Two generations gone—gone in a moment! I have felt for myself, but I have also felt for the prince regent. My Charlotte is gone from the country—it has lost her. She was a good, she was an admirable woman. None could know my Charlotte as I did know her. It was my study, my duty, to know her character, but it was also my delight. – Prince Leopold to Sir Thomas Lawrence after the death of his wife.
Princess Charlotte and Prince Leopold at their Wedding
Princess Charlotte’s death after giving birth to a still-born son on November 5, 1817 elicited a national outpouring of grief that was unprecedented in Britain, and her funeral drew massive mourning crowds on a scale similar to those who thronged to Princess Diana’s funeral in 1997. In stark contrast to her father, the Prince Regent, who was universally despised, the young princess was extremely popular, and her pregnancy was closely followed by an enthusiastic public. Charlotte, the only child of George, Prince of Wales (later Prince Regent and George IV) by his wife Caroline of Brunswick, had been married a mere seventeen months before to Prince Leopold of Saxe-Coburg-Gotha amid pomp and splendor. A dutiful young Regency wife, she became pregnant almost immediately, but suffered two miscarriages before carrying her third child to full term. Though her grandfather, George III, had 7 sons and 5 daughters, Charlotte was the only legitimate grandchild. Thus this pregnancy was a truly significant one.
Charlotte began her pregnancy as a healthy and robust young woman, but after months of blood-letting and a strict diet, an accepted medical practice prescribed by her physician, Sir Richard Croft, she grew feeble. Her death after her tortuous two-day, 50-hour labor would precipitate a new age in medicine,
Princess Charlotte
ending arch-conservatism in obstetrics. At the time that Princess Charlotte gave birth there were two schools of medical thought in delivering a baby: intervention and non-intervention. During the previous century, anatomical knowledge about the birth process increased. Henrick Van Deventer showed that the female pelvis was unyielding during labor, and forceps were introduced. Intervention during labor was still crude, largely consisting of extracting the baby with forceps during a breech birth in order to save the mother’s life. A cesarean section, which might have saved the baby, would surely have resulted in Princess Charlotte’s death.
Princess Charlotte’s physician had married the daughter of a prominent physician who had trained him and who belonged to the non-intervention school of obstetrics. On the evening of November 3, the Princess’s water broke. Although Dr. Croft had accurately diagnosed a breech birth, he decided not to use forceps during the first stage of labor. He also did not administer pain killers. Prince Leopold was so concerned about his wife’s labor that he rarely left her side.
Throughout the Princess’s labour, Royal Physicians, courtiers and ladies-in-waiting had been in constant attendance. The Archbishop of Canterbury and the Home Secretary waited in a downstairs room, while her husband, Prince Leopold, was often at her side. The first stage of her labour, lasting 26 hours, was characterised by inefficient contractions of the uterus – there was very slow progress towards the full dilatation, or opening up, of the cervix that is an essential step in natural birth. The second stage of labour, that part involving the actual pushing of the baby out into the world, which at the beginning of the 21st century we believe should be accomplished in two or three hours, dragged on for twenty-four. The attending doctors were concerned by the appearance of meconium, the dark green bowel contents of the newborn – meconium detected in the course of labour suggests that the infant is becoming distressed. And indeed the child, a boy, was stillborn. Following the birth there was a brisk haemorrhage which undoubtedly contributed to the Princess’s demise. Despite the best efforts of the galaxy of medical talent gathered at Charlotte’s bedside, the royal line could not be secured. So depressed by the tragic event was the Royal Physician Sir Richard Croft that he later committed suicide. – De Costa
After 50 hours, Princess Charlotte delivered a stillborn 9-pound son. His head had been in a sideways position and was too large for her pelvis. After the delivery Charlotte seemed to do well at first, and she was even given some port wine to drink after two days without food (she mentioned later that the alcohol made her tipsy), but after several hours she became restless, had difficulty breathing, and her pulse became rapid and feeble. She developed malaise and weakness, followed by somnolence then agitation, with progressive worsening and death. Five and half hours after her delivery she died from post partum haemorrhage and shock. Three months after this event, Sir Richard Croft committed suicide, unable to live with the resulting criticism and the knowledge that he had been responsible for the two deaths. Later it was concluded that:
Physicians attending her had failed to act with effective means at their disposal, hastening her demise. In the aftermath of this widely publicized tragedy, “rational intervention” — best represented in the work of Davis — gained force once again. This development included the use of ergot (to stimulate uterine contraction during labor and for expulsion of the placenta), experimentation with blood transfusion, and the introduction of anesthesia for obstetrics by Simpson, all intended to make birth safer, as well as less painful. – Obstetric Literature and the Changing Character of Childbirth
For my other post about medicine in this era, click on: The Physician in the 19th Century
For more information about this triple tragedy and about the Princess, click on the links below:
- An Extract from Hail Caesar by Caroline de Costa
Jane Austen's World 
Very interesting!
