Female genital mutilation was a problem in the sixties, and it’s a problem today.

We know that BBC’s Call the Midwife is a show about strong women. The series, originally inspired by Jennifer Worth’s memoirs about working as a midwife in East London in the sixties, has become a staple of Sunday night viewing, and not just for its earnestness.

Call the Midwife showcases virtues while not shying from pushing the boundaries and tackling difficult story lines. “Whoever heard of a midwife as a . . . heroine?” Worth asks in her memoir that inspired the series. “Yet midwifery is the very stuff of drama. Every child is conceived either in love or lust, is born in pain, followed by joy or sometimes remorse. A midwife is in the thick of it, she sees it all.”

The heroines of Call the Midwife see abuse, miscarriage, illness, pain, and, as the series veers into the 1960s version of Poplar, this season tackles perhaps its most important if under-discussed topic yet—the painful realities of female genital mutilation (FGM).

The episode that aired in the United Kingdom in February and airs this Sunday, May 7, in the United States, is one that has been widely praised for its brave and sensitive portrayal of a difficult subject. The screenwriter Heidi Thomas mentioned that she had wanted to write the story line for a long while but waited until it was historically the right time for the episode. Given the recent news of FGM practices even here in the United States, Thomas could not have timed it better.

In the 1960s, immigrant communities set down roots in East London. Nadifa—the woman in the episode—hails from Somaliland, present-day Somalia, where a majority of girls were at risk for FGM. FGM entails the partial or complete removal of the female genitalia for nonmedical reasons. FGM makes sex excruciatingly painful for women, exposes women to HIV, and can lead to dangerous complications in pregnancy. And yet, tradition holds so much sway that FGM continues to this day. Even though the practice is outlawed in the U.S. and the U.K., traditional communities still inflict FGM on young women, often traveling to their country of origin where the cutting is performed. In some communities, FGM is seen as a way to maintain sexual purity, and it may be seen as a rite of passage. The ritual is passed down from woman to woman as a matter of honor.

As the practice is illegal in most Western countries and controversial in others, Thomas made a concentrated effort to present the medical realities of the issue rather than engaging in a debate. The patient in the episode, Nadifa, experiences pregnancy complications due to FGM while grappling with the emotional ramifications of causing strife in her community or breaking the cycle of cutting.

“We are a medical drama, not a moral drama. We are not judging this woman,” Thomas told Radio Times. “You do have to be careful not to impose a modern mindset on the attitude of either the white characters or the Somalian women in that part of the story.”

Transporting the issue to 1960s London provides the distance that helps to accurately portray a controversial issue, and the characters handle the startling and unexpected complications with the grace and strength we have come to expect from the women of Call the Midwife. The historical relocation illuminates the roots of the anti-FGM activism and catalyzes the movement today in 2017.

Despite the work of activists and new legislation, FGM persists. In the U.K., six thousand new cases were reported last year, and U.K. hospitals treat one woman affected by FGM every hour. Current estimates from Equality Now suggest that 507,000 girls in the U.S. are at risk for FGM. Around the world, more than 200 million girls have undergone FGM.

At the helm of modern-day anti-FGM activism is Nimco Ali, a British activist who underwent FGM as a 7-year-old in Somalia. Ali co-founded a group called Daughters of Eve that aims to raise awareness and pass legislation to protect young women. For this particular episode, Call the Midwife producers consulted Ali for her perspective. As a survivor and advocate, Ali understands not only the pain and betrayal of unasked-for cutting but also the importance of rites of passage into womanhood. As a result, Daughters of Eve has become an exemplar of culturally sensitive and appropriate messages to halt the spread of FGM while maintaining bonds in communities of non-Western women.

Call the Midwife accurately depicts how the cycle of violence continues over generations. In the episode, as Nadifa welcomes her new baby, her younger sister is sent off to Somaliland for circumcision, against the advice of the midwives. As the realities of FGM continue to be exposed, Call the Midwife sets the standard for a fearless way to stand together with survivors of FGM worldwide. “If you look at the statistics around FGM,” Ali says, “they look massive, and there’s no way to come at it, but it’s one girl in one generation. It’s about breaking the cycle.” After the episode ends, viewers are left with a sense that maybe we are better equipped today to combat this issue than the midwives were in the sixties. I, for one, was left with the feeling that the midwives of Poplar would be proud of Ali, her fellow Daughters of Eve, and all survivors of FGM who courageously work to curb the practice.

Photo Credit: BBC