It’s summertime in Poplar, but there’s no rest for the midwives, beach days, or sunny trips to Portofino as the warm weather sets in. Everyone is up to their necks in appointments, and even the youngest of the “Midwife” crew, Timothy and Reggie, are tasked with work when Episode 4 begins. Summer vacation? We don’t know her.

Losing Patients to the Competition

This week, Phyllis meets Simone at the Florrie Hall antenatal and baby clinic for a routine pregnancy check-in. Simone prides herself in being a modern mother, and though she had her first baby at Dr. Turner’s maternity home, she has opted out of a delivery there or with any of the midwives for the birth of her second child. Instead, she’s chosen to go to St. Cuthbert’s and doesn’t shy away from shouting out her praises over the competing hospital.

She even goes so far as to call home births “primitive” (tell us how you really feel, Simone) and isn’t bothered saying it straight to Phyllis’ face. Phyllis argues that Dr. Turner and the midwives offer quality care equal to that of the nurses and doctors at St. Cuthbert’s, but Simone refuses to believe it. Her unsolicited career feedback leaves Phyllis flustered following their appointment, but Sister Monica Joan comes to her aid with a well-deserved ice cream, after overhearing the women’s conversation. At least someone gets it.

A Family Full of Girls

Simone might be throwing shade at the midwives, but the maternity home is bustling as always with mothers and their newborns when Vinita Khatri arrives to deliver her third child. Trixie steps in as her midwife and Vinita gives birth to a beautiful baby girl. However, only minutes after greeting her new daughter, Vinita’s labor pains begin again, and Trixie discovers that she has an undiagnosed twin on the way. Trixie calls in Shelagh and Dr. Turner to help her deliver Vinita’s twin, another girl to make four daughters total!

Following their birth, Vinita’s husband Ramesh visits the maternity home and performs a traditional Jatakarma ritual to celebrate and welcome his new daughters into the world. Though Ramesh mostly seems pleased by his growing family, Vinita senses his disappointment at the news of not just one new daughter but a second. This is further validated when Ramesh comments that throughout Vinita’s pregnancy he had only been thinking of names for a son and is now overwhelmed at the idea of having to find two names for girls.

This irks Vinita, who feels that he’s dancing around what he really wants to say, which is that he really wanted a son. Ramesh leaves her with their argument and frustrations still suspended between them, but what he doesn’t realize is that any reconciliation will have to be put on hold when things take a turn at the maternity home.

Reggie’s Health Issues

As an infection silently spreads at the maternity home, over at the Buckle’s abode, Fred and Violet are overjoyed to have Reggie home for the summer. However, their typically cheerful son is different upon his return to Poplar. His usual interests, like helping Fred garden or joining Cyril for game nights at the social club, don’t appeal to him, and he chooses to stay home most days. Rather than the happy, involved person that they’re used to, Reggie has become more lethargic and unmotivated. Violet and Fred grow concerned by his behavior, but can’t seem to determine what’s wrong.

The Fight Between Home Births and Hospital Births

As Reggie quietly battles with his health issues alone, across town, Shelagh, Dr. Turner and Phyllis attend a training session at St. Cuthbert’s to learn how to use a Ventouse machine. Dr. Turner is enthusiastic to try out the new medical equipment, which is intended to help with deliveries and serve as an alternative to forceps, but Shelagh is appalled by the cost to purchase one, and Phyllis remains skeptical, noting that it can only be used if the baby is in the correction position during labor. Even so, they are all open to testing it out to expand on their own learnings and for potential use in the maternity home should any funding become available. (Matthew? Are you there?)

While they’re practicing, Shelagh asks St. Cuthbert’s doctor Mr. Walsh if the machine has ever been used in a home birth setting. He responds in the negative and reasons that home births are not cutting edge anymore, a comment that’s like deja vu for Phyllis after her appointment with Simone. He notices that both women take issue with this and decides to lean into his insult by remarking to Phyllis that incorporating new tools and practices into a labor can be a difficult adjustment for anyone used to “old school” techniques. Understandably, Phyllis does not take his snub well.

She stands her ground and reminds him that she has over 40 years of experience in their field and that while she has no issues with embracing innovation, she makes sure to approach everything with caution. Shelagh appreciates the clap back but this only seems to aggravate Mr. Walsh who feels the need to make an observation about Phyllis’ age – rude – and how she has continued to practice midwifery past the State retirement age.

Infection at the Maternity Home

Mr. Walsh’s feedback is totally uncalled for, but as we the Midwife stans already know, Phyllis and her superhero colleagues are not only extremely skilled and qualified for their roles, but they also maintain strong, lasting relationships with all of their patients. As we’ve seen from past seasons, this special attention to everyone in the community and an empathetic way of handling their cases has often set them apart from St. Cuthbert’s in the past. Take that!

It’s this same devotion that they have to put into action when they return to the maternity home where they find that Vinita’s twins and two mothers in their care have come down with a nasty infection. Dr. Turner diagnoses the twins with gastroenteritis and worries that the highly contagious infection could continue to spread to the others.

His worst fears are confirmed when all five newborns at the maternity home come down with the infection, and he ultimately decides to close down both the maternity home and his surgery to prevent a community outbreak. Since he, Shelagh, Timothy and Trixie have already been exposed, they all stay on to take care of the mothers and their babies until everyone has fully recovered.

Sister Julienne, Miss Higgins and the others quickly set up a replacement surgery at Nonnatus House with a stand-in doctor, but the unexpected outbreak shakes them. Sister Monica Joan is perhaps the most distraught of them all and the news moves her to go to the maternity home to provide her assistance.

