There is plenty of tension downstairs, as Daisy isn't feeling the new kitchen maid at all. She cuts Ivy down every chance she gets.
Sir Phillip thinks he is the end all, be all when it comes to delivering babies and isn't keen on the idea of Dr. Clarkson tagging along while he attends to Lady Sybil. It's very much a point of contention because Richard wants Sir Phillip to handle the birth but Cora only feels comfortable with Dr. Clarkson. Sybil is their baby girl and they want what's best for her so neither will back down.
While Sir Phillip is at the house, Matthew decides to consult him about his own health. He's concerned that he may be the reason Lady Mary hasn't become pregnant yet. Sir Phillip assures him that physically, he is fine. These things take time and he just needs to stop being anxious.