An unexpected turn of events leads to a wedding being hastily arranged. Shelagh finally goes into labour. The arrival of the pill leads to unforeseen consequences.
The government plans to close down small hospitals in favour of larger establishments. Dr Turner and Shelagh prepare for an inspection that will decide the fate of Nonnatus House – but the staff is shocked to find Sister Ursula has no intention of helping to save the maternity home. Barbara comes to the aid of a woman from the Chinese community who is struggling to get on with her mother-in-law, and whose baby is seriously ill.
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Sister Ursula continues to reign with an iron fist and the midwives at Nonnatus House struggle to toe the line, especially when she insists they must not be emotionally involved with their patients. This unpopular new edict is immediately put to the test when new father George Marsh is badly burnt in an explosion at the docks and is unable to support his new family, and when expectant mother Penny Reed and her anxious husband Derek are brought to the attention of Nonnatus House. Penny and Derek both have achondroplasia (colloquially known as dwarfism) and problems with the pregnancy are anticipated, including their baby being stillborn or only living for a short time. As the midwives prepare the Reeds for an infant that may not live, their unconditional devotion to one another and to their unborn child makes a deep impact, especially on Patsy, who is facing one of her toughest decisions yet. Elsewhere, barmaid Valerie Dyer’s quick thinking catches Shelagh’s attention when they are first on hand to deal with the casualties at the dock fire. Shelagh is appalled by the general lack of basic health and safety in the docks and strives to make a difference to the men that work there. Dr Turner and Shelagh also share the happy news of Shelagh’s pregnancy with their children.
The midwives receive a rapturous and warm welcome home from their South African adventure but all is not well at Nonnatus House. In their absence, Sister Ursula has been running a very tight ship and it is quickly announced that she will remain in charge at Nonnatus House, above Sisiter Julienne. The midwives are drawn into helping Trudy, a heavily pregnant mother whose husband has just been released from prison for extortion. Gradually, the problems below the surface of their marriage become clear. Trapped and with no clear way out, Trudy’s suffering sends shock waves through Nonnatus House, most noticeably affecting Sister Mary Cynthia who is experiencing increased anxiety following her recent attack. Elsewhere, Shelagh harbours a secret and struggles to tell Dr Turner, and Patsy receives some distressing news about her father in Hong Kong.
The nuns are trying to help a tiny struggling mission hospital on the Eastern Cape. But can they save the hospital from closing down – and perform a Christmas miracle a long way from home?