The Alarming Obstetrical History of Queen Anne, Historically Portrayed in The Favourite

Today Queen Anne, is the talk of the town as her story and palace intrigue came to the big screen in the movie the Favourite and the role won Olivia Coleman an Academy Award last night. But to the gynecologists, she has also been known as the Queen. Literally, of miscarriages. As the Queen of Great Britain she ascended to her throne in 1702. At the time she ruled England, Scotland and Ireland, and it was she who untied England and Scotland. Queen Ann’s legacy was destined to only be historical rather than genetic as her obstetrical history was very poor and thus sad. She had no children that lived passed childhood. Medical historians have never established what her actual gynecological problems was. We know many common causes of recurrent miscarriages, and she had 17. It was speculated that she perhaps a double uterus, uterine fibroids, infections, or something more complex such as antiphospholipid syndrome, but she never produced an heir although she had many pregnancies. Some of her pregnancies made it to the second and third trimester, one was a live birth who was able to be baptized. Queen Anne of England had so many miscarriages she would have been labeled a habitual aborter in our time. Gynos now label those who have three or more miscarriages a habitual aborter. In truth, they are extremely common in fertile as well as those who never have a birth to term. Actually once you have 2 miscarriages your chance of miscarrying again is roughly 30%. 80% of miscarriages are in the first trimester of pregnancy, as were most of hers. For each week of pregnancy duration the risk of miscarriage decreases. Queen Anne began her rein with 4 miscarriages, and by the end of her rein she had at least 17 miscarriages, and no heir to the throne, ending her line of ascension. Queen Anne, thus by producing no heirs, went from being the Queen of England, Scotland and Ireland, to ending the line of Stuarts.

Bleeding in early pregnancy is common, between 1/4 and 1/5 women have bleeding and about half of these pregnancies will end in a miscarriage by 20 weeks of pregnancy. The causes of miscarriage are many, although some will not have a firm diagnosis. Most gynos won’t have you performing an evaluation of why you are miscarrying until you have had the first 3 or more early pregnancy losses, but there is a movement to do more extensive testing after a single miscarriage.

Age is a factor. Miscarriage risk roughly doubles between the ages of 20 and 40. Queen Anne’s last known pregnancy was when she was bout age 35. “Unexplained” infertility and “unexplained” miscarriages may also just be the consequence of ovarian aging. With about 10% of women experiencing relatively early menopause before the age of 45. Recent studies showing a decline in fertility about 13 years before the true age of menopause, meaning that these 10% of women would start to experience ovarian aging by 32 and accelerated infertility by around the age of 37. Have you had a miscarriage, was a cause found? For instance, did your gyno check the age of your ovaries?  Many causes are actually treatable, perhaps you can discuss with us at your next appointment.

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Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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