raine (right) © BBC TV

 

The bedroom is crowded and airless. On the bed a woman cries out – an animal, guttural growl that stops the heart and steals the breath. Crouching beside her, two midwives in antiquated uniform encourage her into one last effort. The woman emits a deep groan, and the midwives show their relief as – at last – the baby lies, tiny, in their hands.

“…. and cut,” says the director gently.

For a moment no one moves. Behind the camera, a woman is quietly crying. Her name is Terri Coates. Terri is a practising midwife, a midwifery tutor and a clinical adviser to the drama she has just been watching. In her distinguished career Terri has delivered thousands of real babies. This was just make-believe. And yet her tears are real.

Call the Midwife is a six-part BBC television drama that tells the story of young midwives working in the deprived east London district of Poplar in the late 1950s. The series has surprised many by blending a cosy, Sunday evening drama narrative with graphic scenes of childbirth – and a stark exploration of social and medical issues such as venereal disease, birth control, prostitution and public health. The mix has proven potent, with audience figures in excess of ten million – a record for the channel.

Yet programmes such as Call the Midwife can prompt debate amongst communicators of science, technology, engineering and medicine (STEM). Is popular drama a suitable place for the accurate portrayal of medical procedure? Are the scenes sufficiently plausible in their representation of practitioners? Or do such programmes take liberties with science and medicine in order to entertain – and by doing so damage the real business of accurate STEM communication?

Coates has shared many of these misgivings when watching portrayals of childbirth on TV over the years: “Births tended to be just a woman screaming in labour. Very hammed up, with very little control. The topic of conversation the next day at work would be ‘Did you see that? It was dreadful!’”

The producers of Call the Midwife felt the same, and so employed Coates as a series adviser to oversee clinical details from script to screen. This included the use of period medical instruments, and providing on-set tutoring to actresses playing midwives in difficult labour scenes. At times, Coates found the experience unsettling.

“When the scene is not right, I feel I should be there looking after the women. It feels like I’ve got very junior students not knowing what they’re doing. But the actresses only seem to have the hesitancy and uncertainty that a junior student would have. Suddenly their training as an actress takes over, and they display the confidence that I need them to show. It’s amazing.”

Coates is a stickler for detail, and believes that this can only come through oversight of the entire TV production process. It can be a full-time job: “I’ve waited until twelve at night for emails to arrive, because corrections to scenes are just coming through.”

Yet for all its clinical accuracy, Call the Midwife remains drama. Its duty is ultimately to tell a story, not to teach. How did Coates balance her desire for realism with the wider needs of television narrative? “As long as what they’re portraying is plausible – and they’re not getting midwives or women to do something utterly ridiculous – I don’t mind the narratives being tweaked so that they can have a plausible outcome, rather than just a clinically accurate outcome.”

This ‘tweaking’ suggests that an effective portrayal of STEM in drama may involve a compromise between ideas of strict accuracy and Coates’ wider sense of plausibility. The two words are often conflated – yet plausibility seems more than simply an adherence to what is strictly ‘real’. It suggests a representation of reality that matches the experiences of its audience to produce a powerful collective engagement with STEM issues.

The recent controversy involving David Attenborough’s nature documentary ‘Frozen Planet’ provides an interesting demonstration of this tension between accuracy and plausibility in TV narrative. Programme makers were criticised when it was discovered that camera shots of a female polar bear and her cubs had been filmed in a Netherlands zoo – and not in the Arctic, as inferred by the documentary.

Responding to this criticism in the Guardian, the head of the BBC Natural History unit, Andrew Jackson, made some intriguing comments: “Personally, when I watch these films I want to be transported to these places. I wouldn’t want it to suddenly break away and say: ‘Meanwhile in a zoo in the Netherlands we filmed this.’ I also think our audience is slightly cleverer than that. They know that when we film something incredibly difficult we must have had to use some artifice.”

Artifice? In science documentary? Audiences might have assumed that the ‘artificial’ was the preserve of drama, and not science communication. Yet similar narrative premises are clearly employed by both TV drama and documentary to provide audience engagement.

Series like Call the Midwife demonstrate the power of drama to engage a mass audience with issues in medicine, science or technology. Yet the importance we place on ideas of accuracy – and its value in communication – may be a roadblock to our understanding of what makes an audience connect to science narratives – and through this, to science itself.

If experts like Terri Coates can be reduced to tears by dramatic artifice, then perhaps TV’s labours are a little more fertile than we imagined.

Stephen McGann is studying for an MSc in Science Communication at Imperial College. He is also a professional actor, and appears as ‘Dr Turner’ in the BBC drama series Call the Midwife.