Ruhma is introduced as a
sonographer for
Emma Reid (
Dido Miles) and
Howard Bellamy (
Ian Kelsey) and it is explained that her and Emma are former colleagues.
Mrs Tembe (
Lorna Laidlaw) calls her into the Mill, and whilst waiting, a pregnant patient of
Sid Vere's (
Ashley Rice) begins to feel ill, so she treats her. When
Jimmi Clay (
Adrian Lewis Morgan) and
Heston Carter (
Owen Brenman) hear of Ruhma's potential hiring, they disagree, insisting that the Mill does not need a midwife. However, Mrs Tembe disagrees and appoints Ruhma. Ruhma and Heston attend the theatre together and he later takes her on a date to a restaurant. Heston asks Ruhma to his house for dinner, where she explains her housing difficulties. Heston invites her to live with him, so Ruhma and her children,
Shak (Sunjay Midda) and
Alia (Mandy Thandi), go to live with him. Ruhma plans to propose to Heston on her birthday, while Heston has the same idea. He proposes to Ruhma in a restaurant by arranging a Bollywood style dance routine and she says yes. After the pair become engaged, Shak expresses his unhappiness with the wedding. Ruhma receives a
tip-off that she could sell furniture from
people's estates. She sells the furniture online to make money for the wedding. On their wedding day, the police arrive at the venue and take Ruhma in for questioning. They accuse her of stealing the items and selling them for a monetary gain, to which she refuses and insists that she had no knowledge of the items being stolen. She is eventually released, but due to the ordeal, they are unable to sign the register, meaning they not legally married. They rush to the registry office when there is a cancellation and sign it. When Ruhma mishears
Ayesha Lee (
Laura Rollins) and
Al Haskey (
Ian Midlane), she reveals that she is losing her hearing. Heston suggests seeking treatment from a private audiologist and although she initially disagrees due to pledging loyalty to the
NHS, she later seeks private help. When Ruhma learns that a nude video of Alia (now
Lisa Ambalavanar) and her boyfriend
Tariq Amiri (
Chaneil Kular) has been posted online, she is embarrassed and infuriated, but supports her. When Tariq is later run over, the entire Carter family unit are suspected as culprits for the
hit and run, but are later cleared by the police. Heston is killed when Al crashes the car that the pair are in. Although she attempts to remain positive for her children, she is devastated. She suggests that the Mill honour Heston's memory by buying a memorial bench for the outside area. When Heston's memorial bench is stolen, Ruhma finds it on a secondhand sale website. She tracks down the seller,
Lee Harwood (Matthew Mellahieu), and forces him to reassemble the bench at the Mill, which she later has concreted into the ground. When the
COVID-19 pandemic affects Letherbridge, Ruhma is admitted into hospital with symptoms of
coronavirus, which she tests positive for. After being on life support, she survives. While treating a heavily pregnant
Carrie Wade (Sarah Ovens), Carrie's fiancé
Doug Machin (
Michael Hobbs) flirts with Ruhma on numerous occasions, but she declines his advances. While on a house visit, Doug kisses her and Ruhma backs away, while Carrie watches. Carrie assumes that Ruhma kissed Doug and Doug lies by affirming her claims, leading to Carrie filing a report against Ruhma. She is suspended and an investigation into Ruhma's competency takes place.
Grahame McKenna (
Paul Bazely), who leads the investigation, is unable to find a consensus, and leaves her suspended from her job for months. While suspended, Ruhma allows one of her patients,
Tanya Rees (
Leila Mimmack), to stay at her house due to formerly being in an abusive relationship.
Deborah Kovak (Jamie-Rose Monk) is hired in Ruhma's place as a temporary midwife and she discovers that Ruhma has allowed Tanya to stay at her house. Deborah reports Ruhma in an attempt take her job role permanently, but
Zara Carmichael (
Elisabeth Dermot Walsh) asks Deborah to leave the Mill and helps Ruhma to get her position reinstated. ==Reception==