Vera is always helping people. She regularly visits one sick neighbor, and invites another, Reg, to supper because she thinks he isn't eating properly.

Vera cleans the houses of the “well-to-do.” In one of these, we encounter Susan, the daughter of the family.

Vera visits a house that is much shabbier than those of her employers. A distressed young woman is waiting. Vera offers her kind words of reassurance as she removes various items from her bag, and proceeds to perform an abortion.

This is Vera's secret life that she has never discussed with her family. They are totally unaware of her activities, which were of course illegal in England until the late 1960's.

We see the perennially cheerful Vera visiting a number of pregnant women. They vary in age, but all are working- or lower-middle class.

Her appointments are made through Lily, whom she has known since they were children, and who now operates a black market service for items such as tea and sugar, which are still in short supply in post-war England.

Susan, meanwhile, has been raped by a date, and finds herself pregnant. She seeks advice from an experienced older woman, and, following visits to a private doctor and a psychiatrist (to whom she has to demonstrate instability), she attends an expensive and discreet private clinic. Her parents are quite unaware of her termination and of her ordeal.

Vera's home life goes on happily, as before. Reg quickly becomes part of the family, and starts to "walk out" with the somewhat introverted Ethel. Eventually, he proposes marriage, and she accepts, much to everybody's delight.

Sid enjoys the life of an urban post-war young man, and Stan continues to work for Frank, whose 1930's semi-detached house contrasts vividly with Vera and Stan's small if clean
tenement flat. While Frank is extremely fond of his brother and family, his wife Joyce, with
her upwardly mobile material aspirations, looks down on them.

One weekend, a girl whom Vera has “helped” is suddenly taken ill, and is rushed into hospital. It is obvious to the doctor what has happened, and the girl's mother reluctantly admits the truth when the police are called in.

Frank and Joyce go to Vera and Stan's flat one Sunday to celebrate Ethel and Reg's engagement, and to announce their own news - that Joyce is expecting their first child.

They have barely broken this news when there is a knock on the door. Stan opens it, to discover the police, who enter and ask to see Vera. They will not reveal to the family the reason for their intrusion.

The Detective Inspector, his Detective Sergeant and the uniformed policewoman accompany a stunned Vera into the bedroom. She knows why they have come. Barely able to speak,
she admits everything, and, at their request, produces her abortion kit from a cupboard.

Still with no explanation given to the increasingly distressed family, Vera is taken away in a police car. Stan follows on foot in the snow, while the others stay behind.

At the police station, Vera is interrogated further, and then makes and signs a statement, while a perplexed Stan waits, still in the dark.

Detective Inspector Webster is as sympathetic and as patient as possible. Vera explains how
she just tries to help girls who are in trouble. Her sole motive is compassion. She is horrified
at the suggestion that she might have received money for doing this, and is deeply shocked to discover that Lily has been charging the women fees.

Vera is now formally charged with her crime, and Inspector Webster suggests that since Stan is inevitably going to find out the truth anyway, why doesn't she tell him herself? The Inspector brings in the bewildered Stan, and Vera confesses all.

Stunned, Stan goes home. His reaction is to be understanding and supportive, but he is angry as well. Ethel is distressed, and Sid is at first furious and disgusted, but later relents.

After a night in a cell, Vera appears before the magistrate, and with no opposition from the police, she is released on bail.

Vera is completely traumatized by what has happened. Just before Christmas, she is brought back before the magistrate's court, and she is committed to trial in January.

Christmas at the Drake flat is a subdued affair. Joyce makes it clear that she would rather not be there, but Reg declares it's the best Christmas he's had in a long time.

Prior to the criminal trial, Vera's solicitor tells her that none of her employers will give her a character reference, and that the shortest sentence they can hope for is eighteen months.

At the trial, in spite of the effort of her defense lawyer to emphasize her strong moral
character, and the fact the she did not profit from her "crimes", the judge determines to make an example of Vera Drake, and she is sent to prison for two-and-a-half years.

In the women's prison, Vera talks to two other inmates, both abortionists. They are serving longer sentences than hers because their clients both died. They assure her that, as a first-time offender, she will have to serve only half her sentence.

Meanwhile, at the flat, Stan, Sid, Ethel and Reg sit around the table all lost for words...