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Oh absolutely! I love toeing the line of realism vs fantasy in romances, but they always need to remain a reliable escape. Worrying about maternal death...not much of an escape! (If you want to read about accoucheurs fictionally, my book is The Governess Without Guilt, and then I also wrote up my research into accoucheurs - which made me cross my legs a lot because it is GORY - for my newsletter subscribers)

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Loved reading this! I read Catherine Called Birdy in 5th grade and was traumatized, but reading your thoughts made me want to revisit it.

Have you read Eloisa James' books Potent Pleasures and Midnight Pleasures? They are her first two books, published in 1999 and 2000, and both contain graphic, traumatic experiences of childbirth on page.

In the first, the heroine nearly dies during childbirth after exhausting herself in a fit of terror, believing that her husband, the hero, will take her child away. She delivers the baby, recovers, and the book ends abruptly and unbelievably 15 pages later.

In the second, the heroine is seven months pregnant when she learns that her baby is dead in utero. The subsequent stillbirth is on page. They have a child in the epilogue.

I don’t think I could recommend either book but, I haven't stopped thinking about them.

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I've been thinking a lot about this lately (in the context of reading about Gothic literature, but also in the TTRPG system I play regularly that often serves functionally as a 'write your own Regency romance novels' game) and I am so thrilled to see this analysis, it's so good and thought-provoking. Thank you.

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Very interesting! Like you said, it is hard to figure out how to make room for this kind of story on page in the romance genre (rather than being flashbacks from a widower's perspective or an adult child thinking about the mother they lost). I wrote a historical romance with an accoucheur (man mid-wife) as the hero. The pregnancy is not the heroine's, and yet even though the mother in question was not actually a main character, I still was very concerned not only that she could not die in childbirth but also that the reader would not be worried that she might die. But as a writer, I also enjoy having these genre constraints as a challenge to write towards/against!

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