Chapter 2 : Evidence
I showed the historical evidence to Suzanne Schuld, a registered nurse of over thirty years’ experience of critical care and emergency medicine; she in turn showed it to her colleagues, Melissa Rockefeller, MD, Karen Maury, MD, and Michele Sequerra, MD. I also showed the evidence to Sylvia Howard, a midwife with decades of experience. I am enormously grateful to these five medical experts for their ground-breaking theories and opinions, which shed new light on why, and how, Jane Seymour died, and which inform the final pages of my novel. Any mistakes in my interpretation of the information they gave me are mine alone.
As I suspected, there were almost certainly two distinct illnesses, and the first was probably food poisoning – my original theory. In regard to the second illness, as there was no report of fever, endometritis (puerperal fever) or puerperal sepsis (which have similar symptoms) seem unlikely. Sepsis cannot be entirely excluded, although the doctors were sceptical as there was no documented fever, and there are other clues that make it more likely that Jane died from a combination of other factors. If she had developed endometritis shortly after giving birth, there would have been progressive deterioration, and it is doubtful that she would have been well enough to host the christening reception, or felt like eating rich foods.
On the evidence we have, death was probably due to a combination of dehydration and embolism, leading ultimately to heart failure.
Possibly Jane had a thrombosis in a leg or in her pelvic circulation, and pieces broke off and migrated to her heart and lungs. Rushing to the close stool while suffering from food poisoning, or getting up to enable her servants to clean or change her bed, might have dislodged a piece of clot.
Embolisms do not always lead to instant death, and not all are fatal. Jane could easily had one or more small ones that would have put a strain on her heart and respiratory muscles and worn out her ability to breathe, especially if she had less oxygen-carrying capacity due to anaemia. It might be significant that she had 'skin is so whitish that it may be called rather pale’, which may indicate that she was anaemic. When she was pregnant with Edward VI, she had a craving for quails, which have a high iron content. Many experts think that some women crave the nutrients their body needs.
A woman can become vulnerable to iron-deficiency anaemia after repeated pregnancies and miscarriages. Each pregnancy can place a high demand on a woman’s stores of iron, and the foetus and vital organs, such as the muscles that facilitate childbirth, can be starved of oxygen. Left untreated – and the condition was unknown in Tudor times – iron-deficiency anaemia can have serious implications for the health of mother and child. It can lower resistance to infections, increase the risk of premature labour, lead to maternal death, and make a woman far more vulnerable to an embolism.
If an anaemic woman becomes pregnant, the ova stored in the ovaries can weaken over time and become unviable. It can prevent the growing cells of the foetus from dividing and growing properly, which may result in a miscarriage, which in turn can exacerbate the anaemia. It is possible that Jane Seymour suffered one, possibly two, miscarriages before she became pregnant with Edward.