Pearl Winston is an impoverished mother in the poor district of Poplar. She was one of Nurse Lee's first patients, appearing in the pilot episode. She is portrayed by Lorraine Stanley.
Pearl's case was the first case that Jenny undertook wherein the true ugliness of poverty is shown. Pearl's case shows Jenny that snobbery has no place in the East End, as the women are all mothers who just want healthy, happy babies, and shows that all women in the area face different challenges and struggles in obtaining that goal (be it poverty, emotional pain, lack of knowledge, fear or anger) and it is not the mark of a good nurse to judge them for it.
Pearl is first seen when Jenny Lee is arriving off the train on her way to Nonnatus House. She and another woman were in brawl in the streets, exchanging both blows and words as other women and children cheered on. It is revealed that Pearl's husband had been having an affair with the woman, despite he and Pearl having a toddler and another one on the way. As the police arrive to unsuccessfully break up the spat, Sister Evangelina also arrives and breaks through the argument, and is very disappointed to find that Pearl was a part of the brawl. Pearl is mortified upon finding that her shirt has opened, revealing her bra and pregnant belly. Sister Evangelina then walks Pearl up the stairs to her flat to examine her.
Some time later, at 32 weeks pregnant, Pearl comes in with her young son for an appointment with Nurse Lee. She is looked down upon by another young mother, and Pearl is obviously less well off than the rest of them, as well as appearing vulgar and not really caring when her son urinates on the floor. When Nurse Lee calls her for her exam, Pearl immediately takes off her underwear and a pungent smell emerges, much to Jenny's disgust. Pearl happily makes herself comfortable on the bed, sighing that it's the first time she's rested all day. When Jenny tries to get a urine sample from her, Pearl complains and persuades her to do a pelvic exam first. As Jenny gets ready, Pearl remarks that she's had "shocking discharge".
Immediately upon examining Pearl's vulva, Jenny finds a lump, and realizes it's a syphilitic chancre. Jenny leaves the exam in a rush, spluttering about getting a more senior nurse, clearly revolted, much to Pearl's offense. Later, Jenny scrubs her hands raw, and when Sister Julienne comes to her, confirming Jenny's suspicion. The Sister relays that the baby is at risk, due to the mother's illness. Upon seeing that the nurse is still scrubbing her hands, she tells Jenny that she won't catch anything.
However, Jenny is still horrified that Pearl could have felt the lump beforehand, and not have cared enough to get it checked out. The Sister tells Jenny that Pearl isn't used to caring or being cared about. Jenny admits that she didn't know "people lived like this". Later, Jenny arrives to Pearl's flat to start her on a course of antibiotics. When Jenny talks to Trixie about finding it hard to work in the East End, Trixie replies that when she first began work, she thought she "deserved all manner of medals" but soon came to realize the mothers are the brave ones for pushing through the trials they face with every baby, and still having the heart to keep going. Trixie calls the woman of Poplar heroines.
Some time later, Nurse Lee goes to Pearl's home on another home visit. The door is open, and Pearl is seen curled up on the couch, listening to the radio.
Pearl is heartbroken because her baby died, due to the syphilis. Hollowly, she tells Jenny that "you can't win em all" and that she wants her milk dried up. When the nurse revels that she came prepared with Epsom Salts, Pearl lightens just a little and tells Jenny she'll make her some tea. When Jenny tries to suggest that she take over, Pearl declines, saying that she has to keep going. She then shows Jenny her single China tea cup, left to her from her grandmother.
Pearl assumes that Jenny thinks poorly of the women of Poplar, but Jenny denies this and honestly tells Pearl that she believes they're all heroines. Pearl smiles and looks out the window as the tea brews.