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The birth of a new child in the British royal family is a special occasion – but it’s one that needs a lot of planning. And when Kate Middleton was preparing for second child Charlotte, she had an in-depth plan for the event. But given that she and husband Prince William had arranged a specialist team for the birth, it may surprise you what actually happened.

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William – who is second in line to inherit the U.K. throne – married Kate Middleton in April 2011 and the two became the Duke and Duchess of Cambridge. As a result, it wasn’t long before they had a child who would be next in line to become king or queen. Kate announced her first pregnancy in December 2012. And despite complications caused by extreme morning sickness, she had Prince George in the following July.

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But George would not be an only child for too long, as late in 2015 it became known that Kate was pregnant with what would turn out to be a sister. The duchess again struggled with morning sickness fierce enough for her health to be a concern. However, the whole thing ran according to Kate’s plan, and she gave birth to Princess Charlotte only took two and a half hours after entering the hospital.

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Apparently, royal births are complicated affairs. In the earlier days of the British monarchy, the main focus was on the fate of the heir to the throne more than the health of the mother. Officials and ministers would gather in the room to make sure no one had plans to replace a stillborn child with a living, non-royal one.

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Naturally, the last thing a woman in labor wants is a bunch of people in the room watching her intently to see if she’s about to commit treason. And it took a long time for this practise to be abolished; Prince Charles was the first royal baby born without politicians keeping an eye on the birth.

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Poor Queen Marie Antoinette of France could have been killed during childbirth as her courtiers considered it to be practically a spectator sport. When it was announced that she was going into labor, hundreds of people crammed into her room and she reportedly fainted from the heat and stress.

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But the struggle of royal mothers during childbirth goes way further back than Marie Antoinette. Apparently, Tudor high society in England apparently didn’t trust midwives very much. Whenever one was hired, she had to swear an oath that she wouldn’t steal the placenta, the umbilical cord or any other sort of post-birth matter. This was because royal families of old worried that people would use those things for witchcraft, according to the Evening Standard.

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In Tudor times those watching the mother would have been been hoping for a boy. Up to that period, there had never been a ruling queen in England and women could only inherit the throne if there was no other option. That’s why King Henry VIII worked his way through so many wives – he was desperate for one of them to give him a male heir.

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Thankfully, the concept of only males being worthy of the throne has also passed. Before Prince George was born, the British government decided to fix the rule which stated that a younger brother would ascend the throne over an older sister. And the law of “absolute primogeniture” came into effect in March 2015.

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These days, fathers are also allowed to be present for the births of their children as well. According to Town & Country Magazine, Charles wrote a moving message to his godmother Patricia Brabourne after he witnessed William’s birth. He said, “I am so thankful I was beside Diana’s bedside the whole time because by the end of the day I really felt as though I’d shared deeply the process of birth. And as a result, [I] was rewarded by seeing a small creature which belonged to us – even though he seemed to belong to everyone else as well!”

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Apparently, the leadup to a royal birth is a chaotic time full of rules and regulations. Even if a royal woman knows the gender of her baby, they will not announce it to the world. In fact, no major royals have to date ever announced the gender of a new child prior to its birth.

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And royal birth announcements often provide a fascinating snapshot of the times. When Queen Elizabeth was pregnant with Prince Andrew in 1959, the announcement read, “[Her majesty] will undertake no further public engagements. [She] deeply regrets the disappointment which her inability to carry out her projected tour in West Africa as arranged this autumn may bring to many of her people in Ghana, Sierra Leone, and the Gambia.”

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The mechanics of royal births were also a squeamish subject in the 1950s. Of course, a new baby was something to be celebrated, but it also meant admitting that royals were willing to have sex as much as anyone else was. And this was a concept that was hard for some stiff-upper-lip Brits to get their heads around.

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Elizabeth herself reportedly disliked the fuss that surrounded the birth of her children. And this might have been another reason for the apologetic statement. She also gave birth at home with medical staff in attendance instead of going to hospital – as is the tradition these days.

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In years gone by, doctors went to the royals – rather than the other way around. When Elizabeth’s father King George VI needed major surgery on his lung, doctors operated on him inside Buckingham Palace. Interestingly, people were kept informed of his condition via bulletins posted outside the building.

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But it was the generation after Elizabeth who really modernized royal births. Her daughter Princess Anne and her daughter-in-law Princess Diana opted not to give birth to their children in royal palaces. Instead, they went to the Lindo Wing at London’s St Mary’s Hospital – and that’s what Kate did too.

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Of course, one of the potential issues that arises with a royal being treated in hospital is the intervention of other people. And some of them have far from noble motives. While Kate Middleton was in hospital during her pregnancy with Prince George, a radio station prank called in and it had terrible consequences.

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The hosts of an Australian radio show called Hot30 Countdown decided to call up the hospital and pretend to be Queen Elizabeth inquiring after Kate. A nurse named Jacintha Saldanha believed the hoax and transferred the call to another member of staff – one closer to Kate. And the whole encounter was played on the radio.

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Jacintha then sadly committed suicide three days after the hospital stunt was recorded. She reportedly left several notes behind and one of them blamed the radio show for her decision to end her life. It later transpired that she’d had mental health issues and had attempted to kill herself twice before.

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Kate and William never publicly commented on Jacintha’s passing – but there were repercussions elsewhere. The radio show was cancelled and some companies pulled their advertising from the entire station. And in India, Jacintha’s country of birth, protesters gathered outside the British High Commission and demanded justice.

