Kay’s series depicts ‘messy, raw and real’ births
‘This Is Going to Hurt’ goes full throttle on realism to avoid perfect little bundle trope
“Bloody show” is a colorful term for the mixture of blood and mucus that indicates the cervix is preparing for labor.
It is one of the many strange, sticky bodily secretions you are likely to encounter for the first time when you become a parent: colostrum (yellowish early breast milk), meconium (baby’s tar-like first bowel movement), vernix (the creamy white stuff often covering newborns when they’re born).
I thought of the term again recently as I watched an episode of “This Is Going to Hurt,” a darkly comic TV series following a team of stressed-out doctors and midwives in the obstetrics and gynecology ward of an under-resourced London hospital.
During a particularly chaotic shift, haughty chief consultant Mr. Lockhart (Alex Jennings) is showing off the facilities for a visiting politician and phalanx of reporters. He opens the door to a newly refurbished delivery room — which, unbeknownst to him, has just been used for a water birth — and discovers what looks like the aftermath of a bathtub dismemberment a la “The Sopranos.” Blood cascades across the floor in front of a tub filled with rust-colored water. Soiled linens, unable to soak up the mess, sit discarded in a heap nearby. It is quite a bloody show.
Based on a memoir by Adam Kay, “This Is Going to Hurt” features some of the most visceral depictions of labor, pregnancy and reproductive health emergencies ever to grace the small screen.
In the dizzying opening sequence, Adam, played with prickly brilliance by Ben Whishaw, finds a pregnant woman in obvious distress in the hospital parking lot and lifts her dress to discover her baby’s prolapsed arm dangling between her legs.
Adam springs into action and, by the time the baby is safely delivered, via C-section, his clothes are soaked in blood. And that’s just the beginning. Over the course of “This Is Going to Hurt’s” seven episodes (now streaming on AMC+), you will laugh grimly as a woozy doctor passes out during a C-section and lands, face first, in a patient’s open belly. You will hear the word “labia” more than you ever have in your life. You will learn what a placenta looks like, if you don’t already know. And you will understand that even when it is uncomplicated, childbirth is always messy.
“I’m sure there are some people who have absolutely uneventful, easy labors, where they’re able to speak in full sentences the entire time, and look like they’ve just come out of makeup at the end, but that was not my experience,” said Kay, the series’ creator and a former National Health Service doctor in Great Britain. “I wanted this to be the one show that doctors and nurses and midwives watched and didn’t go, ‘It wouldn’t have been like that.’ We went full throttle on the realism.”
The goal was to show births that were “messy, raw and real,” said Lucy Forbes, who directed four episodes, including the pilot. “It was very important to me that the births weren’t sanitized and (didn’t feel) cheesy.”
She worked with director of photography Benedict Spence to “escape the washed-out, over-lit look that you usually get in medical dramas,” and was also keen to avoid
“the perfect little bundle trope — a clean and pristine
baby who looks too old to have just been born being handed to a mother, when in reality everything is sticky and sweaty and bloody.”
Finding a way to make the show “visceral and truthful but not unpleasant” required constant discussion among the creative team, said Kay.
There were few rules “other than to make sure we showed the audience what it’s really like,” said Forbes. “In reality, doctors are frequently covered in bodily fluids. It soaks through their clothes to their skin and down to their shoes.”
This commitment to verisimilitude led to some darkly humorous moments on set, as when a stuntwoman who had been lying on the floor all day stood up and the blood from her pregnancy belly
poured out on the floor. “It was like a scene from ‘The Shining,’ ” recalled Forbes. “After a very tense day on set the whole cast and crew exploded with laughter.”
And unlike many medical dramas, which use one or two consultants to address a wide array of issues, “This Is Going to Hurt” employed 16 medical advisers with distinct areas of expertise, including midwives, nurses, obstetricians and anesthetists.
To ensure the babies who appear in the show are convincingly tiny, casting agents found parents who were due to give birth while the show was in production and were willing to hire out their newborns. (Other scenes used models and prosthetics created by Millennium FX.)
“This Is Going to Hurt” is the cynical twin of “Call the Midwife,” a period drama
about a group of midwives operating in the impoverished East End of London in the 1950s and 1960s. After more than a decade on the BBC, it remains one of the most-watched programs in the U.K., where it airs at a family friendly hour and must be judicious in its use of blood and gore. (Stateside, new seasons air on PBS and older seasons are available on Netflix.)
Despite these restraints, “Call the Midwife” is refreshingly, even radically matter-of-fact about the reality of inhabiting a reproductive body. With cheerful efficiency, the midwives cycle around the streets of Poplar, collecting urine samples and snipping umbilical cords. They have witnessed, firsthand, virtually every physical and emotional complication related to childbearing, and understand what makes pregnancy so perilous for many of their patients. Perhaps most powerful of all, “Call the Midwife” has captured a broad spectrum of birth experiences, some quite remarkable, others long and grueling in unexceptional ways.
The series, based on books by Jennifer Worth, has long since moved beyond its source material. Each season, creator Heidi Thomas researches new storylines by combing through old newspapers and looking at historical data on births, deaths and illness in the borough of London in which the series is set. Statistics can tell a powerful story.
As Thomas said during a recent appearance, “A dysentery outbreak in a nursery school — well, if that’s not drama, I don’t know what is.”