Sister Monica Joan Steps Up

Though she has largely been off-duty as a midwife, she explains to her peers that she has experience working with children in similar conditions. After seeing far too many babies die from infections like this in the past, she refuses to let it happen again. Though the women have their reservations about letting her go, her assistance ends up being quite useful when Shelagh becomes too ill to stay on at the maternity home.

Sister Monica Joan helps monitor the newborns in the nursery, who need 24/7 care, and is the first to spot when one of Vinita’s twins stops breathing. Trixie manages to resuscitate her, but her high heart rate rings the alarm bells, and they know she’ll have to go to the hospital for additional treatment. Right as the ambulance leaves, Ramesh arrives and learns what has happened.

Since he’s unable to visit Vinita, he asks Dr. Turner to relay a message to her. It’s clear that he regrets the argument they had before the maternity home closed down, and he asks Dr. Turner to tell Vinita just how much he cherishes his family and how grateful he is for all four of his daughters. He also visits his youngest in the hospital to make sure she has a loved one closeby.

Phyllis’ Letter from the Board of Health

As the “quaranteam” tends to nappies and tries to keep all their babies stable, back at Nonnatus House, Phyllis faces yet another challenge. Before one of her appointments, she finds a note in her car from the London Board of Health asking her to appear in front of a panel. A little birdy, or in this case more like a shark (aka Mr. Walsh), has alerted them to the fact that Phyllis continues to work past the State retirement age. Sister Julienne is as irritated about the notice as Phyllis is, but informs her that she must go to avoid angering the Board.

Mr. Walsh and his need for revenge has truly tested Phyllis’ confidence. However, as her career hangs in the balance, she must continue her work, and perhaps the least likely person to ask for her help is Simone. She has gone into labor, and though she was originally scheduled for a hospital delivery, a combination of pain and panic has paralyzed her, and she refuses to leave her house.

Pleasant or not, Phyllis goes above and beyond for all of her patients, and quickly makes her way to Simone and Larry’s house. There is mild complication when her baby’s shoulder gets caught on her pelvic bone, but Phyllis is able to carefully deliver her baby boy. However, issues arise again when a delay in Simone’s afterbirth results in significant bleeding. Phyllis asks Larry to call for an ambulance, but as they wait, Simone expresses how grateful she is that Phyllis was there to help her through her delivery after all.

The Test Results Are In

Later, Reggie confides in Cyril about his sudden change in mood and energy and tells him that he thinks he might be dying. He’s worried about his constant fatigue (something he noticed that his biological mother experienced before she died) and also reveals that he’s been experiencing pain in his hands and head.

Concerned, Cyril takes him to Dr. Turner for an examination. He performs a blood test on Reggie, which shows that he has hypothyroidism, an underactive thyroid. The diagnosis explains his symptoms, and while it’s not the news that Fred and Violet want to hear, they’re thankful to know that there’s a way to help him move forward. Dr. Turner tells Reggie that he’ll be required to take one pill every day for the rest of his life to keep things under control but also assures him that it will help life return to the way it was.

The Maternity Home Re-Opens

From Reggie’s diagnosis to Vinita’s twins, the test results continue to roll in. When Dr. Turner returns to the maternity home, he receives an update that shows E. Coli was the cause for the infection. The group gets in touch with all of their recent patients, and they’re able to determine that the source of the outbreak was actually a patient who had already checked out of the maternity home prior to its closure. By the time they learn this information, however, all of the babies and mothers who have been quarantined are finally on the road to recovery, and they’re able to welcome visitors into the home again.

Sister Monica Joan Repreminds the Board

It’s a major relief to the four who have spent days caring for everyone with little contact from the outside, but unfortunately, the celebrations don’t last long. Word about the outbreak makes its way to the Board of Health, and it’s just another strike against Dr. Turner and especially Nonnatus House. Although Dr. Turner made sure to inform the Board of the incident, the Chairman of the Board, Mr. Threapwood, chastises him for failing to consult the Board before taking action.

Dr. Turner manages to get away with a warning, but the Board continues its takedown of Nonnatus House. Phyllis has already proven one skeptic wrong this episode, though it doesn’t assuage the anxiety that she has as the Board members hold so much power over her future as a midwife.

Luckily for her, she has a trick up her sleeve – one that she wasn’t even aware of – when Sister Monica Joan accompanies her to the meeting. Although it’s a closed session, Sister Monica Joan interrupts it anyway (we would expect nothing less) when she overhears the Board questioning Phyllis’ medical competence.

She shuts it down and is quick to point out that while the three men are questioning Phyllis’ age, it’s in fact a direct result of a full and well-lived life that Phyllis has so much experience, the necessary skills and compassion for the patients she cares for. Sister Monica Joan also wisely observes that Phyllis is younger than every member of the all-male Board, and that despite this, she is the one who is being scrutinized for some reason. ✋🎤(In the words of Michelle Yeoh, “Ladies, don’t let anybody tell you you are ever past your prime.”)

Trouble for Nonnatus House

Mr. Threapwood and his colleagues are not pleased with the outcome of their meeting. Put in their place by Sister Monica Joan, with no comeback in hand – because she is right, after all –, they agree to let Phyllis remain in her position as long as she takes refresher courses at St. Cuthbert’s. It’s a small win, but the Board still threatens to audit Nonnatus House and its practices at a later date.

It wasn’t that long ago that the midwives faced the possible demise of the House when they fought to keep it alive through community support and brought Matthew on as a benefactor. Yet as modern medicine thrives, it’s apparent that their future in Poplar is on shaky grounds.

Forgot how we got here? Catch up with “Call the Midwife” with the Season 12, Episode 3 GIF Recap.