Five Things Republicans Can Learn about Health Policy from Call the Midwife

Have you seen Call the Midwife?

The hour-long PBS drama follows a group of young midwives in London's East End in the 1950s, led by a convent of Anglican nursing nuns, the Sisters of St. Raymond Nonnatus. The show's premise offers an opportunity to examine reproductive health on television without having to contend with contemporary political quandaries, and provides an excellent teachable moment for the anti-choice among us. Plus, it's just good TV.

The series aired in 2011 on the BBC, and PBS has now picked up the entire first season. The first three episodes have treated viewers to a smorgasbord of reproductive rights issues, replete with class tensions, sexual indiscretions, and triumph over adversity as seen through the eyes of new midwife Jenny Lee.

So before Romney follows through on his threat to defund PBS, here are five things Republicans can learn by watching Jenny and Chummy pedal through the East End on their bicycles.

1. Restricting contraception affects poor women more than it affects women of means.

The midwives at Nonnatus House deliver 80–100 babies a month. "As soon as one grows out of its pram, another arrives to take its place," muses Sister Martha Jean, a bit of exposition that underscores how women in this impoverished neighborhood have little access to whatever birth control existed at the time. When Paul Ryan vows to get rid of the contraception-mandate aspect of the Affordable Care Act because it's a violation of religious freedom, what he's really doing is advocating that contraception be made less affordable. As Call the Midwife shows, health policy that ignores the contraceptive needs of low-income women functions as a barrier to financial stability. That's not to say that poor women who have only two children will be suddenly lifted out of poverty, but even Romney, with all his magical thinking, can agree that raising children costs money.

2. Adoption is not always a viable alternative to abortion.

In the second episode, 15-year-old Mary, an Irish runaway from an abusive home who has been lured into prostitution, finds herself with "one in the oven," as a friend puts it. "There are ways," to end the pregnancy, her friend tells her, but Mary is determined to keep the child. Unfortunately, the Sisters don't agree, and the child is put up for adoption without Mary's permission.

Conservatives often push for adoption as a viable alternative to abortion without addressing the ways in which this option could be abused. Giving a child up for adoption is certainly a good choice for some women, but the reality is that adoption was not necessarily a choice in the 1950s, and is very often not a workable option for women today.

3. Sex, love, and reproduction are always more complicated than they appear.

In episode three, 41-year-old Winnie finds herself with child, and is less than thrilled with the prospect. By contrast, her husband, who has no children of his own, is ecstatic. We don't know the reason for her anxiety over the pregnancy until she's in labor, when she yells "I'm afraid it'll be black!" Winnie, a devoted mother to three previous children with a doting husband, has been indulging other desires—but, despite the baby's parentage, husband Ted is besotted. "I reckon I don't know much about babies," he says as he stares into the child's eyes, "But I reckon this is the most beautiful baby in the world."

When Republicans craft health policy based on ideals of abstinence and monogamy, it betrays a naïve view of human relationships. Sexual desire is complicated. People are rarely what they appear. And sometimes, as Ted and Winnie's story shows, love can conquer all. We should create realistic health policy that can accommodate this complexity.

4. Prevention is better than damage control.

Call the Midwife showcases the compassion and dedication the nuns have toward their patients. The Sisters are daily witnesses to the reality of too many babies, and are intimately familiar with the health problems that can result from years of back-to-back pregnancies. At the same time, they have no way to help their patients who may find themselves pregnant ten times in as many years, and that means that most of their work takes the form of damage control. One of Jenny's first patients is pregnant with her 25th child; elsewhere, she treats a woman with syphilis that's been festering for years, and offers consolation to the patient when she miscarries.

Good public health policy puts resources into prevention rather than just treating the problem at the other end, and call the Midwife gives many graphic examples of why this is a good idea.

5. Strict moral codes don't change how people act, just how they react.

As Amanda Marcotte writes on Reproductive Health Reality Check, "There's this myth that the 50s was an era when people somehow controlled themselves sexually and STDs and unwanted pregnancy weren't major public health problems." Call the Midwife offers plenty of evidence that this was not the case. What was different is that people – especially women – couldn't be honest about it.

Stay tuned—there are three more episodes of Call the Midwife to come, and I'll be posting here every Monday until the end of the season.

Comments

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I read the original book and

I read the original book and the introduction says the number of births went down to 4 or 5 a month in 1963, once the pill became available. I think that says it all.

I thought one of the most

I thought one of the most interesting parts in (I believe) the latest episode, was the 40+ year old woman with rickets who could finally have a living child because NHS would pay for her to have a caesarian birth. If that doesn't say we need better health care for, especially, the less well off, I don't know what does.

The first three episodes have

The first three episodes have treated viewers to a smorgasbord of reproductive rights issues, replete with class tensions, sexual indiscretions, and triumph over adversity as seen through the eyes of new midwife Jenny Lee teethwhiteninggel

So before Romney follows

So before Romney follows through on his threat to defund PBS, here are five things Republicans can learn by watching Jenny and Chummy pedal through the East End on their bicycles teethwhiteningkits