We can’t really tell you what it was like in the delivery room of the private Lindo wing of St. Mary’s Hospital in London. But we can tell you what it would have been like for other historical royal women. And let’s just say, it wasn’t always pleasant—although in some cases, it changed the way babies were born for everyone.

1. Giving birth with an audience

For hundreds of years, royal women gave birth in front of spectators. It was a big custom among the French royalty—poor Marie Antoinette was almost killed by the great crush of people who poured into her bedchamber at Versailles when the doctor shouted that the baby was coming. Contemporary reports claim that it was stiflingly hot, that it was impossible to move for spectators, and that some people were climbing atop the furniture for a better view. No wonder she fainted. (And no wonder the custom was abandoned soon after. Well, sort of: The royal mother still gave birth before a crowd of people—ministers, advisors, trustworthy types—just a smaller one.)

A public viewing, no matter how uncomfortable for the one being viewed, was designed to prove to the entire court that the child was indeed the fruit of the royal woman’s womb, that there hadn’t been a switch up at some point.

Even if it wasn’t an official public—as in any punters off the street—policy, other royal women were expected to deliver their babies to an audience. Still, it didn’t work for Mary of Modena, queen consort of the Catholic King James II. No less than 70 people reportedly witnessed the birth of their longed-for son and heir, James Francis Edward Stuart, on June 10, 1688. But gossips still claimed that he was a changeling child smuggled into the birthing chamber in a warming pan, and that the real prince had been stillborn. The whole conspiracy was cooked up by Protestants wary that the Catholic King James II would raise his son, the heir to the throne, a Catholic; that would constitute a further imposition of what they now considered a foreign religion on a Protestant people. The supposed illegitimacy of young James, however, furnished William of Orange, the next Protestant in line for the British throne, with a good reason to invade.

But measures to make sure that the royal baby was indeed the right one were still in place until 1936. Until then, and including the births of Queen Elizabeth II and her sister, Princess Margaret, the British Home Secretary was required to stand outside the door of the birthing room, just to be sure.

2. Palace or hospital?

Maybe it’s comforting to know that royal women tend to give birth generally the same as other women, and the mechanisms of those births tend to follow the customs of the day. That meant that for the vast majority of royal family history, babies were born at home, or at whatever palatial estate the royal mother happened to be in at the time. Prince Charles, heir to the British crown, was born November 14, 1948, at Buckingham Palace. (Or rather, as the BBC put it, “Her Royal Highness Princess Elizabeth, Duchess of Edinburgh, was safely delivered of a prince at 9:14 p.m.”)

At the time, roughly one in three women in the UK gave birth at home. It wasn’t until more than 20 years later that a member of the royal family would be born in a hospital. In 1970, Lord Nicholas Windsor, son of the Duke and Duchess of Kent, was the first royal baby to be born in a hospital (University College London—that’s where I gave birth! I feel famous!). That was, incidentally, the same year that the Peel Report in the UK recommended that every British woman should give birth in a hospital, not at home, for the safety of the infant. Now, less than 3 percent of British mothers give birth at home—and the royals are among the majority who go the hospital route.

3. A bit of chloroform? Queen Victoria starts a fad

Queen Victoria was all about setting standards and starting fads, some of them better than others. For the vast majority of human existence, pain relief for women in labour was rare—and for at least some of history, said to be against the wishes of God. One woman in 1591 was burned at the stake after she asked for pain relief during the birth of her twins. Though not quite so extreme, that was the general attitude even after the discovery of relatively safe anesthetics in the 19th century. Ether and chloroform were all right for things like surgery and limb removal, but delivering babies the painful way was woman’s lot in life.

And then, in 1853, at the birth of her eighth child, Prince Leopold, Queen Victoria asked her attending physician for a bit of the good stuff. Dr. John Snow (the visionary doctor who figured out that the deadly cholera outbreaks cutting swathes through the city were being transmitted by water-born microbes) administered chloroform to the Queen via a saturated cloth: “Her majesty expressed great relief from the application, the pains being very trifling during the uterine contractions, and whilst between the periods of contraction there was complete ease.” I’ll bet.

Victoria’s decision, however, and the decision of people around her to tell everyone about it, ushered in a new era of drugs for childbirth. For good or for ill: After the floodgates opened, doctors were throwing anything and everything at delivering mothers, from nitrous oxide (whip-its!) and quinine (anti-malarial!) to cocaine and opium. By the end of the century, modern science determined that modern ladies—well, modern ladies of the upper and middle classes, and definitely not poor women—were too delicate to give birth without significant aid. During the early part of the 20th century, some doctors advocated “twilight sleep” for those women who could afford it. “Twilight sleep” was basically super-strong drugs that didn’t knock you out during the birth— women under the influence of this cheery cocktail routinely hallucinated and had to be restrained and blindfolded during childbirth—but they did make sure you didn’t remember a damn thing except waking up in the morning with an adorable new baby. Um, thanks, Victoria?

4. Get a grip: Forceps

Nowadays, instrumental births are more common; in the UK, around one in eight women delivers her child with help from a Ventouse (the vacuum) or forceps. Before the invention of the forceps, however, there were few options to unstick a stuck baby that didn’t result in the death of the mother or the child. The less said about that the better.

But beginning in the late 1500s, one family had a secret gadget that seemed to miraculously free the baby without (too much) harm and save the mother as well: The Chamberlen family had invented the first obstetric forceps. And they didn’t tell anyone for the next 200 years. French Huguenots Dr. William Chamberlen and his pregnant wife and three children sailed to England in 1569. No one knows whether it was this Chamberlen or one of his sons called Peter (he had two) who developed the first forceps design, but by the 1600s, the Chamberlens were the "men midwives" of choice to the British social elite. Men midwives, as they were actually called, were the newest, hottest thing in obstetrics, putting female midwives out of business left and right. Of course, it was still quite inappropriate for a man who was not her husband to see a lady’s bits, so male midwives were forced to work almost blindfolded: The female patient would be covered in a sheet from her neck down, the other end of the sheet tied around the male midwife’s neck, forming a kind of tent.

This actually worked out well for the Chamberlens, as it meant they could keep their lifesaving—and incredibly lucrative—instrument a secret. The Chamberlens by now were favorites of pregnant British royals and aristocracy, though the rest of the medical community pretty much hated them. In the early 1700s, Hugh Chamberlen finally made the design for the forceps public, although they were almost immediately the subject of fierce debate—some doctors and midwives thought they killed more infants than they saved.

It took the death of a royal princess to make people think otherwise. In 1817, Princess Charlotte, the only daughter of Princess Caroline and George, Prince of Wales (later George IV), died after delivering a stillborn baby boy. The national outpouring of grief was intense—the British people had loved Charlotte in direct proportion to how much they hated her father, which was a lot. But while the nation clad itself in black, Charlotte’s death had another, more long-term effect: The attending doctor was excoriated in public for not using forceps to deliver the child. The demand for forceps soared, ushering a new era of birthing protocol; the doctor, however, killed himself three months after Charlotte’s death.