Note: This episode contains references of sexual abuse.

Celebrations are much in order for the two newest, official employees of Nonnatus House: Joyce Highland and Rosalind Clifford! After passing their exams with flying colors, the two young women are prepared to begin their promising midwifery careers.

But the shadow of last week’s revelations still lingers large – the security of Nonnatus House could be in financial jeopardy due to Matthew’s financial missteps. Will he be able to remedy all that has gone wrong?

Matthew Approaches Sister Julienne

After last week’s bombshell news week regarding Matthew’s financial affairs, one can only wonder about the future state of the Aylwards – and perhaps even more worryingly, Nonnatus House at large. 

Matthew drives Trixie to work, having decided to come clean to Sister Julienne. In her office, he tries to persuade Sister Julienne to sign a document that would transfer the ownership of Nonnatus House from him to the Order. Matthew admits to her his dire financial state and tells her that once he is declared bankrupt, the decision will no longer be his to make. His sense of self-respect has dissipated, although Sister Julienne assures him that she and the other midwives have nothing but respect and love for Matthew.

But Sister Julienne’s kind words can’t do much to lessen the blow of what ensues next. While the midwives prepare to embark on their daily routes, a bailiff arrives to seize Matthew’s car. As the vehicle is the property of Aylward Estates, it technically no longer belongs to Matthew. There’s nothing he can do except sign the release papers while midwives and bystanders observe his and Trixie’s embarrassing moment.

Afterwards, Violet takes Matthew out for breakfast where she reminds him that he will turn things around. She believes he will not only find a way out of this predicament, but will also learn things from it. However, Matthew seems more keen to find a solution – and fast – rather than sit with his thoughts.

Visiting the Factory

Posters and pamphlets in hand, Nurse Crane and Rosalind arrive at the women’s factory for their health presentation on menstruation and pregnancy. But the majority of the factory employees don’t come off as the most receptive of crowds. In fact, many women appear to enjoy poking fun at the midwives’ talking points; no one is engaging with the reproductive health topics in a serious manner.

That is until one quiet, younger-looking teenager raises her hand to speak. But before she even opens her mouth to talk, she’s met with taunts and laughs from the workers, as one employee even says, “It speaks.” Rosalind encourages the young woman, Alison Casey, to ask her a question, but Alison, too humiliated, lowers her hand.

Later on, Rosalind warmly checks on Alison and reminds her that if there’s anything she’d like to ask, Rosalind is more than willing to listen. But Alison is quiet and doesn’t take the nurse up on her offer. While Nurse Crane and Rosalind pack up the car afterward, they surmise that the young woman is concealing her pregnancy, due to her oversized jumper and chloasma across her face – a common skin condition many pregnant women develop.

And they’re right. After a long day at work, Alison returns home where she lives with her mom and younger siblings. Mrs. Casey bemoans Alison for wearing the same oversized jumper, but just as Nurse Crane and Rosalind guessed, Alison is concealing her large, very pregnant stomach.

Meanwhile, as Trixie gives a tour of the maternity ward to a group of expectant mothers, Joyce meets Gerri Godfrey, a pregnant mother who has recently become single. The two women discuss Gerri’s birthing plan, with Joyce recommending the idea of a home birth.

Turnips, Anyone?

If there’s one thing that could instantly add value to one’s life, Fred Buckle seems to have the answer: turnips. According to the news he’s heard, turnips have had quite an excellent harvest this year, and as such, he is eager to get in on the action. However, when Fred initially tells Violet that he bought some turnips from a friend, he’s met with a lukewarm reception – especially since the store does not sell vegetables.

But fear not! As Fred articulates to his wife, turnips are not vegetables… rather, they are “seasonal novelties.” This sounds a bit more appealing to Violet, and it looks as though Fred has gotten his wife’s approval. Let the turnip extravaganza commence.

Matthew's Proposition

With the burden of fiscal matters weighing down on Matthew and the entire Aylward family, he assures Trixie that he won't accept this situation lying down. In fact, there may be a sliver of hope in the works. Matthew tells his wife that he recently remembered purchasing two warehouses in New York City from his friend Chester. The promising news? Matthew bought them from his personal account, not Aylward Estate.

