There were plenty of changes to the world of Call the Midwife with the return of season eight on BBC One tonight.
Most notably was the absence of Sister Winifred (played by Victoria Yeates), who chose to stay and carry out her work at the children’s orphanage in the Christmas special.
In other upsetting scenes for long-time fans, favourite Sister Monica Joan (Judy Parfitt) continues to suffer with her dementia after she disappeared from Nonnatus House.
The rest of the midwives went into panic, and when they eventually found her the elderly Sister had broken the law and had to be escorted home by the police.
But the real trauma in the latest episode was that of a young girl who had conducted an illegal abortion in secret.
When her sister, who had just given birth herself, realised what she had done and the suffering was getting worse, she rushed her over to the midwives for immediate medical assistance.
“She’s having a miscarriage, and not naturally,” the woman warned, as Nurse Valerie Dyer (Jennifer Kirby) welcomed them both in gravely.
The following scenes were increasingly traumatic, as reality finally dawned on the new mother’s sister what she had done.
Valerie was forced to explain to the woman she would have to deliver the foetus in the toilet, and things were tense as a local policeman sat in the Nonnatus House kitchen eating cake with some of the other midwives.
In the 1960s abortion was illegal in the eyes of the law, and the guest character had been forced to visit a dodgy practitioner at her own home in secret.
In pain, the pregnant woman cried through her trauma as Valerie told her “this will be over soon, I promise you”.
“Is it going to be over soon?” she sobbed.
The midwives later faced a struggle over if they made the right decision in helping the woman considering her illegal actions.
“Did we do the right thing bringing her in?” Valerie asked anxiously, but Sister Julienne’s (Jenny Agutter) response was firm.
“Midwife means ‘with woman,’” she said. “Whatever choices or mistakes they might have made.”
But things took an even more tragic turn as after delivering the foetus, the woman suffered further complications and had her entire womb removed in theatre, meaning she could never have children.
Taking to Twitter, viewers were truly horrified by the storyline.
One person wrote: “#CallTheMidwife poor woman. Back street abortions were barbaric. High risk of infection… even death in many cases. Thank god things have progressed.”
“Just poured my heart out to #callthemidwife,” another fan shared.
A third sobbed: “This is breaking my heart #callthemidwife.”
The episode appeared to be a devastating comment on the circumstances of the time, as later one of the new nurses questioned where the illegal abortions would end.
“It’ll end where it always ends, with silence,” Sister Julienne simply replied.
Call the Midwife continues Sundays at 8pm on BBC One.