Instead of holiday cheer, sickness has taken hold at Nonnatus House as Christmas approaches. Trixie, Valerie, Lucille, Sister Julienne, the Turners—they’re all ill. But Mother Mildred has just the thing: a convalescent period away from Poplar. They can get fresh sea air aplenty in the Outer Hebrides, storm-battered islands off the coast of Scotland, because, if you’re under the weather, why not subject yourself to even more extreme weather?
While Sisters Hilda, Frances, and Monica Joan hold down the fort in London, everyone else, including Fred, packs off for the journey north. Sister Frances is put in charge of the Turner children and Sister Hilda of Nonnatus House, but Hilda quickly slips in her stewardship. Sister Monica Joan wished to go to Scotland, in the hopes of seeing a white stag—Christian myth has it that a mystic saw Jesus between a white stag’s antlers. So she cleverly manipulates Hilda into allowing her access to the House’s petty cash and affirming her “mental capacities” to be independent—thus very clearly demonstrating how they are in no way diminished. Off she goes, convincing the train conductor and police along the way to aid her in her trek to the islands.
It’s a long one, requiring train, boat, and car. Mother Mildred—who angrily chastises Sister Monica Joan when she arrives—is thinking about setting up a chapter house in the Hebrides to provide medical care. The closest hospital is two hours away, and the lone nurse in town married the area’s single doctor. The Nonnatans are filling the gap the new couple left when they decamped for somewhere more cosmopolitan.
For the region where the midwives set up base is very rural: they are staying in a dusty, cold stone convent, and the electricity is fickle. Some people only speak Gaelic, the hardy old Mrs. Norris tells the midwives, while warning them to keep the hall in which they will set up a clinic as clean as she left it.
Despite the midwives’ doubts, Mother Mildred is proved right about the need for them when many women show up for the clinic, including Mrs. Norris’s granddaughter, Janet. She left for the city for a few years, but returned and fell in love with an outsider who had come to the Hebrides to man a lighthouse. He helped her see her birthplace with fresh eyes, and now she adores it—she is excited to raise her coming child there.
A honking car pulls up to the clinic, with a new mother and her baby, still connected by the umbilical cord, inside. Maggie gave birth half an hour ago in the car; the midwives tend to her and the newborn. She has lost a lot of blood, and only half the placenta has appeared—she may need a hospital, but it’s too far away. Luckily, she expels the rest of the placenta and is safe.
While some people like Janet have come to cherish their isolated home, others wish to escape it. Effie is a hotheaded young woman whose personality is as rash and bright as her red hair. Her mother got pregnant with her by a visiting sailor when she was working in a mainland town, then returned to the Hebrides and raised Effie there until her death of tuberculosis. Effie now lives with her mother’s sister, who has her own young daughter Isla and another child on the way. Effie’s aunt fears for her niece, who won’t be reined in, just like her mother.
When Effie turns the radio to rock and roll and dances with Isla, Isla’s nightgown catches flame from the fireplace, burning her legs. Isla won’t stop screaming and crying, even after the nurses come to treat her burns.
Janet is also hurting. She’s been having pains in her side that she initially dismissed but has finally accepted as labor pains. Unfortunately, she’s too far along to be brought to the mainland—help will have to come to her at the lighthouse. Lucille and Valerie set off with Fred and Doctor Turner to try to convince someone to row them to the lighthouse, but the ferryman refuses, given that it’s a Sunday, when he is religiously obliged to rest. So they borrow his boat and row themselves off.
The religious convictions of the islanders also dash Mother Mildred’s hopes for a new branch house. As Presbyterians, the local council doesn’t want the Nonnatans there permanently and has denied them any space for a long-term branch house. They will have to find another place where they are needed.
They are certainly needed in the short term at the lighthouse. Lucille and Valerie help Janet through the birth of a healthy son. But, soon after, Janet vomits, and the pain in her side remains. That’s when Doctor Turner realizes she has appendicitis that was disguised by her pregnancy; her appendix needs to be removed. But a bad storm has blown up, and the Coast Guard cannot evacuate Janet to a hospital until it has passed. Doctor Turner will have to conduct an appendectomy himself.
Under the direction of Valerie, Fred prepares an operating room in the kitchen, scrubbing and sterilizing everything. Doctor Turner is nervous: he hasn’t done an appendectomy since he was in the war. It doesn’t help that the electricity goes out right before the operation, so that he has to do his work by the light of a single lamp and flashlight held by Fred. But the surgery is successful—and necessary. If Janet’s appendix hadn’t been removed, it would have burst by morning.
Effie has her own trying night during the storm. When her aunt goes to work, she leaves Isla alone to go drink from a hidden whiskey bottle by the shore. Phyllis and Trixie are surprised to find Isla by herself when they arrive to change her dressings, but coax her into sitting still by ushering a beloved calf into the room. Pleased with their success at calming Isla down, they leave for the convent in the dark night and find Effie passed out in the road.
They bring her back to the convent and Phyllis sits with her through the night: the former alcoholic Trixie finds it hard to watch another person struggle with drink, especially when she has been dressed in Trixie’s own pajamas. Before she leaves, she points out to Phyllis that Effie is drinking because she’s unhappy.
The next morning, Phyllis also finds herself identifying with the young woman. While Trixie speaks with Effie’s aunt, Phyllis tries to comfort Effie, bonding over their shared experience as the daughter of a single, unwed mother and the loneliness that could entail. When Effie’s aunt appears, both she and Effie are more prepared to explain their behaviors and hopes for each other.
Mrs. Norris, the uncompromising older lady who first met the midwives in town, is also beginning to soften her attitude. Visiting the lighthouse to see her granddaughter Janet and her newborn the day after the storm, she is impressed by how the Nonnatans saved Janet. She decides to invite them all to a holiday party before they leave. She’ll even let Fred decorate, whereas earlier she forced him to throw away the “pagan” Christmas tree he put up to cheer the children at the clinic.
For the party, Fred enlists all the villagers to make paper chains. Reggie, who is missing Fred at home with Violet, loves them. Miss Higgins noticed his joy in making them and learned that he wanted to be in the Guinness Book of World Records for longest paper chain—so she promptly contacted Guinness and enlisted all of Poplar to help. Upon hearing of this plan from Violet, Fred decides to contribute as much as he can, so after the party he gathers up the chains and brings them back to Poplar.
Before the Nonnatans leave the Outer Hebrides, however, Sister Monica Joan still has to see her white stag. She feels called one day to walk outside to some monumental crags, followed by a worried Sister Julienne and curious Mother Mildred. There she sees a magnificent white stag, and is sublimely pleased. Her display of faith helps Mother Mildred realize that, even if the Nonnatans will not have a branch house in the Outer Hebrides, there will be another place they are needed. There always is.