Although I write Regency-set historicals, I am thankful every day of my life that I was born in the 20th century. Sixty years ago, it took a pair of forceps to bring me into the world. I bear the depressions of them on my skull to this day. And were it not for a C-section, my son would have died, and me with him, twenty-six years ago.
Thank you for this. Moving and fascinating reading.
It makes a rather terrifying reading. If the foremost royal woman in the land did not get proper care during pregnancy and labour what was then the situation for other women !
consider the fact that 3 of Jane Austens sisters in laws died in childbed ! (2 during her lifetime). They seem to hve had babies almost every year.
What would it have meant for the Jane Austen heroines ?
We hear of few pregnancies in Jane Austens books at least to the main characters. In PP Charlotte Lucas is pregnant in the end of the book but she is no main character. In the end of Mansfield Park there is an allusion wich can be interpreted that Fanny is going to havea baby (she and Edmund moves to the parsonage in Mansfield to be close to the family).
risking having a baby every year risking loosing ones health or life in the prosess. Seems enought reason to close the bedroom door for Mr Darcy,Mr Bingley,Mr Knightley and other austen heroes however hadsome they may be !
Anna-Karin, Joanna, Bells, and Janeen: Thank you for your comments. Before obstetrics entered the modern age, one in two women died in childbirth (See Catherine Delors’ blog at this link). Women dreaded giving birth, and who could blame them? There were the hardy ones, like Emily Fitzgerald, nee Lennox (1731-1814), who bore 19 children. Generally a woman who did not die in childbirth, or from its complications, could be expected to live to a healthy old age. Antonia Fraser cites a study which found that 45 percent of aristocratic women in the 17th century died before age 45, one-quarter dying from childbirth. (They All Died So Young) By the early part of the 20th century, the situation had not changed drastically, with seventeen per cent of women still dying in childbirth. (Old Midwives Tales) Most of these deaths resulted from puerperal fever, a bacterial infection of the uterus that could be prevented by washing hands.
Here’s a link to Childbirth, midwife, and obstetricians in The Netherlands during Johannes Vermeer’s time, which shows a variety of instruments and birthing techniques during the 17th century.
Women today are lucky when it comes to giving birth.
Sorry Vic, just a small (but important) correction : “One in two women died in childbirth” – I was quite surprised by this, so I checked the blog and it’s rather one in ten women.
One also needs to consider that back in those days, a lack of hygiene was directly responsible for many deaths, as was illnesses from not realizing that uterine tissue would be left behind and become necrotic. More women survive today not necessarily due to a drastic rise in interventions, but due to simply hygiene. In America today, women who give births using midwives, the rate of even c-sections is drastically lower than with OB/GYNs in hospitals. In America today, we have the second highest rate of maternal and infant deaths out of all the developed nations, the lowest use of midwives, and one of the highest intervention rates.
