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?
When a baby is born with severe deformities of the kind later identified as caused by the drug thalidomide, the midwives find it difficult to handle the situation, and the baby's father rejects her completely, to his wife's dismay. Trixie's new sideline as a keep fit instructor brings her into conflict with Sister Julienne, and she also becomes suspicious of the relationship between Barbara and Tom. Rather than return to Wales as her mother wishes, Delia moves into Nonnatus House.
Barbara treats a pregnant woman whose dockworker husband is struggling to support her as opportunities for work dry up. She is forced into a difficult decision that leaves Barbara facing the biggest test of her career. Nurse Crane meets a kindred spirit when she learns to speak Spanish, and Sister Evangelina helps a woman with breastfeeding, leading to unforeseen consequences.
A outbreak of typhoid erupts, and suspicion over who the carrier could be threatens to break apart a closely knit family. Sister Winfred faces a personal dilemma when a local teacher is revealed to be pregnant by a married man. When the woman takes matters into her own hands, Sister Winifred is forced to consider the role her own prejudices may have played. Meanwhile, Barbara inadvertently agrees to go to dinner with Tom, but is wracked with worry about how Trixie will react.
Sister Julienne is seconded to a maternity ward, and is impressed by how modern technology is being used to help the mothers - but is left with a moral dilemma after assisting on a traumatic birth. A young man from Poplar is delighted to be accepted into university, but his mother is less than happy. His dreams are jeopardised when his girlfriend gets pregnant, a development that puts pressure on the whole family.
Turner and Shelagh are at the forefront of the advances in medical technology, and begin a campaign to ensure better respiratory health for their patients. However, Timothy fears their own lifestyle is not good for them and tries to encourage his parents to give up smoking. Violet injures her back and is forced to leave the shop in Fred's hands, a decision that strengthens their relationship but which proves to have other, unforeseen consequences. A new mother's past comes to light, with devastating repercussions for her family. Nurse Crane draws on her own experiences to help her.
Poplar is rocked by a series of unhappy attacks on women, and a prostitute is too ashamed to report what she knows - but her actions lead to a dangerous man roaming the streets, with devastating consequences for the residents of Nonnatus House. A mother tries to keep her daughter's pregnancy a secret to avoid gossip, putting her life in danger. The Turners go on a long overdue holiday, but the weather ruins their plans.
The introduction of the contraceptive pill is welcomed by Dr Turner, but some of his colleagues are less keen on the idea. Patsy tries to help a bargee who wants to give birth among her own community rather than in a maternity ward. Nurse Crane deals with an emergency during a storm, and a familiar face returns to Nonnatus House - but has been changed by her time away.
With Christmas just around the corner, the time has come to accept the things that have passed, and look to the future. The cause of the recent spate of infant limb deformities is finally uncovered and realising that his own prescriptions could have exacerbated the tragedy, Dr Turner is forced to jump into action in an effort to stop any further damage.