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One year after Constance killed the father of her children she is still living in the house. She has succumbed to alcoholism and depression, drinking until midday and passing out on the couch. She is having financial problems and unpaid bills are piling up. A seven-year-old Tate is mostly left to his own devices. In the hallway, where he is playing, the door to the basement opens "on its own". Tate is not scared, rather intrigued, and rolls his toy truck down the staircase to the basement. When he goes down to retrieve it, the Infantata attacks him. Nora stops the Infantata and soothes Tate. She dries his tears and cuddles him. Tate says to Nora, he wishes she was his mommy. Nora teaches Tate what he will years later teach Violet: That in order to get ghosts to disappear for a while, you just need to say "Go Away!" forcefully.
In the present, Nora and Tate are in the basement once more. At first, Nora doesn't remember who Tate is. She is crying and says that she is sad. When Tate mentions the baby, she remembers him. Tate tells Nora that everything has changed because he loves Violet and he can't take Violet's brother away. Nora says that she will.
Ben tries to get Violet into the car so they can pick up Vivien from the hospital and then fly all to Florida together to Vivien's sister Jo. Ben either does not mention or does not remember that Tate is the Rubber Man, who raped his wife and attacked and drugged him. He does say to Violet, however, that he mistrusts both Violet and Tate. Violet lies to Ben and tells him that she hasn't seen Tate in weeks. Violet tells Ben she can't and that she is physically sick and will throw up, but after much protesting, Ben manages to get her into the car. Violet lies down in the back seat of the car. In the instant the car has left the property and reaches the road, Violet disappears from the back of the car and reappears upstairs in the house. Ben does not notice.
Tate and Violet discuss how they will be able to hide Violet's death from her parents a while longer since they are planning to go to Florida where Violet's aunt lives; they also discuss their future in the house. Tate says to Violet that she won't be able to hide her death from her parents for long. She replies that she is afraid that her parents will permanently go insane if they find out. Tate tries to cheer her up with something on YouTube on Violet's laptop, but can't find the website, because he spells it "utube". Violet is worried about their future together, saying that Chad and Patrick are a terrible example. Tate replies that they are different since they love each other. Violet is depressed that she and Tate will not be able to have children.
Chad and Patrick are decorating a nursery. Chad is using a yam to stamp animals on the wall and Patrick is painting a cupboard and a crib. Tate and Violet walk into the room, and Violet says "who asked you to decorate the nursery?" Chad tells her that it's his house and they are having twins. Violet asks if one of the nurses in the basement is their surrogate mother. Chad tells Violet that it's her own mother. Violet says it doesn't matter because as soon they get back her parents are leaving. Chad replies her parents won't leave because Violet is stuck in the house. Chad asks if Violet was born via a c-section, "...is there is an existing zipper we might use?" in regards to taking Vivien's twins. Tate tells Chad to back off and Chad replies, "What are you gonna do? Murder me?"
Violet tells Constance about what the ghosts are planning, so Constance goes to talk to Chad. Constance initially just rants homophobically at Chad ("You're perverted! You perverted men should not have children"). Chad remains calm, citing academic studies that show that the children of gay couples do not develop differently from those raised by single parents or straight couples. He also justifiably questions Constance's own track record at being a mother. In the end, Constance lets it slip that Tate is the father by saying that he can have Ben and Vivien's child, but not her grandson. Chad seems intrigued and amused by the news but says he still wants both of the babies. He even discusses killing them by smothering them with a pillow, so they can be "cute forever".
Violet talks to medium Billie Dean about getting rid of Chad and Patrick. Billie Dean says to Violet and Constance that she knows of one very successful exorcism, in the year 1590: The Roanoke Colony in present-day North Carolina. Billie Dean says that all settlers died and subsequently haunted the local Native Americans (the Croatan tribe). One of the elders used property that the English settlers left behind and burned it. He then said the name of their tribe "Croatoan" as a spell against them. This worked according to Billie Dean.
