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A chance encounter with an impoverished child forces Trixie to see an unfamiliar darker side of life. As Nonnatus House welcomes a new resident, Nurse Barbara Gilbert, Tom Hereward has a surprise romantic gesture in store for Trixie.
Barbara faces her most challenging case to date when she treats first-time mother Abigail Bissette and the birth does not go according to plan. As Sister Julienne struggles with the increasing financial pressure on Nonnatus House, a mystery benefactor comes to the rescue. Elsewhere Sister Evangelina is unimpressed by newly arrived nurse Phyllis Crane.
The Nonnatus team rallies to support first-time parents Marie and Tony Amos when Tony is arrested for gross indecency with another male. Elsewhere, as Poplar is gripped by an outbreak of dysentery, Trixie undertakes her first official church duty since her engagement to Tom.
The midwives face one of their busiest nights to date, whilst Sister Winifred concentrates her efforts on the prostitutes of Poplar. Elsewhere, cracks start to appear in Trixie and Tom Hereward's relationship.
Sister Julienne's faith is challenged when a mother refuses medicine for her newborn baby. Dr Turner's involvement in the case forces him to face his own demons. Meanwhile, Barbara must work out a way to communicate with a pregnant Sylheti woman.
Patsy's brusque manner lands her in trouble with the nuns and she is removed from midwifery duties. Trixie agrees to go on a date with a curate, Tom Hereward. Dr Turner and Shelagh discuss how they might expand their family.
As Jenny returns to Nonnatus House, her encounter with nervous expectant mum Faye forces her to break the rules. Chummy throws herself into preparations for her mother's visit, whilst Sister Julienne and Cynthia deal with acute mental illness in a newly delivered mother.
As preparations are made for Chummy to nurse her dying mother at home, Jenny finds herself drawn to help. Whilst Shelagh and Dr Turner await news from the Adoption Society, Shelagh pulls out all the stops when she enters her choir into a competition. Season finale.