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’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,

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: