Wednesday, September 24, 2008

Question from Emily - Further thoughts on Catherine of Aragon's miscarriages, etc.

This really isn't a question, more so a thought on a possible reason Katherine of Aragon had such trouble delivering live children.

This came to me today while researching a condition that a few of my family members have: a bicornuate uterus.

This basically means that the uterus is malformed into two distinct sections (forming a heart shape) in varying degrees of severity, and this results in:

-high rates of miscarriage
-high risk of premature delivery
-high risk of weak live births (the infant doesn't have enough room to grow, so is stunted in growth and weak as a result)

And I thought to myself, this fits Katherine's situation pretty well. I mean, obviously we will never know, and it's never wise to make a medical diagnosis hundreds of years later, but I think it's a possibility.

At least two of her pregnancies ended in premature births/miscarriages, (there may have been more, as miscarriages in the first trimester were unlikely to have been recorded accurately) and of the three that were born alive, only one (Mary, obviously) survived.

"Prince Henry," I think can be dismissed as a result of high infant mortality, as he did survive for several weeks. Her last pregnancy, however, resulted in a small and weak daughter (although some sources say she is stillborn?).

Healthy infants are possible with this condition, so Mary isn't a problem with this hypothesis.

The only true problem I see with this is that Katherine's mother, grandmother, and sisters all seem to have had no trouble conceiving and bearing live children. Mary, unfortunately, can give us no information either, as she was likely past her fertile days by the time she married Phillip. This condition isn't always an inherited one, but usually there are a few other family members who show symptoms. In my family, for example, my great grandmother and my mother are both good candidates for this condition, and my cousin definitely has it.

Anyway, this is just a thought that came to me.

People always make a big deal over Henry not being able to have children, when in reality he may just have had rotten luck with the women he bedded. Katherine may definitely have had some kind of uterine malformation, in my opinion, Anne's miscarriages were quite possibly the result of the Rh factor, and poor Jane Seymour never had a chance to prove she could continue to bear him children.

[Ed. note - other threads on the reproductive issues of Henry and his wives listed below]


Elizabeth M. said...

Could the condition first showed up with Catherine? It is an intriguing possibility, and I have long wondered if she had some type of condition which made pregnancies difficult. From 1510 to 1518 she had no real trouble conceiving--though there was a nearly 2 year gap in between Mary and the last baby daughter that was either stillborn or died soon after birth and then she never conceived again.
Is there another possibility that she may have suffered from some sort of internal damage during the birth of the New Year's Boy that affected her childbearing ability from then on?

Anonymous said...

Katherine's pregnancies went as so:
1510 - stillborn girl
1511 - Prince Henry. Died 52 days later.
1513, Premature boy, stillborn or short-lived.
At the end of 1514, she delivered another stillborn son.
1516 - Mary.
1518 - stillborn daughter in November.

Only .4% of women in the world today have a bicornuate uterus. Therefore, I strongly doubt that was the problem.

My guess is that it was a comination of different things that caused all of the miscarriages and deaths. Stillbirths can be caused by bacterial infections, birth defects, chromosomal aberrations, maternal diabetes, high blood pressure, ICP, maternal consumption of alcohol, placental abruptions, physical trama, Rh disease, and umbilical cord accidents.

And they couldn't do anything to fix it back then. She was just unlucky.

I'm also in favor of the Henry having syphilis theory, but I've heard that it's been sort of discredited.

Anonymous said...

The theory that Henry VIII had syphilis has indeed been largely discredited. Those who first proposed the theory decades ago did so based on how syphilis affects people in modern times. It is today a long-term illness with few and mild initial symptoms.

They failed to consider how it affected people when it was first introduced into Europe in the 1490s. If Henry VIII had contracted syphilis, he would have done so well before about 1520. At that point the epidemic was still in its very earliest stages and was still characterized by dramatic initial symptoms and rapid death (see Jon Arrizabalaga, John Henderson, and Roger French's "The Great Pox: The French Disease in Renaissance Europe," Yale Univ Press, 1997).

Neither Henry nor Katherine of Aragon died of syphilis. Nor did any of his four known children die from syphilis, though they would likely have contracted it at birth from their respective mothers had those mothers had it. And syphilis was easily recognized and diagnosed during the period, despite the limited medical knowledge of the day. Surely had Henry had syphilis, at least one of his many wives or mistresses would have contracted it from him and later been diagnosed with it. But since none were, it is very unlikely that he had it or that he transmitted it to Katherine or any of his other wives or mistresses.

Emily Z said...

Hi hilary,

I admit, it is a rare condition, I just thought it was an interesting possibility that I had never heard addressed in regards to Katherine.

However, the statistic you quoted isn't exactly correct, because we don't know how many women have this condition.

Only recently have doctors been able to reliably diagnose it. For example, my great grandmother had miscarriage after miscarriage after miscarriage before finally being able to bear my grandmother. Her numerous pregnancies that all ended in either miscarriages or stillbirths caused to her adopt after the birth of my grandmother. She was never diagnosed, but she is a strong candidate for the condition, and I was intrigued at how similar her situation was to Katherine's.

Also, not EVERY woman with a bicornuate uterus has problems, and therefore, not every woman with a bicornuate uterus is diagnosed. I know a woman, for example, who had three kids before getting her tubes tied - during the procedure the doctor noticed that she was bicornuate.

