It's time for a Grey's Anatomy finale. Make yourself some calming tea, preemptively. The episode begins with Meredith and Alex talking it out while laying in the grass, a callback to a classic Mer-Christina vignette. This season has done a really great job of cementing Alex and Meredith's friendship (and, thank god, removing any will-they-won't-they sexual tension). Part of that is purely the bond of shared trauma, but it's more than that — way back in season 2, Meredith was advocating for Alex, their "dirty uncle Sal." They were always kind of the same dark and twisty.
The episode's one patient drama is so explicitly for the benefit of moving forward the Grey's docs' own dramas, it's painful. An elderly woman with dementia is brought in, and immediately mistakes Jackson for her husband. "Protect me, don't leave me, you're my husband," she implores. Gee, Jackson, you don't have an ex-wife you're still in love with, do you? Who's maybe having your baby?
Which brings us to the most exciting thread of the night — April giving birth in Meredith's house. It makes sense: That house has seen weddings, mental breakdowns, ghost sex that was actually cancer sex — it was only a matter of time before it played host to a home birth. April ends up alone with Ben in Mer's house after he drives her there to look for Owen's wedding rings (because she's his best man, which is actually adorable), when her water breaks. Having a home birth with a competent doctor isn't actually high drama, so of course Grey's ups the stakes. The baby is breeched, and Ben's going to have to perform a C-section on Meredith's kitchen table with an old scalpel, hand sanitizer, ice, and dish towels. For inexplicable reasons, Ben calls Jackson who's able to hear April scream as Ben cuts a baby out of her with no anesthesia whatsoever. It's horrifying (but actually not the scariest in-home-Cesarean that has ever graced Shondaland).
The baby is totally fine, which is important, but the most important thing happens when they arrive at the hospital: Jackson doesn't even go to look at his newborn daughter, but instead rushes in by April's side. Because he loves her. April is fine, and the adorable family creates an adorable tableau. Important things like, "Let's get back together," and "This life-or-death situation made me realize how much I need you," are not said, but there's always season 13.
The episode's big reveal is why Jo won't marry Alex, which isn't that big a reveal. When you love someone and want to commit to them (evidenced by her desperate suggestion that they have a baby) but won't marry them and won't tell them why, you're either in the witness protection program or already married. Jo is the latter, explaining to DeLuca, who agreed to get her home safe when she got very drunk at the bar, that she married a man while she was homeless and he became abusive, so she hid, and divorcing him isn't an option because he'd find her. Jo isn't even her real name. But her confession is barely out before Alex burst in on what looks like Jo (who had tipsily stripped to get ready for bed) and DeLuca in a very compromising position. Alex punches DeLuca, because of course he does. And the wedding. After some yelling at Meredith, running away in the rain and drinking slurpies with her sisters, Amelia finally walks down the aisle. Meredith is nice and supportive (after initially trying to get Owen to call Christina to talk him out of it...), and the ceremony looks lovely, and everything is going swimmingly, and Riggs, who Owen kind of (sort of) made peace with, is looking at Meredith like she is his favorite sex buddy of all time. So obviously this is the perfect moment for Maggie to tell her sis she has a total crush on Riggs. She wants to pass him a check yes/no note, and she's pretty sure he's going to check yes. Drama! And, it should be noted, we don't see an exchanging of vows between Owen and Amelia. Could it be a season end wedding fake out? Probably not, but there's always that possibility!