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<p>[QUOTE=&quot;Stork, post: 2562393, member: 71642&quot;]<img src="http://[IMG]https://collectivecoin.imgix.net/zWdVi3HjTj6Up5Fi8LcP_Charlotte%20combo.jpg" class="bbCodeImage wysiwygImage" alt="" unselectable="on" />[/IMG]<img src="https://collectivecoin.imgix.net/zWdVi3HjTj6Up5Fi8LcP_Charlotte%20combo.jpg" class="bbCodeImage wysiwygImage" alt="" unselectable="on" /></p><p><br /></p><p>T. Webb and G. Mills.&nbsp; 1817, bronze, 50 mm.&nbsp; The death of Princess Charlotte.&nbsp; </p><p><br /></p><p>Princess Charlotte was the only legitimate child of the future King George IV and thus the heiress presumptive for the throne of England.&nbsp; Born in 1796 to unpopular parents, she herself was extremely popular with the public.&nbsp; &nbsp; </p><p><br /></p><p>She declined marriage to the Prince of Orange and subsequently married, for real affection if not love, the somewhat impoverished Prince Leopold of Saxe-Coburg-Saalfeld.&nbsp; It was a happy marriage and after two miscarriages she subsequently carried the next pregnancy to term.</p><p><br /></p><p>She was cared for by Sir Richard Croft who was of the more conservative, lower intervention, school of obstetric care.&nbsp; Early in pregnancy she gained excess weight and was subsequently put on a strict diet.&nbsp; Bleedings were done as was standard practice for the time.&nbsp; Thus she entered her confinement in a weakened state and carrying a large child.&nbsp; </p><p><br /></p><p>Her water broke and she labored for 50 hours, apparently crowning for 24 of the hours with the baby in a malpresentation--either breech or more likely &#039;occiput&#039; transverse&#039; (head down but looking sideways instead of up or down...not generally favorable for a delivery) depending on descriptions given.&nbsp; </p><p><br /></p><p>Signs of fetal stress were seen (meconium/passing of fetal stool) and indeed once she delivered, the baby was stillborn (and weighed 9#). </p><p><br /></p><p>Princess Charlotte herself passed away about 6 hours later after heavy bleeding. Her death could have been due solely to the post partum hemorrhage (at risk given her length of labor and large baby) or possibly complicated by sepsis and/or DIC.&nbsp; </p><p><br /></p><p>Sir Croft was heavily criticized for declining advice to use forceps (even barring an expert consultant from attending to the Princess according to some sources). Forceps may or may not have saved either of them, but would have improved the odds.&nbsp; Sir Croft later killed himself, and thus the delivery is known as the &#039;triple obstetric tragedy&#039;.</p><p><br /></p><p>The Prince-Regent George and his wife, Caroline pretty much hated each other and no attempt was made for another child after the birth of Charlotte.&nbsp; After Caroline&#039;s death (and after a failed attempt at divorce or annulment) the future King made no attempt at re-marriage or fathering another heir.&nbsp; Subsequently the race was on with his siblings to produce an heir, with success by the Duke of Kent who was able to marry and eventually the future Queen Victoria was born.&nbsp; </p><p><br /></p><p>Queen Victoria was quite prolific, and from Victoria&#039;s offspring the hemophilia B gene (suspected to be a spontaneous mutation in her mother) was introduced into ruling houses of Spain, Germany and Russia.</p><p><br /></p><p>Interestingly Queen Victoria married Albert, the nephew of Princess Charlotte&#039;s husband (who, after Charlotte&#039;s death, became the King of Belgium.&nbsp; He had turned down the offer to become the King of Greece so he progressed rather far from being the broke dude who married a Princess, but I digress).</p><p><br /></p><p>One could argue that obstetrical choices led to rather dramatic historical outcomes.&nbsp; Different choices might have at the very least, saved the Princess, who may have had a second child and resulted in a drastically different future.</p><p><br /></p><p>In addition, the idea of interventions in the labor process gained traction including increased use of forceps, uterotonics (medications resulting in stronger and increased contractions in labor and more importantly, for reducing bleeding after delivery), and the idea of using pain medications.&nbsp; Queen Victoria herself was a very early adopter by using chloroform for the birth of her last child, subsequently singing the praises and paving the way to modern pain management for labor.[/QUOTE]</p><p><br /></p>

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