Billie Dean recognizes that Violet is dead and speaks to her through telepathy. She tells Violet that she is sorry that Violet died so young. In response, Violet pleads with Billie Dean telepathically to not tell her parents of her death.
Billie Dean talks about the great evils that feed the house. Immediately afterward, Tate appears. Billie Dean is with her back to him but instantly senses his presence. Billie Dean is visibly shaken and states that "He cannot be here". Tate says that he wants to help, but Bille says, "You've helped enough," referring to the fact that Tate was the one who raped Vivien and is the cause of the Antichrist, and their problems in the first place. When Violet asks what Billie Dean's reaction was all about, Constance replies that it was just because it is emotionally difficult for a medium to encounter a dead person. Since Violet herself is dead and Billie Dean has no problem with her, Violet knows this to be untrue.
Dr. Marchesi is recommending bed rest for Vivien, but she insists on flying to Florida to stay with her sister. He believes that her obstetrician will suggest that she have an emergency C-section because one of the twins is growing at a rapid rate. Vivien wasn't going to tell Ben about the status of the babies, but he insists on hearing it from the Doctor, who explains that even though Vivien is only six months pregnant, one of the babies is growing at a rapid rate, and is taking all the nutrition from the other baby who may die.
After learning of the ritual Violet returns to her room where Tate is upset because the medium "said all those things about [him]". Violet needs a talisman from Chad and Patrick to do the ritual. Tate believes that Billie Dean's ritual is "bull-shit" and will not work. He nonetheless goes to see Patrick, who is still decorating the nursery and tries to seduce him. Patrick beats him up instead. Patrick screams at Tate for murdering him and trapping him with a man that he wanted to leave and did not love. Chad overhears this, and storms off with Patrick running after him, leaving Tate smiling on the floor and holds up Patrick's ring, which he managed to steal off Patrick's finger when he was getting beat up. Violet, in turn, steals an expensive Rolex watch from Chad, who had taken it off to paint the nursery.
Ben and Vivien arrive at the house. Vivien is so scared of the house that she says that she will remain in the car and wait for Ben and Violet. Ben believes that Violet jumped out of the car at a red light. Violet tries to tell her father that she's dead and cannot leave since the spirits of people who die in the house remained trapped there, but he doesn't believe her. Instead Ben believes that Violet is on drugs when she says all of those things.
Vivien goes into labor in the car. Constance takes her to the living room where Dr. Montgomery and the dead nurses Maria and Gladys are there to assist her. Ben tries to call an ambulance for Vivien. Miraculously, his cell phone suddenly has no reception anymore and the landline is dead. Troy and Bryan smash Ben's car outside with baseball bats, making it unusable due to all the glass splinters on all seats. The electricity goes out in the house.
Dr. Montgomery (with the assistance from the nurses Maria and Gladys) has to do the delivery as Vivien and Ben cannot leave and cannot get an ambulance to come either. The delivery is illuminated by masses of candles since the electricity is gone. Dr. Montgomery gives Vivien ether against the pain. The first baby, the one that Ben fathered, is stillborn. Since the baby died in the house, it's spirit will also remain there, and thus Dr. Montgomery hands it over to Nora, who intends to raise it as her own. The second one that Tate fathered is alive and healthy. Both Ben and Vivien ask about who the people assisting the birth are and notice their garish bloody wounds, but Constance evades their questions. During the birth, Ben is slowly going insane. Dr. Montgomery and the bleeding nurses terrify him. He also keeps thinking about Hayden.
