In this week's episode of 22 Kids and Counting, Millie Radford is left deeply shaken after her husband, Harley Passmore, is rushed to hospital with fears of a stroke. The incident brings to a head a period of significant stress and disagreement between the couple concerning Harley's desire to legally adopt Millie's four-year-old daughter, Ophelia. Millie, who married Harley in a £9,000 ceremony last year, has been hesitant about the adoption, primarily due to concerns about how Ophelia might react to discovering Harley is not her biological father, and the potential for the biological father to re-enter their lives.

Harley has been a constant presence in Ophelia's life since she was six months old, raising her as his own alongside their two children, Chester, three, and Elodie, one. He expresses a strong desire for formal adoption, wanting Ophelia to share the family name and for their father-daughter bond to be legally recognized. He believes that as Ophelia grows older, she will question why her name differs from her siblings and parents. However, Millie, aged 23, fears the emotional burden on Ophelia, who is only four, and worries about potential resentment or 'hatred' towards Harley when she learns the truth.

The tension culminates in a heated argument between Millie and Harley, followed by Harley's urgent hospitalisation. A distressed Millie calls her mum, Sue Radford, describing Harley's symptoms: one side of his face had gone lopsided, his words were slurred, and he was visibly panicking. Suspecting a stroke, an ambulance transports Harley to the hospital, while Sue and Noel Radford take care of the children at their Morecambe home. Millie stays with Harley in the stroke ward, feeling immense guilt and wondering if their argument contributed to his condition, emphasizing how unimaginable life would be without him, given he has been with her through most of her motherhood journey.

After a night of anxious waiting, Harley receives reassuring news: he did not suffer a stroke. Instead, he is diagnosed with Bell's Palsy, a neurological disorder causing temporary paralysis or weakness on one side of the face. This health scare profoundly impacts Millie, making her reassess her stance on Ophelia's adoption. She realizes how terrifying the prospect of losing Harley was and how much Ophelia loves him, leading her to decide to proceed with the adoption process, stating, “If anything was to happen to Harley, I know that Ophelia would have loved Harley to be her dad, so that is what I'm going to make happen.”

Despite Millie's newfound resolve, the legal journey proves more complex than anticipated. Although Ophelia's biological father's name is not on her birth certificate and he was reportedly 'not interested' in being a dad, full adoption would require contacting him. Harley expresses concern that the biological father could simply refuse consent. Millie also fears that contacting him might prompt him to want to be involved in Ophelia's life, which would be 'a lot' for the young girl to process. Ultimately, they decide to pursue a step parental responsibility agreement, which grants Harley the same rights as a biological parent regarding decision-making for Ophelia, including her surname, schooling, and consent for medical operations.

Initially, Harley celebrates this outcome with Noel, Sue, and the family, enjoying drinks and fish and chips on the beach. However, his underlying desire for full adoption remains. The episode concludes with a significant revelation: Harley secretly texts Ophelia's biological father, expressing his continued wish for his name to be on Ophelia's birth certificate and acknowledging the four years he has invested in her life. The Radford family, known as Britain's biggest, continues to share their unique experiences on Channel 5's 22 Kids and Counting.