One of Downton’s most beloved characters was the youngest Crawley daughter, Sybil. The sweet but rebellious Sybil fell in love with the family’s Irish chauffeur (an important qualifier, since Ireland and England were not exactly buddy-buddy at this point in history) and they married and had a child together.
In a plot twist required by the actress’ disinterest in renewing her contract, Sybil dies shortly after giving birth to her daughter in the third season. Writers sprinkled plenty of hints that something was amiss: in fact, the family’s trusted doctor (the very Scottish Dr. Clarkson) is constantly at odds with a presumably more “legit” doctor who, in the end, completely misses the signs of Sybil’s distress – eclampsia.
Eclampsia occurs when a woman’s blood pressure rises dangerously high before, during and/or after giving birth. Signs of pre-eclampsia, the state that precedes the more critical state of being eclamptic, may be so insidious that they are misconstrued as harmless. By the time true eclampsia sets in, the course is final — and fatal. Eclampsia itself manifests with severe seizures, a horrific headache, swelling, nausea and eventually fatal hemorrhaging.
The key to diagnosing and preventing eclampsia is keeping a close eye on a mother’s blood pressure reading and testing her urine for protein. In modern day obstetrics, this is part and parcel for prenatal care. But in the early to mid 1900s, the science was imperfect. Differences of opinion and time-wasting ego puffing ultimately lead to Sybil’s death, something that certainly isn’t unique to Downton’s time.
While the show nailed the vagaries of preeclampsia symptoms – which even one hundred years later are still sometimes missed or misconstrued as “normal” pregnancy symptoms in their early stages – both doctors at Lady Sybil’s side somehow “forgot” that magnesium sulfate had been shown to work not only as a prophylaxis for eclampsia, but a potentially life saving treatment as early as 1905. Lady Sybil may have ultimately succumbed anyway, but any doctor worth his salt (no pun intended in regards to MgSO4) would have at least made an attempt to administer a dose, and at the very least should have had it on hand to attend a home childbirth.