Although this is news to get excited about, Trixie is hesitant to celebrate: If this goes through, she doesn’t want her husband to just gamble his money away again. She’s also a bit less than pleased that he went ahead and gave notice to Jonty’s nanny without consulting her first. But she’s willing to let it slide, at least at first, because Matthew is showing signs of hope and confidence again…

Over breakfast the next morning, Matthew tells Trixie that after discussing with Chester over the phone, it sounds as though his friend will be able to raise all the necessary capital. Trixie responds by saying that it definitely sounds like something for the two of them to discuss and urges her husband to keep her in the loop. After all, as their situation stands, the family will have to live off her nursing wages for at least the next five years. Matthew is receptive to her request, but equally as adamant in redeeming himself.

Alison in Labor

In the middle of the night, Alison begins to go into labor. As it’s clear no one else is aware of her pregnancy, Alison chooses to muster through the pain alone. In the early morning, Miss Higgins finds the young mother-to-be waiting outside the maternity ward, still dressed in her nightgown.

Rosalind helps prepare Alison for her procedure, but calming down the patient is not an easy task. She’s visibly upset and in anguish – this whole ordeal seems to invoke a painful toll on Alison, both physically and emotionally. Rosalind tries to assure Alison that she is safe and that both she and her baby will be looked after, but the young woman seems far from convinced.

Informing Alison’s Mother

As Alison progresses through her labor, Rosalind informs Sister Julienne and Dr. Turner about Alison’s distressed condition. The nurse is also struck by how little Alison seems to know about how she even got pregnant…

Dr. Turner takes on the task of breaking the news to Mrs. Casey about Alison’s secret pregnancy. The mother is completely stunned over not realizing her daughter’s state, and equally as worried about how their family will cope with the situation.

Meanwhile, in the delivery room, both Sister Julienne and Rosalind coach Alison through her pushes. After a lot of screaming, she finally gives birth to her newborn, a baby boy. Yet Alison doesn’t seem keen to hold her child, at least not yet.

A Mysterious Visitor

Nonnatus House welcomes a mysterious visitor named Sylvester, who claims to be Joyce’s cousin. However, when Joyce returns home after work, it’s soon made clear that Sylvester is not in fact her cousin. 

While politely seeing the man out the door, the truth comes out: Sylvester is Joyce’s former husband whom she left four years ago due to the physical violence and abuse he inflicted upon her. The reason he was able to track her down was because of the article posted in the Gazette that highlighted Joyce’s nursing accomplishments. It also turns out Joyce has been holding another secret – her real name isn’t “Joyce,” rather it’s Claudine Warren.

Joyce reminds her former husband of the reasons why she left, making it abundantly clear she has no intention to return to her life with him. But Sylvester is stubborn and points out that Joyce is still technically married to him, and there’s nothing she can do to change that as he won’t allow it. With little else to say, Joyce shuts the door in Sylvester’s face and attempts to catch a moment to breathe.

Similar to Joyce, Trixie is battling her own emotional and mental challenges. Since learning the news of Matthew’s release from Aylward Estates, she has been struggling to catch any sleep at night, a result of both insomnia and nightmares. Dr. Turner prescribes Trixie with a dose of sleeping pills. It’s a short-term solution, but one that will hopefully allow her the much-required rest she desperately needs.

Diagnosed with Syphilis

Back at Dr. Turner’s office, Miss Higgins presents him with the blood results from some of his recent patients. One of these documents contains a concerning revelation: Alison has tested positive for syphilis.

Dr. Turner breaks the news to Rosalind who is equally as shocked. He reminds her that it’s paramount to monitor Alison’s baby in case he begins to show symptoms of the STD. In the meantime, both mother and son must start taking penicillin right away.

When Dr. Turner explains the diagnosis to Alison, she initially seems confused by what syphilis is and how she or the baby would have gotten it. Dr. Turner explains that one acquires syphilis through sexual activity – though, her child would have developed it through Alison’s bloodstream. However, a wave of shock ripples across the room when Alison announces that if she has the venereal disease, then her mother must have it also.

