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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.