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Part 1: As a terrified Kendall (Alicia Minshew) is prepped for an emergency C-section, Erica presses Joe to tell her what her unborn grandson's chances truly are. At the crash site, Ryan watches anxiously as the paramedics work on Spike and Greenlee. Meanwhile, Derek calls Jackson with news of his daughter's accident. Zach attempts to reassure Kendall, who insists on remaining awake and alert throughout the entire procedure. As she's wheeled into the OR, Kendall is alarmed to suddenly see Spike arriving on a stretcher.
Part 2: Later, Annie consoles a shaken Ryan while the surgeons try to stop Spike's internal bleeding. Aidan explains to Jackson why the location of Greenlee's accident proves she was taking off with the baby. Jonathan volunteers to donate blood to Spike after the child's spleen ruptures. Krystal reminds a scowling Adam why he's always his own worst enemy. Kendall and Zach's son is born alive and is immediately rushed into the neonatal intensive care unit. Joe cautions Ryan that the next 24 hours will be critical for Spike.
Part 3: Staring through the window of the NICU, Zach watches his newborn struggling to breathe. A tearful Greenlee swears to Jackson that she was bringing Spike back to his mother. Kendall becomes hysterical after Erica arranges for her new grandchild to be christened immediately. Josh offers his grateful brother-in-law some moral support.