Introduction

Call the Midwife1 has been a highly popular television series since 2012 and the BBC has announced that three further series are to be filmed. This paper examines the nature and background of the programme. Although the series deals mostly with midwifery and nursing in East London, we discuss the introduction of some dental themes for the first time.

Call the Midwife: a book

This book was written in 2002 by Jennifer Worth (1935–2011), a British nurse, midwife and musician. Originally trained as a nurse at the Royal Berkshire Hospital, Reading, she then went to London to train as a midwife. Worth became a staff nurse at the London Hospital, Whitechapel in the early 1950s. She worked with the Sisters of St John the Divine, an Anglican community of nuns, to aid the poor. She then transferred to the Elizabeth Garrett Anderson Hospital, Bloomsbury, and finally worked at the Marie Curie Hospital, Hampstead.

Worth retired from nursing in 1973 to pursue her musical interests and later began to write. Her first volume of memoirs, Call the Midwife,2 appeared in 2002, became a bestseller and was re-issued in 2007. Shadows of the Workhouse3 followed in 2005 and Farewell to the East End4 in 2009. The trilogy drew on her work as a midwife in the poverty-stricken East End of London. All became bestsellers.

Worth became a midwife in London's Docklands in the 1950s. Coming from a sheltered background she was deeply shocked. Many babies were delivered in terrible surroundings and had to endure awful care, or even none. But while Worth witnessed brutality and tragedy she also met amazing kindness and understanding, tempered by a great deal of Cockney humour. She earned the confidences of many of the women.

Worth was attached to an order of nuns who had worked in the slums since the 1870s. Call the Midwife tells the story of the women she treated, the community of nuns and the friendship of the midwives with whom she trained. She brought to life the colourful world of the 1950s East End.

Nonnatus House

In the book, Worth talks1 of a group of midwives based with a sect of nuns in Nonnatus House, in the heart of London's Docklands. Their practice covered the densely populated areas of Stepney, Limehouse, Millwall, The Isle of Dogs, Cubit Town, Poplar, Bow, Mile End and Whitechapel. She explains that St. Nonnatus is a pseudonym taken from Sir Raymond Nonnatus, the patron saint of midwives, obstetricians, pregnant women, childbirth and newborn babies. He was born in Spain in 1204 by Caesarian section, non natus. In 1240 he became a priest.

Midwife and the BBC

The Midwife book was so popular that the BBC decided to utilise the story for a series. Fresh from writing the script for Cranford,5 Heidi Thomas was commissioned to adapt Worth's memoir. The author was delighted to cooperate with Thomas but sadly died on 31 May 2011, just before filming began. The first episode, aired in January 2012, was dedicated to Worth. The initial stars were Vanessa Redgrave, Miranda Hart, Jenny Agutter, Pam Ferris, Judy Parfitt, Helen George and Laura Main. The book's central character, Jenny Lee, is played by Jessica Raine and is based on Jennifer Worth. Her older self is played by Vanessa Redgrave, who provides a 'voice-over' during each episode.

Viewers have to remember the story deals with a chapter in the history of women before the advent of the Pill in the late 1960s, when abortions were illegal. The first episode was an instant hit. Attracting 9.6 million viewers, it beat Sherlock6 and the first episode of the latest Downton Abbey.7 Series 1 gained the highest ratings for a new BBC drama launch on BBC 1 with a consolidated audience of 11.4 million viewers. Each series has been hugely popular in America, Australia, Sweden, China, Israel and Russia.

Although aired by the BBC, Midwife is produced by CTM6 Productions Ltd. This is a part of Neal Street Productions, a highly respected independent company producing programmes for film, television and the theatre in Britain and the USA. Set up in 2003 by Sam Mendes, Pippa Harris and Caro Newling, the company celebrated its tenth anniversary in 2013, when Nicolas Brown joined the board of directors.

Call the Midwife was nominated for and gained a number of BAFTA and National TV awards. With the programme's huge popularity it was time for some dental storylines

The BDA museum and Rachel Bairsto

The show's script executive, Katy Harmer, contacted the BDA Museum in 2016 to seek assistance with a forthcoming episode of the new series (series 6). Although the storyline wasn't yet decided, they wanted information about dentistry in 1962. Rachel was able to supply them with 1960s pictures of dental surgeries, as well as photographs of equipment used at that time which were in the museum's stores. Much of the relevant stored equipment was acquired from the dental surgery of Leslie Leggett when he retired from his Norwich dental practice. The X-ray machine, dental unit and anaesthetic apparatus proved to be inspirational to the TV set builders. The BDA's John McLean Archive (a living history of dentistry) provided a valuable source of background information about the condition of the nation's teeth and the treatments available in 1962. As the UK's first adult dental health survey did not take place until 1968, interviews in that archive were invaluable. Especially relevant were those of John Craig and Julian Bedford. The museum archives also provided information about the NHS in the 1960s.

Stanley Gelbier and the TV production

For further background information Katy Harmer was referred to Stanley to provide an account of dentistry and welfare services at that time. Having qualified in the autumn of 1961 he knew the era well. There followed many telephone conversations and email exchanges. Initially she wanted to learn from him more detail about the use of some of the equipment. Later discussions were on the state of dental health of children and adults in 1962. They then turned naturally to prevention including simple dental health education messages, ensuring all were appropriate for the year. Thus fluoride toothpastes were off the agenda; but the toothbrushing drill for children was not. Sadly it was an era of dental clearances for a number of adults, so the question of general anaesthetics and full dentures came to the fore.

All of this was taken on board by Katy and her colleagues. Stanley was then asked what might or might not be appropriate to be put into a script. A number of possible lines and then a full script were shown to him for comments. Advice on amendments were invariably taken on board, for example, whether it would be right for a patient to have a clearance under a general anaesthetic and wake up with gleaming new teeth. He was then invited to the Longcross Studio where filming was to take place, to ensure all was right on the day, becoming consultant dental adviser to the production team.

Longcross Studios, Surrey

Established in 2006 and with over 200 acres of backlot space, its facilities are much in demand. There are four main stages (buildings) plus numerous workshops. The studios were once an important Ministry of Defence site. A 2¼ mile test track, once used to test 80 ton army tanks, is now used for filming outdoor scenes. For example car races and crashes for a TV soap, Emmerdale,8 take place there. A 150-year-old manor house is used by film and TV companies. Many blockbuster films have been fully or partially filmed there; including famous British and American films such as Fast & Furious 6, World War Z, Thor 2, Skyfall, War Horse and Clash of the Titans. CTM6 Productions use it to record Call the Midwife.

Stanley's wife Marilyn accompanied him to the studio: she had qualified as a dentist in 1962 so also had first-hand knowledge of the era. They discovered that these TV people work long hours. He was emailed a 'call sheet' produced after that day's recording, which ended at 8 pm. The sheet indicated that he was wanted on set at 7.30 am. Several people were picked up from home at 6 am in time to be in make-up by 7 am.

Filming the scenes

Immediately on arrival Stanley was whisked off to a small studio with a mock-up of a dental surgery. It was the dental department of the local St Cuthbert's Hospital (Fig. 1).

Figure 1: Preparing to film the scene in St Cuthbert's Hospital dental examination room.
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Crystal is sitting rigid in the dentist's chair

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He was immediately introduced to the director, Lisa Clarke, plus actors appearing in the dental scenes; especially to Jack Hawkins who was to play Christopher the dentist. Stanley had previously joked that he could play the dentist but it was obvious that Hawkins was more suitable to play the love interest. He and Stanley spent time together to ensure he got things dentally correct. It was amazing how quickly he took on board dental actions, including reassuring the patient (Fig. 2) and the use of forceps (Fig. 3). Incredibly, Laura Elphinstone, the actress playing Crystal, the woman who was to have a clearance, had previously been fitted with an overlay plate with no teeth. She wore this when waking up to appear edentulous. That and some 'blood' applied by the make-up artist made the whole thing very realistic. Obviously, she had to practise wearing that and later a denture with gleaming teeth over her own teeth. Her performance was incredible, especially as she awoke from the gas session. Nurse Trixie, played by Helen George, was on hand to reassure her. The two other actors in the scene were Craig Bryce (the anaesthetist) and Caroline Knight (the dental nurse).

Figure 2: Christopher says 'I'll put you to sleep and while you are dreaming of lovely things, I will deal with everything.
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And when you wake up all the pain will be gone.'; 'I'm going to make sure you get dentures that look as good as or indeed better than the real thing.' Trixie holds Crystal's arm

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Figure 3
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Teeth being extracted by dentist Christopher

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It was utterly amazing how much attention went into the detail. Stanley gave lots of advice on set then watched the acting on a screen with the script supervisor to ensure everything would look authentic for the viewers. Sometimes the director or the 'dentist' popped out to check details; and on occasion Stanley went in to suggest an improvement was needed. All comments were taken on board. If there was something Stanley did not know it was useful to have Marilyn present as a back-up. For example, she was better at recognising some of the badly decayed teeth which they wanted to match to the correct forceps.

Although Stanley was not then present he knew from the script that some school children would be receiving dental health education at the community centre.

For an amateur photographer it was interesting to note that at no time during filming did the cameraman seem to use a zoom shot. Each view was separate. He kept changing the enormous camera lenses from a large box with several dozen carefully stored lenses which someone came out of the studio to change.

The script supervisor, who was also responsible for the recordings, said the video editor jiggles everything until the last minute to ensure all the separate bits are pulled together. Remembering that most things are not filmed in the order of the story, this constitutes a real jigsaw puzzle.

The Gelbiers' contribution finished at about 5.30 pm but some people continued to work until 8 pm. Katy Harmer then took them about half a mile away to see 'Nonnatus House' (Fig. 4) where many of the routine indoor scenes are filmed, for example the nuns' and nurses' dining room. Also some outdoor sets for Midwife. It was incredible to tap a couple of house walls in the street and find they were artificial – they would never have known it.

Figure 4
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Nonnatus House

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Postscript

Marilyn and Stanley had a very interesting day with the production company. Everyone they met – producers, director, actors, make up people and support staff – were all lovely. As the day progressed Stanley was filled with admiration for everyone and their jobs; and their kindness to ensure he was happy with everything they did. It was a day to remember. Shooting of the dental scenes took place on 16 August 2016. The programme aired on 19 February 2017. Feedback from a number of viewers suggests that the work involved was worthwhile.