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Lucille is trapped in a lift with a woman in labour while working at St Cuthbert's, and Nurse Crane helps a Sylheti woman with fistula.
Sister Julienne cares for a pregnant prostitute, while Dr Turner puzzles over a mysterious string of symptoms.
Four new doctors arrive at Nonnatus House and ruffle some feathers. Fred and Reggie try to help an old man and his pigeons, while Dr Turner tries to solve the old man's cough.
As the unfamiliar terrain of the Hebrides stretches the team to the utmost at Christmas, their return to Poplar sees them braving a landscape that feels suddenly unfamiliar. Budgets are being cut, and hospitals reorganised. Terraced houses are being demolished, and traditional family structures torn apart. There are wrecking balls everywhere, and it's up to Sister Julienne, and the midwives and medics of Nonnatus House, to help find a way out of the rubble. When they themselves come under threat, their job becomes even harder.