Violet sees her mother go into labor and immediately goes to the basement, realizing that she needs to hurry with the exorcism of Chad and Patrick. She burns both Chad's Rolex and Patrick's ring. Chad appears. Violet says "Croatan" over and over again, but nothing happens. Billie Dean was wrong. Chad is bemused by Violet's attempts to banish him and tells her that all the spells and chants to "rid evil spirits" is bullshit. He burns the red crib in the furnace that Violet burned Chad's watch and Patrick's ring in. He no longer wants to adopt Vivien's babies with Patrick after overhearing that Patrick truly will never love him. He turns to Violet and says "But it could be worse. Your man may love you, but he'll always be a monster." Violet denies this, saying that Tate doesn't remember committing the school shooting and thus has changed. Chad then reveals angrily that Tate was the one who murdered him and Patrick and raped her mother. Violet is shocked and says Chad is lying, but they hear Vivien screaming in labor upstairs and Chad says they'll soon find out.
Vivien is dying after giving birth to Tate's baby. Ben pleads with her to stay with him. Violet is on the other side of the bed and pleads the opposite: For Vivien to let go and join her in the netherworld. Vivien goes with Violet and dies in front of Ben. The nurses and Dr. Montgomery disappear, leaving Ben alone in the living room in front of Vivien's body.
Constance takes the baby into the kitchen to wash it off. Here she meets Moira who cries happy tears when seeing the baby. Hayden enters and says that the child is hers.
Violet confronts Tate who is lying on her bed, telling him her mother is dead, and that her father is alone downstairs. Tate says that he is sad because he liked her dad and that he knew she and her mother were close. Violet is cold and distant, jerking away when Tate reaches to comfort her. Violet confronts Tate about the Westfield Massacre that he committed. Tate does not seem to remember at all. He starts to cry and says "Why would I do that?" over and over again. He does, however, remember that he was shot by the police. Violet asks why he murdered Chad and Patrick and raped her mother. Violet says that Tate murdered her mother because the baby Tate impregnated her with killing her. Tate has no answer other than "I was different then. You changed me." Violet tells him she believes that and that she loves him, but she cannot forgive him. She tells him that she was wrong about him: Tate is not like her, attracted to darkness, he actually is the darkness. She says Tate has to pay for what he did. She then uses the method that Tate taught her to make ghosts disappear for a while, telling him to "Go Away". Tate initially resists this, crying and yelling that Violet was all he had, all he wanted and that he loves her. Violet screams "GO AWAY!" several times, all while Tate is yelling and crying, but disappears. Violet is left sobbing alone in the bedroom that was once hers, but Vivien appears as a ghost to comfort her. Violet tells her mother she's sorry that she lost her baby, Vivien tells her that she didn't lose her baby, hugging Violet.
- Denis O'Hare (Larry Harvey) is credited but does not appear.
- Commentary: Ryan Murphy warns finale contains 'the most shocking scene we've ever done'.
- Commentary: Connie Britton talks Vivien shocker and filming birthing sequence. “It was exhausting and brutal”
- The show that is playing in the living room in the first scene, in which Constance is passed out and drunk is "Newhart". In the scene that we are shown Newhart's character Bob says "You always give a guy a second chance. That's the golden rule."
- "Newhart" ended its eight-year run with the revelation that whole series had been an epic nightmare dreamed by the character Bob Newhart played in his first sitcom, a psychiatrist named Robert Hartley.
- The doctor says to Ben and Vivien that the phenomenon in which one fetus is killing the other through taking all the nutrients is called "intrauterine omophagia". This condition does not actually exist. Omophagia means eating of raw meat, an ironic definition given Vivien was fed offal during her pregnancy.
- There is a condition called "twin to twin transfusion syndrome (TTTS)" which affects identical twins, in which the dominant twin takes blood and nutrients from the recipient twin and can ultimately lead to the death of one or both twins. This would not be the case in this situation, as the twins are not only fraternal, they are from different fathers.
- The top grossing film of 1984 was... "Ghostbusters".
- The address of the Murder House is given as "939 Berro Drive, LA 90068".
- Why can Violet be with Vivien as ghosts, but Tate not with Hugo?
- Why does Nora not remember things?
- Why does Tate not remember the school shooting?
- Is the "stillborn" baby really dead/a ghost? Or did Dr. Montgomery just say that? Is it really now an 6-month premature baby that will remain in that form forever?