A brief history of royal mothers and childbirth

Royal births have always attracted public attention, especially those that resulted in a new heir. Recently, historians have analysed these events for what they show about past birth practices, since royal births were often better documented than those of private citizens. The royal pregnancy of 1688 is unusually well-recorded, in part because James’s daughters Mary and Anne (the children from his first marriage) were gossipy, snide correspondents.

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From the start, the queen’s pregnancy was doubted. Rumours flew about the palace and marketplace. Perhaps the pregnancy was fake, or maybe the papal nuncio, Ferdinado D’Adda, was the father (certainly, his surname made him the target of sniggers). “[T]here may be foul play intended,” wrote Anne suspiciously, to her sister.

The queen went into labour on 10 June at St James’s Palace. She was attended by three women: the Woman of the Bedchamber (a similar role to a lady-in-waiting), a midwife, and her old nurse. When the king arrived, Mary asked him whether he had sent for the dowager queen. “I have sent for everyone,” was his reply.

Within a few minutes, 67 people filled the room – the queen dowager, court ladies, the Privy Council, and royal physicians. Although she wasn’t in attendance herself, Anne reported the chain of events to her sister: “When she [Mary] was in great pain the king called in haste for my Lord Chancellor, who came up to the bedside to show he was there, upon which the rest of the Privy Councillors did the same thing,” she wrote. “Then the queen desired the king to hide her face with his head and periwig, which he did, for she said she could not be brought to bed and have so many men look on her; for all the Council stood close at the bed’s feet...”

When Mary delivered a baby boy, the king invited the Privy Council to bear witness to the legitimacy of the royal offspring. To James and Mary, it must have seemed that a birthing room packed with worthies might stem the rumours. It didn’t.

Tattle had it that the birth was fake: a baby had been smuggled in, it was said, hidden in a bed warming pan. Or perhaps the birth was real… but the infant had died and been replaced with the child of the wet nurse – and the new baby James was actually the son of a brick-maker.

Before a year was out, the baby’s half sister Mary and her husband, William of Orange, arrived in England and took the throne. Anne eventually succeeded the couple as ruler, but fared no better in securing the line: she had five stillbirths, seven miscarriages, and five live births, none of whom lived to adulthood. (She did not, however, keep 17 child-substitute rabbits, as suggested by the recent movie The Favourite).

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Princess Charlotte

A successful royal birth could be career-making for the birth attendants. On the birth of his son, James II gave the midwife 500 guineas and knighted the queen’s physician on the spot; Charles Locock, obstetrician to Queen Victoria, received £1,000 for delivering Princess Victoria; knighthoods flowed for Elizabeth II’s gynaecologists and obstetricians; as did those for the principals on the Duchess of Cambridge’s 20-strong medical team.

But when things went wrong, the consequences of the blistering public scrutiny of royal birth could be devastating.

Richard Croft was the early 19th century’s leading ‘accoucheur’ (today’s obstetrician). When the Prince of Wales’ only child, 21-year-old Princess Charlotte, became pregnant again after two miscarriages, Croft was the obvious choice to deliver the child. The princess and her husband, Prince Leopold of Saxe-Coburg-Saalfeld, chose to stay at their country residence for the birth. When Charlotte went into labour at 7pm on Monday 3 November 1817, express riders set off for London with orders for the Privy Council to attend. They duly gathered in the Library adjacent to the princess’s room and were regularly updated by notes sent out from the birthing room.

Charlotte, Croft and Mrs Griffiths (the ‘monthly nurse’ who assisted the accoucheur and cared for mother and child for a month) were shortly joined by the Physician-in-Ordinary and Croft’s brother-in-law, Matthew Baillie. In the early hours of the morning, another accoucheur, John Sims, was called in. All three men concurred that the labour was slow but normal and so, according to practice, nature should be left to take its course. As the princess’s contractions continued, and “she showed no marks of deficient strength during her labour”, the doctors decided against using forceps to help speed the birth.

Finally, after 50 hours of labour, the princess delivered a stillborn boy. Efforts to resuscitate him using a warm bath failed. Charlotte, Croft said later, appeared “as well as Ladies usually are, after equally protracted labours” and she had chicken broth, toast and a glass of port. The doctors retired to rest, and Prince Leopold joined his wife. A little later the doctors were called back: Charlotte was deteriorating rapidly. She heard a “singing noise in her heard” and suffered “spasmodic affections of the chest”– convulsions. The widely-used remedy of laudanum didn’t help: she struggled to breathe, her pulse became irregular and her skin turned cold. At 2.30am on 6 November 1817, Charlotte died.

The outpouring of grief for the dead princess was intense. “It really was as though every household throughout Great Britain had lost a favourite child," one commentator wrote.

Charlotte had been George III’s only living grandchild. Her death prompted a rush to their bedrooms by her uncles and aunts to secure the line of succession. The first to do so was Prince Edward and his wife, Princess Victoria. Their daughter, born in 1819, became the new heir: Victoria.