When used properly, interventions can save lives. When used when not needed, they can cost lives. Unfortunately many interventions are so routine that many women can’t imagine not having IVs put into their spines and then being cut open even with a complete lack of any remote medical need, just a desire to not push. Perhaps more unfortunately, there is not only more money to be made by doing c-sections in far less time, but doctors are better protected against malpractice, even if death happens, when more interventions are done. The thinking is, “Everything that could be done was done,” while it’s overlooked that over a third of all maternal deaths are due to hemorrhage after c-sections, and of those women, many had no imminent medical need, and likely would have survived a vaginal birth.
While hailing medical interventions today and a lower death rate, do not make the mistake of overlooking the importance of simply hygiene has played, as well as being able to diagnose things such as placenta previa and transverse positioning before birth, both things needing c-sections. (Contrary to popular belief, when the practitioner is properly trained, breech births and even face-presentations, while hard, are just as safe as the ideal crown-down positioning.) Once upon a time people died from simple cuts that weren’t washed and that became infected. It’s not the invention of Neosporin that has cut deaths down to next to nothing. It’s hygiene.
For the record, my daughter was face-down and acynclitic, and was born at home after nearly six hours of active pushing. Both she and I were completely fine, and I didn’t even have any tearing. I felt well enough to make dinner the next day, and we all went out to visit six days after birth. Today she is a rambunctious toddler who is healthy and happy. The OB/GYNs I had prior to my midwife weren’t going to allow anything but a c-section because of a prior medical condition I had that is accepted to not be indicative of automatically needing a c-section, and a c-section is contraindicated in most cases unless there’s imminent need. The OB/GYNs didn’t expect me to live, and my instinct told me it was all wrong. So I went with a midwife. I’m so glad I listened to my body.
[…] A Triple Tragedy: How Princess Charlotte’s Death in 1817 Changed Obstetrics Possibly related posts: (automatically generated)By George! The Wrath of a Princess […]
You mentioned EmilyFitzgerald, we had the wonderful opportunity to live in a stable flat and stewards house conversion at Carton Desmense in the mid 90’s. It was truly a beautiful estate! Emily designed much of the property and the music room was a sight to behold. Both my husband and I wept when we had to come back to the US for business, I could go on and on about our 2 years in Ireland and 3 years in England!
Best wishes,
Mary Anne Komar
[…] A Triple Tragedy: How Princess Charlotte’s Death Changed Obstetrics […]
Looking at maternal death objectively, around 10% of pregnancies and births have complications that threaten the well-being of mother and child. That hasn’t really ever changed and stands today.
Certainly, my understanding of maternity care in the 19th century was that with a competent midwife you stood a better chance of survival from a delivery point of view than with a physician or surgeon. You were most likely to die as has been said from infection.
The use of instruments is, even today, directly associated with higher rates of death, injury and complications to both mother and child. One shudders to think of the catastrophe that dirty forceps, a lack of anatomical understanding and of the birth process would have wrought in Jane Austen’s world.
My understanding in relation to numbers of children born to regency artistocrats and upper classes is that in many ways this was brought upon women by the unpopularity of breastfeeding their own children. In the absence of any means of reliable contrception, breastfeeding was the only means of spacing children for many women and even this is most definitely not a failsafe.
Thank you. You are absolutely correct. For years I have extensively studied the history of childbirth, and continue to do so today. As mentioned in the article, physicians rarely did anything hands on, and surgeons were general surgeons, whereas midwives learned for years under another midwife, and their training was hands on. As my midwife said, “Being a midwife is a way of life.” A midwife is on call 24/7, for no additional pay (except modern hospital midwives). It’s always been that way. With doctors, your doctor might be off the clock and you’re stuck with a stranger. If you have a homebirth midwife, you know who you will get.
