The title of this episode has nothing to do with the plot but the tail ending, when it's established that the Flintstones will be having a baby. The plot actually begins when Fred resents Barney spending so much time taking care of his nephew Marblehead to the point their friendship nearly ends a few times. Then at the end of the show Wilma informs Fred that they are now expecting their own child. Fred is surprisingly happy to hear it.