Dr. Turner is naturally perplexed and concerned by Alison’s comments. Later on, he discusses the subject with Mrs. Casey, who eventually admits that she experienced similar symptoms to syphilis a year ago, but never went to a professional to get her condition checked. She suspects she acquired the STD from her husband who likely has sex with other women when he’s away for work…

Mrs. Godfrey Calls Joyce 

The day for Joyce’s first solo home birth has finally arrived. Mrs. Godfrey, calling in a panic from a telephone booth, tells Joyce she’s experiencing sharp pains. Joyce reassures Gerri that she will be there soon to assist and heads out on her bicycle into the quiet night.

But, unbeknownst to Joyce, Sylvester overhears the address of Mrs. Godfrey’s apartment and sets out to follow Joyce there. What on Earth is he up to now?

Reckoning with Sexual Abuse

While tending to her baby, Alison opens up to Rosalind about deciding on the name of her baby. Mrs. Casey is a firm believer in continuing the legacy of family names, but Alison has no interest in carrying on that tradition. As Rosalind watches Alison, she notices the young mother’s face tense up when the name of her stepdad, Stanley, comes up. The puzzle pieces finally fall in place for Rosalind as she grasps the secret Alison is hiding.

With the horrific secret of Stanley’s sexual abuse made known to Mrs. Casey, the mother is at a loss for words. As she begins to learn the full extent and details of Alison’s trauma, she tries to convince her daughter that she’ll never let Stanley abuse her again. But these are not the words Alison wants to hear. Instead, she wants to find someone who will protect her and her child – a sense of security she feels that her mother failed to give her.

A Big Move for the Future

Well, just as he promised he wouldn’t do, Matthew agrees to the partnership in New York without first consulting Trixie. He’s made his decision, and, for whatever reason, he seems surprised that this infuriates her. The added catch? Because Matthew quickly agreed to the offer, he now has to be in New York City right away… as in he and Jonty are leaving in just a couple of days for the Big Apple.

So where exactly does this leave Trixie? Somewhere in the mix of being confused, shocked, heartbroken, and irate. What she wants more than anything is for the family to stay together and to find a new start. But Trixie and Matthew each seem to have a different definition of an ideal “new start.”

While Matthew isn’t forcing Trixie to join him and Jonty in New York, he’s not entertaining any ideas of backing down. To him, this job symbolizes a chance for him to be the man that Trixie once fell in love with. Though, at this rate, will Trixie decide to ultimately make the move with her new family?

Mrs. Godfrey Gives Birth

While assisting Mrs. Godfrey through her labor, Joyce notices the mother experiencing unusual discomfort. After checking her vitals, she rushes to the nearest payphone to call for an emergency ambulance – she suspects Mrs. Godfrey’s placenta has partially detached. On the way back to the apartment, Joyce is momentarily stopped by Sylvester – who did in fact follow her – but she manages to get around him and back to her patient.

After a stressful birth, Joyce tends to the mother while the ambulance is still on its way. Fortunately, Joyce does enough to halt the bleeding, and Mrs. Godfrey and her child are taken to the hospital.

Afterward, outside Mrs. Godfrey’s apartment, Sylvester waits for Joyce. She’s not interested in talking to him, but he reminds her that she needs his silence… just as he needs her money.

Painful Departures 

Having found support through the Child Welfare Office, Alison makes the decision to move to a foster home. Mrs. Casey tries to convince Alison once again that she won’t let her abusive husband return – but her daughter has made up her mind. It’s time for a fresh start, and an environment where Alison is confident she’ll be able to protect her baby, Martin, from sexual predators like her stepfather.

The time has also come for Matthew and Jonty to depart to New York. In a heavily emotional scene, Trixie says her goodbyes – for now, anyway – to her husband and son. Will she go to them – or will they maybe come back? The future seems ever so unclear.

Forgot how we got here? Catch up on “Call the Midwife” with the Season 13, Episode 6 Recap.