Those of us watching Netflix’s adaptation of The Viscount Who Loved Me in Season 2 of Bridgerton may have been moved by the series’ exploration of grief as seen in the flashback of Violet Bridgerton giving birth to Hyacinth just weeks after her husband died (“A Bee in Your Bonnet”).
The scene is powerful and evocative as the wigged accoucheur refuses to listen to Violet and insists that Anthony answer the question: should he prioritize saving the mother or the child?
There are three main horrors in this scene: that Anthony is being thrust into a terrible responsibility, that the doctor isn’t listening to Violet’s voice, and that the father isn’t there (because he died).
Since I just spent the month of November commuting into Manhattan to spend time with a few texts about the accoucheurs (or man-midwives) of Georgian and Regency England, I thought I would break down the historical accuracy of this scene.
Where would an aristocratic woman give birth in Regency England?
Giving birth was a social event for aristocrats in Regency England. For a first birth, most families made a show of arriving in London specifically for the “Great Event”. In In the Family Way: Childbearing in the British Aristocracy, 1760-1860, Judith Schneid Lewis discusses the ritual of childbirth beginning with separation. Often termed “going to town”, the mother and family would depart from her country home at the last minute to take up quarters in London – often rented rooms – specifically for the birth. They would place straw on the street outside the house to quiet carriage wheels, as well as to draw attention to the expected event. Newspapers reported on arrivals, and aristocratic visitors would stop by the “lying in” rooms throughout the labor.
That said, once the first child or heir was delivered, families often toned down the performance. Many mothers preferred to give birth in their country homes, as we see Violet Bridgerton doing, where they could even choose not to invite visitors into the birthing chambers if they preferred privacy.
The Lying-In Chambers
Whether in town or at their country estate, aristocratic mothers gave birth in rooms specially arranged for the event. This included at least two adjoining rooms: one for the lying-in bed, and the other as a gathering place for family members and visitors. If possible, it also included sleeping accommodations for the doctor and medical attendants.
Aristocratic families used special-made lying-in beds (sometimes referred to as cots) for the birthing beds. They were lightweight and portable. They were also specially designed for easy linen changes and to keep the mother accessible to the doctor. In fact, many families passed their lying-in cots from one mother to another, perhaps similar to how we share hand-me-down cribs today.
So, unlike the hulking four-poster we see in the Bridgerton scene, a Regency aristocratic woman would more likely be giving birth on a purpose-made bed in one of her spare drawing rooms.
Who would be in the Regency birthing room?
In the scene in Bridgerton, we see seven people in the room: Violet, two male doctors, and four uniformed maids.
Lewis’s research indicates that the labor entourage for a typical Regency mother was much smaller, including the accoucheur, a monthly nurse, and a wet nurse.
The Accoucheur
The accoucheur (or man-midwife) was a surgeon who would have taken at least a few medical courses at schools like the University of Edinburgh and apprenticed with practicing accoucheurs. For an aristocratic family, only the best accoucheurs would do, so he likely would have several years’ experience on his own and a good record of delivering healthy babies and mothers.
Adrian Wilson traces the prominence of accoucheurs in The Making of Man-Midwifery: Childbirth in England, 1660-1770. Prior to the eighteenth century, male surgeons or physicians would only have been called into the birthing room in emergencies. Mothers would more likely have been attended to by female midwives. However, in the eighteenth century, the development of forceps and other tools allowed male doctors to deliver living babies to healthy mothers, even in the case of difficult births. That, plus the prestige of the expensive services of an accoucheur, gave rise to man-midwives over the traditional female services, especially in aristocratic circles. (There is a lot more nuance to this, of course, so if you are interested, I highly recommend digging into Wilson’s book.)
The Monthly Nurse
The monthly nurse was, as the name implies, a nurse hired for a full month to assist the accoucheur in birth and attend the mother afterwards. She aimed to arrive several days before the due date (which were not very well estimated back in the day) and stayed for the following month to oversee the mother’s recovery.
Since monthly nurses were dedicated to a mother’s health, they were expensive and therefore a status symbol. Lewis points to one monthly nurse, Mrs. Griffith, referenced by many aristocratic mothers as “the Griff”, who was active from 1810 to 1832. When she retired, her replacement had the audacity to wear “long gold earrings”! (Lewis, p. 164)
The Wet Nurse
The wet nurse’s primary role was to breastfeed the baby.
Where were husbands?
Unlike the husbands of the 1950s who didn’t even go to the hospital with their wives, aristocratic husbands were usually at hand when their wives were “brought to bed.” They might spend their time in the adjoining chamber with other family members and visitors (who drank “the caudle”, a hot spiced wine that was also thought to ease labor pains), or they might even be at their wife’s side.
Birth Practices
In the scene in “A Bee in Your Bonnet,” the doctor tells Violet that she “must not be standing” – and then insists that it is only Anthony’s choice whether to save his mother or the baby.