It’s amazing how simple sanitation and hygiene have saved so many lives. Florence Nightingale was a Civil War era nurse who believed in frequent hand washing, and under her care, far more soldiers lived, and thanks to her, good hygiene rose, and deaths started to decrease. Even today a simple cut in your foot is rarely a killer in the US because we can wash it with clean water and soap, but in countries where clean water is scarce and waste water, what you went to the bathroom in, doubles as drinking water, washing may make it worse, and kill you.
With the aristocracy, their better diets, when compared to the lowly peasants, the regular folk, could account for their higher number of children as well. Aristocratic men were just as likely to sleep with prostitutes as their own wives, and marital relations wasn’t always so often. Remember marriages were usually for business or political purposes, and there was often no affection to be had. If a man’s wife bored him and it was acceptable to have sex with someone he found attractive for the night, then he would. In the lower class, there was no political advantage to be gained, and rarely any business to be obtained, and so marriages were more often for affection. Prostitutes weren’t affordable, and now many women would sleep with a married peasant man just for the hell of it. But the poorer diets of peasant women, despite the likelihood of having more sex than wealthy women, would affect fertility. Just as today we’re told to improve our diets to improve our chances of conception, women in those days with better diets were far more likely to conceive despite fewer nights of sex.
[…] (c) Jane Austen’s World. In A Triple Tragedy: How Princess Charlotte’s Death in 1817 Changed Obstetrics, I discussed the two approaches to obstetrics in the early 19th century – the conservative […]
[…] (c) Jane Austen’s World. In A Triple Tragedy: How Princess Charlotte’s Death in 1817 Changed Obstetrics, I discussed the two approaches to obstetrics in the early 19th century – the conservative […]
My grandmother died in 1928, leaving six orphans behind, from an infection following a miscarriage, something a D&C might have prevented. 50 hours of labor. I can’t imagine.
This also killed may women in the regency era. Not tissue left behind from a miscarriage (though that happened too), but uterine tissue following delivery. In those days it wasn’t known that there could be tissue left behind even after the placenta had been delivered. That necrotic tissue certainly contributed to the higher death rate.
The tragic story of Princess Charlotte is not well known, but if she hadn’t died there wouldn’t have been a Queen Victoria and the history of the Royal Family would be completely different. I feel this story should be better publicised. It’s like she’s been forgotten.
[…] A Triple Tragedy: How Princess Charlotte’s Death in 1817 Changed Obstetrics […]
Huh, I delivered my first child, unmedicated, after 38 hours of labor. We both came out fine but I was so tired near the end that I was literally falling asleep between contractions. 50 hours, my hart goes out to the poor princess.
If you put a knife under the bed, it cuts the pain in half.
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Homebirth mommy,
Enjoyed reading your posts and this article about Princess Charlotte. I doubt that I would have survived childbirth in the Regency era. I lost two infant sons due to early delivery – my last baby boy was delivered breech and only survived less than a day. I was later told by a more knowledgeable doctor that I had an “incompetent cervix” and for my 3rd pregnancy, was given a McDonald’s stitch at the end of my first trimester. I gave birth to my 3rd child, a girl 8 months into the pregnancy and she was fully developed and is now a healthy young adult woman – a dancer all of her life who now teaches and coreographs for her students.
She was delivered C-section (initially to my dismay) but later on, as I looked into the medical reasons, it was the safest way to deliver her and at that point I wasn’t going to lose another child.
I think that mid-wives can be great choices for most childbirths, but if someone has a high risk history such as myself; they should at least have very quick access to a hospital and OB-Gyn familiar with their medical history.
Btw, I have greatly enjoyed watching “Call The Midwives” on PBS this year!
[PS I’m pretty sure that a ‘male doc’ came up with the term, “incompetent cervis!” ;-)]
This story really cuts holes in the modern catch phrases “women are made to birth” and “babies know how to be born” Clearly this isn’t the case for many mothers and babies. I am so grateful to be alive in this time with the advantage of modern obstetrics and to not have to face the likely death sentence of childbirth. It confuses me how the popular natural childbirth movement can romanticize something that devastated so many and why they would want to drag us back to that.