Do you feel that ominous presence too? His name is Mr. Threapwood. As we head into this week’s episode of “Call the Midwife,” the women are walking on eggshells, as the Board of Health and its chairman keep a frustratingly close eye on them. Phyllis’ position at Nonnatus House remains under scrutiny – only saved by Sister Monica Joan’s sass and Phyllis’ willingness to take refresher courses – and Mr. Threapwood informs Sister Julienne that Nonnatus House is no longer allowed to work autonomously and could very likely face closure.

Things are already bad enough, but the midwives’ autoclave is also broken as Episode 5 begins, which feels like the medical equivalent of a broken mirror or someone opening an umbrella inside. They only just overcame a contagious outbreak at the maternity home, and yet their bad luck continues. So throw some salt over your shoulder, and let’s jump in.

Timothy’s Summer Job

Timothy is still in town when we revisit the group this week, but has moved on to another summer job to help the community as a bathing attendant. Though you’d think that the maternity home’s E. coli outbreak may have been the motivation behind his transition, his new role might be even more grueling than the last. Fleas and lice aside, he seeks to challenge himself as a doctor in training and, taking after his father, knows there are plenty of people in Poplar who could use his help.

A Balance Between Work and Family

His mother on the other hand is bogged down by work and keeping the family organized. Shelagh is stressed when she has to deal with the death of the children’s pet rabbit (RIP), an unexpected task which sets her back with an already extremely long list of to-dos for the day. This includes her shift at the maternity home, clinic planning, care of the kids, cooking for the family and more. It’s a two-cigarette kind of day as everything piles up, and Dr. Turner encourages her to take the day off.

A New Father's Mental Health Challenges

This week, we meet Jill and Spencer Wray who have just welcomed their first child. Jill and her mother-in-law Florence are thrilled with the addition of another girl to the family, but Spencer seems wary of his new daughter and keeps his distance. As Nancy tends to Jill as her postnatal nurse, she grows concerned about Spencer’s behavior. He hints that he’s hearing sounds that the others can’t and recites bible verses about his daughter’s birth as if she has summoned something negative to their home.

As the situation progresses, Nancy provides Florence and Jill with Cyril’s information, also urging the women to schedule an appointment with a doctor. Later, Florence meets with Cyril and Mrs. Wallace for their thoughts, and though she hopes they’ll be able to provide her son with the spiritual guidance he needs, they also recommend that Spencer sees a medical professional. Ever since Lucille’s nervous breakdown, they know that the support from their church can only do so much without it. Florence is reluctant but ultimately agrees.

The Family Business

At Nonnatus House, Trixie greets a familiar face and future in-law when Matthew’s father Sir Brigham arrives in Poplar. She welcomes him with open arms to his old stomping grounds, but Matthew is much less enthused. He knows that his father’s visit is less about family time and more about business so that he can examine the state of their properties while he’s in town. When they visit the docks, Sir Brigham observes that business isn’t booming as it was when he lived in the area, and he thinks it’s time for them to finally leave the East End and invest elsewhere.

Living Up to High Expectations

Matthew argues against this, having seen firsthand what Poplar is capable of, and believes there are opportunities for them to expand and create more employment in the neighborhood. His father remains skeptical and exclaims that Matthew, who grew up privileged and has never had a day of hard work in his life, can’t possibly know what he’s talking about or have the evidence to support a business decision like that. This hits Matthew hard, and in a dramatic step to prove Sir Brigham wrong, he signs himself up as a council bathing attendant.

Dr. Turner’s Men’s Health Clinic

Matthew trades his slick suits for council overalls and starts his volunteer position with Timothy. They go door to door with their collapsible baths and hot water, while the midwives bring on a new patient at the recently reopened maternity home. Annette Barkley, mother of a large blended family, is pregnant once again (despite advice against it from her doctors due to her rheumatic heart disease).

The team is already taking precautions as they prepare for Annette’s labor, but Dr. Turner also recommends that her husband Pete attends his men’s health clinic to learn how the family can avoid this in the future. The clinic is organized to help fathers take the burden off their partners and to take more responsibility in preventing pregnancy. In addition to the existing forms of protection, Dr. Turner informs them that vasectomies will be licensed soon.

A New Family Member

In a shocking twist, Dr. Turner’s clinic is more relevant than ever to his own family. He and Shelagh didn’t have any plans to have more children, but Shelagh reveals that she might be pregnant again. She’s missed her monthly and is experiencing all the same symptoms that she did with her last pregnancies. Dr. Turner wants to take the news day by day, but as Shelagh takes in the bigger picture of possibly providing for a growing family, the pressure becomes too much.

Dr. Turner is far more optimistic about their future and doesn’t initially grasp how hard this is for Shelagh when she already has so much on her shoulders - not to mention what she would be putting her body through for another nine months. She confesses that while she knows she’ll love their baby, she doesn’t actually want it during this stage of her life.

The couple anxiously waits to receive Shelagh’s official pregnancy test results, but on the day they’re supposed to arrive, Shelagh’s monthly cycle returns. She thinks that she might even be starting menopause and is relieved to know everything will be as it was again.

Annette’s Hospital Labor

At the maternity home, Annette’s heart problems surface again with a bout of dizziness and trouble breathing. Signs of early labor and heart palpitations mean she’ll have to go to St. Cuthbert’s for her delivery, but Annette struggles with this change of plans and claims that the doctors there were not as sympathetic to her during her last pregnancy and made her feel like a burden. Because Dr. Turner actually listens to his patients, he Iets Phyllis go with her to the hospital to ensure she’s taken care of.

