Doctor's Review: Medicine on the Move

September 22, 2017

Mary I's attempt to produce an heir ended in disgrace when she was forced to reveal her pregnancy was fake.

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An heir-raising experience

Royal babymakers and their often miserable path to motherhood

The international frenzy surrounding prince George Alexander Louis may have seemed like a circus side-show to some; after all, it was just a birth, an everyday event at just about any hospital in the world.

But the attention should come as no surprise. The arrival of a new Royal heir has often been anything but routine. Like all mothers in pre-modern times, princesses and queens had to contend with abysmal maternal, fetal and newborn mortality rates stemming from filthy conditions and dangerous medical interventions, not to mention a complete lack of pain management. England’s political stability and future often depended on nothing more than a healthy human birth; but that was far easier said than done.

An unlikely monarch

Mary I, a.k.a. Mary Tudor (1516 – 1558), was a tragic figure from virtually the minute she was born. Mary’s path to the throne was an unusual one; she became heir because she was the only surviving child of her father, King Henry VIII and Catherine of Aragon. She was removed from the line of succession, and while she eventually came back into favour, it was only behind Edward I, the male heir Henry VIII finally produced with Jane Seymour. With Edward ascending to the throne in 1547, it seemed Mary had no chance of becoming queen, except the high mortality rate of seemingly anybody related to Henry VIII struck again and the boy king died at 15, in 1553, before he could produce an heir. After a brief struggle, Mary, the unlikely new Catholic monarch, was crowned, against her late half-brother’s dying wishes.

Her next order of business, of course, was to produce an heir of her own. A year after her coronation, Mary married Prince Philip I of Spain. The chaos and unusual circumstances surrounding Mary’s young life led to a fairly unusual condition: pseudocyesis, sometimes called a “phantom pregnancy.” Still poorly understood today, according to the New York Times it is only a factor in somewhere between one and six out of every 22,000 pregnancies. One of those happened to be that of the English queen.

The pressure on Mary to produce her own Catholic heir starting at the ripe old age of 38 was obviously an enormous burden, one she didn’t handle very well. She was known to be depressive, and suffered from unspecified menstrual trouble throughout her adolescence, so when the queen began to gain weight and reportedly stopped menstruating shortly after her wedding in September of 1554, the nation held its breath. Her doctors attended to her morning sickness, and assured the world that Mary was indeed expecting.

A Royal hoax?

Mary kept busy during her pregnancy by burning Protestant heretics at the stake and rooting out traitors. In April of 1555, her half-sister Elizabeth was granted a brief reprieve from house arrest (enacted to prevent her from hatching any Protestant plots) to attend Mary during the last month of her confinement and witness the imminent birth. News that a baby boy had been born quickly spread throughout the country and even the rest of Europe, but it proved to be just a rumour.

As the weeks dragged on with no news of a royal baby, people began to wonder. Whispers circulated that the queen had been seen curled up with her knees tucked in, which wasn’t exactly possible for an overdue mother-to-be. Eventually, few people thought that Mary had ever been pregnant. One dubious courtier mocked her outright, saying that the Queen’s pregnancy would “end in wind rather than anything else.”

One thing is certain, however. During this time, Mary believed herself to be pregnant. In June, she issued a statement that God would not allow her child to be born until all the Protestant dissenters were punished, beginning another round of executions. In August, in the 11th month of her false pregnancy, Mary emerged from her confinement chamber at last. She was impossibly thin, utterly silent and completely humiliated. No word of her “pregnancy” was mentioned at court again, at least officially. Her political rivals rejoiced, relishing in the entire situation as a sign of weakness and divine retribution.

So many factors could have contributed to Mary’s phantom pregnancy. Perhaps it was a ruse to keep the attention of her new husband, famous for his philandering. Some medical historians suggest that she had an ovarian tumour or cyst, which mimicked the symptoms of pregnancy; others suggest she actually miscarried but couldn’t face the pain. Most likely Mary was peri-menopausal. Her inability to accept the fact that it was likely too late to have a baby led to what is perhaps the most famous case of pseudocyesis in the literature.

Philip eagerly left court for a couple years to take up the war against France, perhaps as much to dull the sting of the humiliation as to head his armies. When he came back in 1557, accompanied by his beloved mistress, he was likely unfazed when Mary informed him several weeks later that she was pregnant again. Nobody believed her. Bloody, barren Mary Tudor died of the flu about a year later in November, 1558 at the age of 42.

The difficulties of succession did not end with Mary. Despite her lengthy reign, Mary’s half-sister and successor, Elizabeth, also didn’t produce an heir, making it three straight monarchs that hadn’t produced a direct heir.

The queen of heartbreak

Unlike the Tudor queens, Queen Anne’s (1665 – 1714) problem was not one of infertility or celibacy. Perhaps the most tragic figure in the history of royal births, poor Queen Anne was pregnant 17 times, with not one of her children surviving to adulthood. Multiple miscarriages, six still-born infants, two babies who died within hours of birth, two daughters who died as toddlers and a son who survived to only 11 left Queen Anne a shell of a woman. Instead of being known as a royal mother, she will be remembered for being the last in the royal line of the house of Stuart, and mother only to a style of architecture.

Of course, the danger wasn’t only to the infants. It’s easy to forget that the relative safety in which most women in the West can give birth is still a fairly recent phenomenon; just 80 years ago, the maternal mortality rate was over 30 times higher than it is today. Which is perhaps why when Kate Middleton delivered baby George, the Royal Family could breathe a sigh of relief. Not only were mother and son both health, the Duchess of Cambridge, the Duke and Duchess of Cambridge had produced an heir — and they’d only needed one try.

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