In Midwifery, There Is No Room for Passing Judgements

Posted by Andrea Altomaro on
© Neal Street Productions

Editor’s Note: The opinions expressed in this blog post are solely those of the author.


As a midwife, I have cared for women from all walks of life. Like I mentioned after last week’s episode, there is no room for passing judgments in midwifery. Sister Winifred says it perfectly when she first meets Bridget Cole, a young, pregnant, unmarried prostitute: “Let’s leave all talk of wickedness at the door.” No matter a woman’s background — her age, socioeconomic status, race, ethnicity, sexual identity — it is a midwife’s job to provide safe, compassionate, and quality care.

Seeing Sister Winifred care for Bridget reminded me a little of my work for Nurse-Family Partnership in Detroit, where I worked right after I first became a midwife. I often see a lot of parallels between Poplar and Detroit, despite the distance of both place and time. Nurse-Family Partnership is an evidence-based community health program that works to transform the lives of vulnerable first-time moms. The nurse home visitors do this by helping women engage in preventative health practices, such as attending prenatal care, providing education about nutrition, and helping them reduce the use of alcohol, cigarettes, and drugs. They provide education about parenting to help women to provide responsible and competent care for their children. Finally, they also work to improve the economic self-sufficiency of the family by helping moms develop a vision for their own future. We worked with low-income women, and often young teen mothers. Our job, much like my job as a midwife now, was to provide education and support, but let the mother make her the decisions that are best for her family.

When Sister Winifred had to make a home visit for Bridget, she was thrust into Bridget’s world, a brothel, where Bridget lived and worked. As a young nun, you can imagine that this made Sister Winifred uncomfortable! It seemed that it was difficult for her to understand why Bridget was still living there, and even still working during her pregnancy. As Bridget reminded Sister Winifred, to “leave talk of wickedness at the door,” I could see Sister Winifred remember her task at hand — providing that compassionate care that midwives are known for.

Sister Winifred was even compelled to help the other women who worked with Bridget to keep themselves safe. She created handouts about safe sex and using protection. At first, she was not well-received; the women were not ready to hear what she had to say. They worried about losing customers if they requested using condoms for protection. Many young women today might feel the same way, worried that their partner will be angry or unwilling if they request using a condom. It’s important that women understand that they are in charge of their sexual health! Wearing condoms every time is the best way to be protected from sexually transmitted infections, as well as preventing pregnancy. At first, Sister Winifred could not get anyone to listen to her. After she provided excellent care for their friend Bridget, the other women were able to trust Sister Winifred, and we see her at the end of the episode teaching the women about safe sex practices. The women had to be ready to learn the information, and no amount of persistence on Sister’s part would help before then. This episode of Call the Midwife was a great reminder to me that building trusting relationships with women and their families is at the core of what we do.


Altomaro_Andrea_posts.jpg Andrea Altomaro (MS, RN, CNM) has been nurse-midwife for the past three years and is currently working for the Henry Ford Health System. Before becoming a midwife, she worked as a nurse in the emergency department and also in labor and delivery.
Read More About Andrea |  Read All Posts by Andrea

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