In practice, the literature from man-midwives recommends prioritizing the mother’s peace of mind during the early stages of labor. One textbook recommended that, while waiting for the baby to work itself into position, accoucheurs allow patients to choose activities like walking, standing, playing cards, or lying in whatever position she found most comfortable. No matter what she chose, she was not to be left alone (Lewis, pp. 174-175)
When the baby’s head was positioned for the birth, then the accoucheur grew more particular. The mother would be brought to one side of the bed (to leave a dry spot in the center for after the baby was delivered), and she would be positioned on her left side with her back to the edge of the bed and her knees bent towards the abdomen. This was considered a natural position that promoted a healthy birth, plus it meant the doctor could get all up in her business without making eye contact (Lewis, p. 176)
The aristocratic mother would likely change into a special outfit at this point: a shift tucked under the arms with a petticoat around the hips. After the birth, the petticoat could easily be removed and the dry shift brought down without her needing to leave the bed to change.
Difficult Births
Aristocratic women were well aware that childbirth was risky business. Lewis documented that aristocratic mothers regularly updated their wills and wrote farewell letters in preparation for labor (p. 74). Meanwhile, Wilson’s research shows for a London accoucheur a 2% stillbirth rate and a 1-2% maternal mortality rate (Wilson p. 19).
When the baby did not position itself naturally to present head first, then the birth became more complicated. It might present itself feet-first or transversely across the womb, making the shoulder, arm, back, or belly go first through the canal (Wilson p. 11). By the nineteenth century, accoucheurs had several tools available to them to assist: the forceps and vectis were used to grasp the baby in the birth canal and bring it out alive. SENSITIVE CONTENT WARNING: The crotchet hook was used to save the mother’s life by performing a craniotomy on the baby and pulling it out dead. (Lewis p. 180)
Generally, the Regency accoucheurs favored natural processes over mechanical interventions. That meant in the case of a difficult birth, they would wait for hours or even days to allow the uterus to push the baby down the vaginal canal. For example, Lewis found a source recommending that accoucheurs wait for the contractions to stop for six hours consecutively with the baby low in the pelvis before breaking out the forceps (p. 178).
This meant that in difficult births, the mother would be trying to give birth naturally via uterine contractions for hours and sometimes days before the mechanical intervention (and, may I remind you, anesthesia was not available until the 1840s, so this was undrugged labor). Then the accoucheur would attempt to bring the child out alive with forceps that would clasp the baby’s head and pull it out mechanically.
If the baby presented itself in such a way that it could not be brought down out of the birth canal with forceps, then the accoucheur might be presented with a decision like in Bridgerton. Either let the mother suffer through a terrible birth that would likely kill her in hopes of a living baby, or perform a craniotomy to pull a dead baby from the mother’s body and allow her to heal. (A Cesarean section was performed only after the mother was already dead.) However, Wilson’s research does not suggest that it would be the man of the house’s decision alone. This was likely a conversation the couple had together. Meanwhile, if presented with the decision during labor, it most likely came at a time when the mother was so exhausted from giving labor for days that she might not even be conscious or coherent. Still, it was not a question taken lightly, and often a minister was called in to help the family decide (Wilson, p. 20-22)
When it comes to the scene in “A Bee in Your Bonnet,” the Bridgerton creators effectively create a terrible scenario that forces Anthony to consider his role in life in a new light, and that shines a light onto Violet’s deep grief. That said, it takes a few liberties to create higher stakes. If you’re interested in the history of childbirth in England, I highly recommend the books referenced to dive into the details. Or give my novel, The Governess Without Guilt, a try!
One bored governess, one handsome doctor, and unlimited unchaperoned nighttime activities. What could possibly go wrong?
Sophia Preston wants adventure, excitement, and self-determination. She hired herself out as a governess to gain independence, and now she has it at Robin Abbey: every day, she gets to mind the Cosgrove children, eat the Cosgrove’s food, and live by Cosgrove’s rules.
When John Anderson arrives as accoucheur ahead of Lady Widlake’s next baby, Sophia immediately sees the potential for excitement. Who wouldn’t want to seduce the handsome young doctor who is guaranteed to move on once Lady Widlake’s baby is born?
John doesn’t mind flirting with the intriguing governess – as long as they aren’t caught. He has goals, and they don’t include ruining his reputation. Still, he must admit that Miss Preston is everything he ever wanted in a woman: smart, beautiful, unlike anyone else he has ever met…
When counterfeit bank notes surface in town, the authorities suspect someone at Robin Abbey is the criminal. Suddenly, both Sophia and John are put under the microscope. They have no choice but to band together to find the true culprit. The only question is: will they find true love, too?
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Katherine Grant writes Regency Romance novels for the modern reader. Her writing has been recognized by Foreword INDIES Book of the Year Awards, the National Indie Book Awards, and the National Indie Excellence Awards. If you love ballgowns, secret kisses, and social commentary, a book hangover is coming your way.
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Sources
Lewis, Judith Schneid. In the Family Way: Childbearing in the British Aristocracy, 1760-1860. New Brunswick, N. J.: Rutgers University Press. 1986.
Wilson, Adrian. The Making of Man-midwifery: Childbirth in England, 1660-1770. United Kingdom, Harvard University Press, 1995.
