Carlos and Gabrielle decide to adopt, but the process comes to be a lot more difficult than either had expected. Susan finally has her surgery as she finally has medical insurance. Meanwhile, a showdown between Bree and her son Andrew lead to a full out war between mother and son. Also, a dying Noah Taylor learns more about Paul Young and his biological grandson Zach. Lastly, Tom is having more difficulty at the job when having to take orders from his boss and wife Lynette.

Susan invites Dr. Ron to meet Karl after he finds out about their arranged marriage. Lynette is surprised that a woman at work is still breastfeeding her child of five. Gabrielle becomes very picky when choosing a birth mother, and a beautiful baby. Bree has to deal with a fresh accusation from Andrew, that of repressed memories.

Carlos and Gaby learn the truth about their baby. An ex-stripper gives birth to her child, and Gabrielle holds her for the first time. Also, Paul Young comes to face his demons head on with Wisteria Lane. Lastly, Lynette is forced to give a court deposition about Bree's drinking and alcoholism.

Lynette is called in to her kids' school as Parker has gone from being obsessed with Dinosaurs to being obsessed with nudity. Carlos and Gabrielle must go to court to get custody of their baby. Bree's father Henry and stepmother Eleanor come to town to mediate between Andrew and her. Susan is convinced that Karl doesn't really love Edie. Later, she goes to a movie theater, and spots Mike with a date.