While the royal family did not blame Croft for Charlotte’s death, that was not the case for the public, many of his colleagues, and his past patients, who demanded “some proper statement from the Doctors… for they certainly do not satisfactorily appear.” Plagued by the murmuring, Croft killed himself.

Queen Victoria

Charlotte’s death spurred an increased inclination for medical intervention in births through the use of instruments and medications – and her cousin Victoria would herself embrace one of those interventions.

Compared with many of her predecessors, Queen Victoria’s path to multiple motherhood was smooth sailing: nine pregnancies all carried to term. However, while Victoria enjoyed getting pregnant (“bliss beyond belief”, she wrote about her wedding night), she described the downside of her many pregnancies: “Aches - and sufferings and miseries and plagues… I had 9 times for eight months to bear with those above named enemies and own it tired me sorely; one feels so pinned down, one’s wings clipped - in fact..… only half oneself.” No proto-feminist, Victoria nonetheless appreciated the burden of birth, and when she heard about a method of relief, she grasped it: anaesthesia.

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In 1847, Edinburgh obstetrician James Simpson demonstrated that chloroform could dull the pain of childbirth. News filtered through to Victoria’s social circle; some of her friends demanded of their accoucheurs “to be delivered without knowing it”.

For the birth of Victoria’s eighth child, Simpson himself was engaged to join her usual birthing team of Charles Locock (‘The Great Deliverer’), nurse Mary Lilly and Prince Albert, who was on hand for all nine births. Leading statesmen sat outside the room, but with the door open for a good view of proceedings. Simpson anesthetised the queen by dripping chloroform onto a handkerchief stuffed into a funnel through which she breathed. “The effect,” wrote Victoria in her diary, “was soothing, quieting and delightful beyond measure.”

Victoria’s insistence on using anaesthetic was not straightforward, however. Religious opinion was against it: pain relief during labour would “rob God of the deep earnest cries which arise in time of trouble for help”, explained one clergyman. Woman had “been ordered that ‘in sorrow’ she shall bring forth”. Medical opinion, too, was divided; “dangerous and unnecessary” harrumphed the medical journal, The Lancet. Victoria used anaesthetic again for her final delivery, Beatrice.

Queen Elizabeth II

When Princess Elizabeth, the future queen, was pregnant with her first child in 1948, she too engaged with an assortment of gynaecological and obstetric luminaries. Four of them, in fact.

The birth itself took place in the Buhl Room at Buckingham Palace, normally a guest room with a lovely view down the Mall. This was no ‘homebirth’ in the usual sense, however: the room was converted into a miniature hospital, as it would be again in 1951 when King George VI’s lung was removed.

Who was in the room with the young princess? (Prince Philip was not; he played squash during Charles’s birth, bringing champagne and carnations to Elizabeth after it was over. But he did attend the birth of his fourth child, Prince Edward, in 1964 – as have all royal fathers since.) Specifically, who was there to formally witness the birth? Over the centuries, the 67 witnesses of Mary of Modena’s time had been whittled down to just one: the Home Secretary. For Elizabeth’s own birth, the Conservative politician William ‘Jix’ Joynson-Hicks had been summoned from his bed to see her born by caesarean section at the home of the Queen Mother’s parents. The question was, would this custom continue?

Alan ‘Tommy’ Lascelles, King George VI’s private secretary, discussed the matter with the king (Elizabeth herself was not consulted). Lascelles was against it: having the Home Secretary as “a sort of supernumerary midwife… was out-of-date and ridiculous” and without any constitutional basis. But Elizabeth felt it important, so Home Secretary James Chuter Ede was invited to be “in attendance when Princess Elizabeth’s baby is born”.

Shortly before the due date, the Canadian High Commissioner met with Lascelles and noted that the Dominions had as much interest in the forthcoming heir as the British. Representatives of the Dominions would be invited to witness the birth as well, wouldn’t they? Alarmed, Lascelles consulted the king again, pointing out that “if the old ritual was observed, there would be no less than seven Ministers sitting in the passage”.

That very day, Buckingham Palace announced the end of “an archaic custom”. Thus, when Charles was born, only the medical staff attended.

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Royal births are, of course, not typical deliveries: they are births supported by massive resources. The modern royal family has tended to be medical in their choices, favouring obstetric-assisted over midwife-assisted births (as has been the UK trend more generally). Despite these resources, a royal mother-to-be has not been completely free to choose how she will give birth: across history, family members, states people and the public have all influenced how royal women have delivered their children. Royals’ choices of who will help them has drawn on professional reputation, but also on personal recommendations from friends and family, resulting in dynasties of medical advisers involved in multiple royal births with multiple royal family members.

The Duke and Duchess of Sussex – Harry and Meghan – are the latest royal couple whose pregnancy is attracting searing interest, and it seems they hope to divert or at least postpone that attention. “Their Royal Highnesses,” a statement from Buckingham Palace recently read, “have taken a personal decision to keep the plans around the arrival of their baby private.” History would say, good luck to them.

Dr Laura Dawes is a historian of medicine, author and broadcaster. Her recent book is Fighting Fit: The Wartime Battle for Britain’s Health (2016)