If you're lucky enough to NOT have complications, you're probably not ever going to know if you have the condition or not, as it's not a condition that is screened for.

Again, I'm not saying, "Oh my god! I think Katherine had this condition!" I'm just saying, "Hey, I know of this condition, and the complications seems pretty similar to what Katherine went through - what does everyone else think?"

We will obviously NEVER know.

Anonymous said...

If you look up Uterine malformation on Wikipedia, it gives several other malformations that might be present in a uterus.

It has a 16% prevalence in women with a history of miscarriages.

Indeed, I know Wikipedia is not a reliable source, but that fact is cited.

So indeed, I did not mean to discredit you, Emily. It is entirely possible.

And it sucks that we'll never know.

I still think the problem was in Henry, though. His four recognized children to survive to adulthood were sickly. And they each had a different mother.

Foose said...

I think Henry gets blamed because of all the wives. When you first hear "six wives," you can't help assuming that surely he must have had a lot of children. When you learn that only three of the wives left one child each (apart from miscarriages and infant deaths), you tend to focus on the man as the problem, which is unfair.

Francois I of France had about 7 children by his first wife, of which only 2 were living by the time he died. He had no children at all -- not even a rumor of a pregnancy -- by his second wife, and despite numerous mistresses he only had one attested illegitimate child. But people don't tend to focus on "What was wrong with Francois I?" (Although here the syphilis accusation might have some merit.)

Charles V, another Henry contemporary, left 1 son and 2 daughters (like Henry), and never married again after his wife died when he was about 38. (He did have two illegitimate children.) One legitimate son seems risky, frankly, but he never seems to have been worried enough to get married again, unlike Henry - the need to get a "Duke of York" is a theme that crops up in official correspondence and testimony post-Jane Seymour.

James IV of Scotland left one legitimate son (again, preceded by a number of infant deaths among the legitimate children, and a huge number of thriving bastards), and that son left only one legitimate daughter (two boys dying in infancy, lots of illegitimate children again surviving to adulthood). You can mark Henry down for not having a huge number of illegitimate children, like his Scots relations, but aside from Henry I "Beauclerc" this was perfectly in keeping with the English royal tradition.

So Henry VIII is rather unfairly judged. His ultimate progenitive record was respectable by the standards of the time. The only super-successful patriarch in that set was Charles's brother the Emperor Ferdinand, who left something like 15 or 16 legitimate children by one wife. (Gustavus Vasa of Sweden did well, too, with three wives, but the second wife had all the children but one.)

But again, it's the fact that Henry married all those wives. It tends to draw attention to the fact that only half of them had successful pregnancies, even though Anne of Cleves quite possibly remained a virgin throughout her marriage to the king.

With all Henry's obsession with the divine prohibition "They shall be childless" during the Divorce, I wonder if he ever started obsessing about it again during his marriages to Catherine Howard and Katherine Parr. He wasn't married to his brother's wife with these women, of course, but he seems to have gotten rather gloomy when Catherine Howard failed to conceive, and perhaps felt he was under divine disapproval for some reason yet again.

Emily Z said...

hilary -

Sorry if it sounded like I was going on the defensive.

I do think that other uterine malformations are quite possible as a reason for Katherine's problems, this just happens to be the one that I'm most familiar with.

And I think that Henry's "childlessness" was probably, as I said, a result of the wives he chose, and possibly partly a result of his own reproductive ability.

As I've stated, I think Katherine likely had SOMETHING wrong with her, be it uterine malformation or something else. It isn't the high number of miscarriages/premature births that is troublesome about her, but rather that she had these troubles before being able to carry Mary. Normally you see increasing pregnancy difficulties as one gets older, not the opposite. Too bad we do not have more information on the actual pregnancies, and not just the results of the deliveries.

Anne, as many have stated, and I agree with, may have suffered from effects from the Rh factor. Or, another possibility, she was well into her thirties by the time she started bearing Henry children - it's likely her fertility was also decreasing after she gave birth to Elizabeth. (I think most historians think she was born around 1501 now? I know for a while a later date was floated around)

And Jane....Jane could have been Henry's saving grace if she hadn't died.

Anne of Cleves, as stated previously, likely never "knew" Henry. Katherine Howard was only married to Henry for about a year and a half, and it's possible by then that Henry, whom I think is an excellent candidate for type 2 diabetes, was likely suffering from impotence.

And Katherine seems that by then even Henry himself had no expectations of children, so I think that by then he knew that something was wrong with himself reproductively.

So, in short, Henry's "childlessness" was probably a result of a number of factors - not just his wives' problems or his own.

Anonymous said...

The fact her parents and sisters didn't have problems with conception it is irrelevant.

Catherine could have caught it off of Arthur whom is roumoured to have had it ( her first husband and henry's brother) and given it to henry.

some people are carriers and not shown in other than their lack of and problems with conception.

Just a thought.

Anonymous said...

Hilary said...
Hilary mentioned in her post that a possible cause of miscarriage could be maternal alcohol consumption...
i am just reading the book, 'Katherine of Aragon.' by Patrick Williams. in this book it mentions that Katherine was warned against drinking the water in England because it was dangerous for ones health and was advised to drink only win. If that was the case, then katherine would either have been continually drunk or would have built up a high tolerance to alcohol similar to an alcoholic. This practice could have been injurious to the developing feotus...