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In the end, the Australian Communications and Media Authority held an inquiry into the incident. It concluded that the radio station was at fault – having committed an illegal act by broadcasting the “prank” without the consent of their targets. Indeed, the whole sad story demonstrated how high the stakes were when royals were involved.

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So merely going into a hospital to give birth is a matter of complicated logistics for a member of the royal family. Of course, the security arrangements have to be top-notch. And just before Princess Charlotte was born in 2015, an anonymous insider spoke to the website Hollywood Life about the issue.

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The person explained, “The security plan is much more detailed this time around. There are more bodyguards camped outside the Lindo Wing, and [there is] a private area for Kate – making sure only doctors, nurses and royal family members are granted access. They do not want a repeat of the security breach last time. If anyone calls, there’s a special password they’ll have to enter to be able to talk to family members.”

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During Prince George’s birth, there had been a live feed of the Lindo Wing door – echoes there maybe of the times in history when people piled into an expectant royal’s bedroom. Kate and William forbade that from happening the second time around. And inside, they enacted their birthing plan.

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Kate took the whip hand for the birth, with a source telling U.K. newspaper the Daily Mail in 2015, “What the duchess wants, the duchess gets.” A big team had gathered together and a host of specialists were ready in case of need. The group was dedicated to Kate so that other people’s care would not be affected by the royal birth.

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Despite the team being on hand, though, Kate insisted on being cared for by midwives. Three of them had been standing by for three months to be ready for up to 24 hours’ coverage. Kate had also forged a good understanding with top midwife Jacqui Dunkley-Bent during George’s birth. And she had no hesitation trusting herself and baby to her care and that of her colleague Arona Ahmed. Indeed, this relationship worked out perfectly as the medical team were not needed and the birth was a total success.

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The Mail on Sunday subsequently reported on what had happened behind closed doors. The newspaper wrote, “While the male doctors waited in a nearby room, it was the red-uniformed midwives – the color denotes their seniority – who monitored Kate as her contractions progressed and supported Prince William.”

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The paper also noted, “Both women are experienced, unflappable and have the full confidence of the obstetricians.” And this is certainly correct. Jacqui Dunkley-Bent is Professor of Midwifery at Imperial College Healthcare NHS Trust, and Arona Ahmed is a lead midwife who received award nominations for her ability to take care of patients.

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The two midwives didn’t share details to the press – but an unnamed insider did. An anonymous person told Us Weekly magazine that Kate had kept Jacqui and Arona on call for a month prior to her expected delivery date. But the actual birth of Princess Charlotte went very smoothly.

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The insider told Us Weekly that the duchess had been in labor for two and a half hours and had given birth to Princess Charlotte without an epidural. According to them, the fact that things were over with so fast was “a surprise to all” and the duke and duchess were “both so happy.”

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After doing the traditional posing for the press in front of the Lindo Wing, Kate and William took their daughter home. Then for the next few days, friends and family members dropped by to see the proud parents. The duchess’ mother and sister came, and not long after that Jacqui also visited the palace.

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Spokespeople for William and Kate then released a statement to the media. It read, “The duke and duchess are hugely grateful for the messages of congratulations they have received from people all over the world. It means a great deal to them that so many people have celebrated the arrival of their new daughter.”

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In 2018 other members of Kate’s medical team talked to Town & Country Magazine about Princess Charlotte’s birth. Professor Tiong Ghee Teoh said, “For anything that could possibly go wrong we had a team of people behind each speciality. Everyone was sworn to secrecy about who it was.”

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And another member of Kate’s team, anesthesiologist Dr. Johanna Bray, told the magazine, “We were on call for three months. You never know when you need to be called – you need to be in town and available. If you are at a party you need to have your car keys at the ready. No drinking!”

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Kate actually ran into her friend Jacqui Dunkley-Bent again in 2018 while she was pregnant with Prince Louis. The two women shared a hug during an event where the duchess was made patron of the Royal College of Obstetricians and Gynaecologists and the Nursing Now campaign.

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And everything went smoothy when Kate gave birth to Prince Louis. Reportedly, Jacqui and Arona Ahmed were on hand to help her out again. Within the space of six hours, Kate had given birth to her third child. Once more, she and her husband presented the baby outside the Lindo Wing.

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In recent years, the Duchess of Cambridge has made it very clear how much she values the work of midwives. In December 2019 she wrote an open letter to the midwives and nurses of the UK which was published on the Royal College of Midwives’ website. Apparently, Kate had spent a few days shadowing midwives at the Kingston Hospital’s Maternity Unit.

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Kate wrote in her letter, “You don’t ask for praise or for recognition but instead unwaveringly continue your amazing work bringing new life into our world. You continue to demonstrate that despite your technical mastery and the advancement of modern medicine. It is the human-to-human relationships and simple acts of kindness that sometimes mean the most.”

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And at the very end of her statement, Kate said, “So as we look ahead to next year, I want to thank you for all that you do. It has been a real privilege learning from you so far, and I look forward to meeting and learning from even more of you in the coming years and decades.” And Professor Jacqui Dunkley-Bent naturally commented on the letter.

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Jacqui told the BBC, “It is a huge honor for the duchess to recognize the importance of our profession and, as we look ahead to 2020, her support will no doubt be a massive boost for all those working in maternity services as we celebrate the year of the nurse and the midwife.” Indeed, it seems that Kate is giving back.

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