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.




  1. Very interesting Steve! Increasingly media outlets are praised for using good technical advisers to ensure accuracy. When the film Contagion came out last year, the Guardian’s science weekly podcast interviewed the science adviser and used that as a jumping board to discuss infectious diseases. I think it is great when TV and films are accurate about science! One of the most disappointing movies I have ever seen was Seven Pounds – it highlighted so many social issues and then in the final scene fell down completely through scientific/medical inaccuracy.

  2. I think there’s a fine line between what a viewers will accept as artifice or reality. We don’t expect reality from drama, but done well it can seem as real as any documentary. The skill with CTM is that while we know it is a drama, because the stories are based on real experience, well researched and well made, we can even accept artifice within the drama context (we all know that at times we are not looking at a real baby). As many of us have experience of childbirth, even as a drama, it would lose credibility if veered too far from the truth. The difference with the documentary is that it is presented to us as truth. Andrew Jackson comments imply that we should all be aware that some things are too dangerous to film and if we are not we are stupid. The trouble with that stance is that with documentaries on subjects that are so removed from our own experience is that we haven’t a clue what that might be. Nobody is saying they shouldn’t have filmed in the zoo, but an announcement at the end of the programme giving reasons why, would have been more honest. Once artifice is used in that setting it leads to question everything else that is presented.

  3. Great piece, Steve, and also a good input of reflections on two borderlines: one between fiction and reality and the other between science and its popularisation.
    They are quite blur and indeed sometimes there is well the possibility of overlap between the two spheres.
    Aristotle defined the drama or tragedy as a form of art which mimics reality. Is it the verosimil aspect that prompts the tears of the viewer, or is it the amplification (hence distortion) of the truth? It is very interesting Coates’ opinion about the use of narrative artefacts as long as the science is not fully distorted. It sounds, indeed, confirming Jackson’s point. The main issue, though, is not related to stupidity, but by the will of the spectator to emotionally participate to the scene. Critical analysis of a scene and emotive participation sometimes cannot cohexist, in my opinion and artistic representations often push you always towards emotive participation: perhaps , this is the measure of their highest impact.

  4. One of the interesting discoveries about the science documentaries we study in Imperial is that docs are not innately ‘real’ in their form or content. Like Attenborough’s programme, they can use many of the same film fiction techniques to represent reality – but we just seem to make greater assumptions of accuracy about them. I think your observation about what is being *presented* as truth is key. Yet I would suggest that there are greater possibilities for the communication of science than simply the focus on accuracy of presentation. I agree entirely with the value Penelope places on the highlighting of social issues – yet feel that this can best come – like Terri noted – through a balance between due accuracy and an engaging authenticity. That’s what I think Attenborough’s doc was aiming for, and that was the premise for Call the Midwife.



  5. Hi Antonio,
    I find this point of connection that prompts the ‘tears in the viewer’ really interesting. I think you’re right to ask what motivates it, and what feeds it. There has been some scholarship on this ‘aesthetic engagement,’ but to my knowledge not a huge amount. I come at it from the angle of a co-engagement point between science and publics – rather than any linear media effects of particular science frames or narratives. A sort of ‘third space’, if you like, in which both communicator and communicatee meet. Perhaps this space is emotive, rather than rational. But then, perhaps that is a quality of the communication side of sci comm, rather than the science. And documentary, like drama, is more communication, than science.

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