Phyllis remains by Annette’s side for emotional support during her delivery while the team at St. Cuthbert’s helps with the birth. They use a Ventouse machine for the first time, which Phyllis and the others were introduced to during Episode 4, to prevent Annette from straining too much and to avoid further heart complications. With the machine’s help, Annette delivers her baby boy. When Pete meets his son later that day, he’s overjoyed, and is also glad to see that Annette is healthy. However, he knows how much this pregnancy tested her heart condition and promises that she won’t have to go through it again, implying that he plans to get a vasectomy.

Finding Help for Spencer

Unfortunately, while the Barkley family’s troubles are resolved, Spencer Wray’s treatment is delayed. The doctor he is referred to is out for the summer holidays, and upon return, is slow to schedule an appointment. When the doctor finally schedules a home visit, it’s too late. Things take a turn for the worse days before Spencer’s appointment. Unsure who else to turn to, Florence asks Cyril to come to the house to help them. He sees that Spencer is having an episode. Spencer tells Cyril that he can hear people speak to him with forked tongues and they’re telling him that his new baby is a demon.

Cyril tries to show him that the baby isn’t a danger to the family, but Spencer won’t let anyone else touch her. He becomes violent, throwing objects around the house. Cyril moves the women to safety and also manages to retrieve the baby. However, when he enters the home once more to talk with Spencer alone, Spencer stabs him with a pair of scissors.

Matthew and Timothy happen to be in a flat down the hall and hear the commotion. Matthew is first on the scene, and when he sees Cyril injured outside the doorway, he rushes in to disarm Spencer until the police arrive.

Cyril goes to the hospital, lucky that Spencer missed all of his major blood vessels, but he’s understandably glum when he returns home. Violet, Fred and Reggie are all waiting for him when he’s discharged, but as much as he appreciates their company, he tells them that he misses Lucille. Hoping to cheer him up, they surprise him the next day by paying for a phone call to Jamaica so that Cyril can talk to Lucille. The kind gift immediately lifts his spirits, but when Lucille’s sister Celine picks up, she tells him that Lucille is at work. He’s confused by this, but learns secondhand that Lucille has taken on a role at the local maternity ward to contribute to rent at her parents’ home and even accepted a six-month position without telling Cyril.

A Broken System

As Cyril wraps his head around Lucille’s secrecy and the fact that she’ll be gone much longer than anticipated, Florence calls Dr. Turner for his help, following the encounter at their home. Dr. Turner rushes over to the police station where Spencer is detained, and he’s distraught to see Spencer’s condition. He’s also extremely concerned to hear that Spencer continues to tell the officers that he’s been hearing voices.

Dr. Turner is forced to sign committal papers for Spencer to be admitted to a psychiatric facility and is disappointed to know that he’ll most likely be sent to the Linchmere. The group has had poor experiences with the facility before, but unfortunately the matter is largely out of Dr. Turner’s control. He’s angry that Spencer could have received treatment earlier before his mental worsened.

When Jill and Florence learn more about Spencer’s diagnosis, schizophrenia, they feel helpless but know that it’s best for him to remain in a mental health facility for further treatment and evaluation. It’s a huge obstacle to take on as a new mother, but Jill vows to stick by Spencer’s side and to support Florence even though they both know that they have a long difficult road ahead of them.

Father-Son Troubles

While Dr. Turner waits for more news on Spencer’s transfer, Matthew tends to his own family matters, even though he has also been shaken by what happened at the Wrays’. He’s upset to learn that his father plans to sell multiple tenement properties that the business owns. This includes the Lisbon Buildings, which were in such an appalling state (e.g. rats, mold and no running water) before Sister Frances, Trixie, and Sister Hilda alerted Matthew to all of its issues. He’s been doing his best to provide funding to it for repairs ever since, and is appalled that his father only appears to care about how this will help their business financially without considering the consequences it will have for its tenants or the neighborhood. He stresses that there’s far more to life than money, something he’s quickly discovered since immersing himself in Poplar life.

Matthew leaves for his council work with the mood soured between them. While he’s away, Trixie runs into Sir Brigham during a break from work and he expresses his regrets over his argument with his son. Trixie emphasizes how much Matthew gave up – his career as a lawyer – to work for the family business, and encourages Sir Brigham to let Matthew know how proud he actually is of him.

He gives her a noncommittal response, but it’s clear that he wants to find a way to make amends with his son. During their conversation, Sir Brigham complains of a lingering chest pain from earlier in the day, but brushes off Trixie’s concerns. It isn’t until Trixie is clearing their dishes later that afternoon that she hears him collapse upstairs and rushes to his aid. Trixie runs into the bathroom to check on him but finds that he has no pulse.

When news of his death, likely from an embolism, reaches Matthew, it’s devastating. Trixie tries to comfort him, but Matthew’s guilt persists as the issues between him and his father remain unresolved. With a funeral to plan, taking care of his now-widowed mother, and leading the family business, everything about the future seems so overwhelming. He’ll have to find a way to move forward through his grief, fortunately with Trixie by his side.

Forgot how we got here? Catch up with Call the Midwife with the Season 12, Episode 4 GIF Recap.