A week ago, in episode 4 of the third season of Downton Abbey, American fans witnessed the tragedy British viewers had already seen—Lady Sybil’s death from eclampsia after childbirth. This week—SPOILER ALERT—episode 5 exonerates Lord Grantham of any role in the fatality and ends with he and his wife sobbing in each other’s arms. The resolution may be emotionally satisfying and medically sound. But it undercuts what is to my mind the most valuable feature of the episode entitled “Doctors’ Disorder”—its implicit defense of women’s reproductive rights.
Broadcast four days after the 40th anniversary of Roe v. Wade, Sybil’s death suggests the urgent need to continue the fight for freedom of choice. Granted, Downton Abbey is produced in England, where the National Health Service provides abortions and where Roe v. Wade is legally irrelevant. And granted, the series takes place in the early 20th century when women could not vote, much less have legal access to birth control—a time when Lord Grantham is appalled by the mere mention of the word “womb” (episode 4) and when it is scandalous for Lady Grantham and her daughters to be served a meal by Ethel, who had a “bastard child” (episode 5). And granted, Sybil dies of eclampsia, not a botched abortion.
Nevertheless, a television show, like any textual production, is influenced by the context in which it appears as well as by the author’s intent. And in America, Sybil’s death in childbirth offers a cautionary tale about the battle currently being waged over pregnant bodies.
For most of Downton Abbey, Lady Sybil was the ideological outlier. In the first season, she helped her maid get a better job as a secretary; in the second season, she worked as a nurse on the home front and then eloped with Tom Branson, the Irish Catholic chauffeur. Sybil’s sympathy for lower-class characters (she is so nice to the evil servant Thomas that he cries at her death), her rejection of the British aristocracy and empire in favor of a working-class Irishman, and her insistence on finding professional work all signal her liberal ideals and feminist sympathies.
In “Doctors’ Disorder,” she meets the opposition in the form of her loving but conservative father. Lord Grantham hires Dr. Sir Philip Tapsell to deliver the baby, despite Lady Grantham’s desire to have the family’s practitioner (and regular cast member) Dr. Clarkson perform the honors. The socio-political and gender conflict is obvious. On one side we have the nouveau riche American mother and the country doctor; on the other is the power couple, Lord Grantham and the “knighted and fashionable” Sir Philip Tapsell. In between is the pregnant Sybil, and we can already guess her fate.
The sparring begins in earnest when Dr. Clarkson detects the signs of Sybil’s pre-eclampsia and wants to perform a caesarean birth. Sir Philip assumes her “distress” is typical for any woman giving birth. But the episode transcends professional rivalry and even Sybil’s medical best interest: It concerns Dr. Clarkson’s respect for—and Sir Philip’s indifference to—Sybil’s independent personhood. In a telling moment, Clarkson draws Sir Philip’s attention to Sybil’s swollen ankles, a common sign of pre-eclampsia. “Maybe she has thick ankles,” Sir Philip responds. “Lots of women do.” But “she does not,” Clarkson says, because he knows Sybil as an individual. “You believed [Sir Philip],” Lady Grantham,” furiously reminds her husband in episode 5, “when Dr. Clarkson knew Sybil’s history and he did not.”
It is “Sybil’s history” that matters so much to Lady Grantham—the 24 years and personal experience that precede her pregnancy and that Sir Philip, and by extension Lord Grantham, arrogantly disregard. Lord Grantham loves his daughter “terribly” (as Sybil says shortly before she dies), and he hires Sir Philip because he thinks him the better doctor. “I will not put Sybil at risk on a whim,” he declares. But in the decisive moments during Sybil’s labor, only Dr. Clarkson knows and respects her enough to distinguish Sybil the woman from her pregnancy. By empowering Sir Philip, Lord Grantham seems to minimize his daughter, and this is partly what Lady Grantham cannot forgive.
At the end of episode 5, we learn that Sybil was doomed regardless. Under orders from the Dowager (the irrepressible Maggie Smith), Dr. Clarkson researches caesarean survival rates for eclampsia and is forced to admit that “in all likelihood [Sybil] would have died anyway.” Hence Lady Grantham absolves her husband of blame. But the revelation does nothing to resolve the original neglect of Sybil’s personhood, even if that did not directly kill her.
“Doctors’ Disorder” also raises explicit questions about choice. When Sir Philip rejects Dr. Clarkson’s recommendation of a caesarean, Lord Grantham reflexively dictates that they follow Sir Philip’s orders. Lady Mary reminds him that “it is not our decision,” and they have to consult Sybil’s husband Tom. Lord Grantham turns in exasperation to his mother, who, as is typical, delivers the punch line: “The decision lies with the chauffeur.”
Of course nobody asks for Lady Sybil’s decision about her body. Given the time period and Sybil’s toxemia-related hallucinations, the oversight seems justified. But we might read Lady Grantham as a stand-in for her daughter. She is the only other woman in the scene who has been pregnant (the Dowager Countess is not present), and she hysterically tells her son-in-law, “I would have taken [Sybil to the hospital] an hour ago!” Her decision, like her daughter’s, is ignored. The baby is born at home, the mother dies and the loop of female loss seems endless: Lady Grantham loses her “baby” (as she keeps calling Sybil), and Sybil’s baby, herself named Sybil, loses her mother.
“Doctors’ Disorder” suggests the perils of interfering with a woman’s reproductive choice. In Sybil’s case the interference has nothing to do with preventing an abortion (though Sir Philip promises Lord Grantham “he can bring [Sybil] through it with a living child,” hinting at the priority placed on the latter’s life). The more basic problem concerns the reproductive control exerted by the characters with the most political and socioeconomic power and the least understanding of the pregnant woman’s perspective. Why, the episode asks, should they be entitled to decide her fate?
Attacks on Roe v. Wade threaten all pregnant women. As Lynn Paltrow, executive director of the National Advocates for Pregnant Women, and Fordham University sociology professor Jeanne Flavin have recently shown in a major study of 413 cases between 1973 (the year of Roe’s passage) and 2005, “post-Roe anti-choice and ‘pro-life’ measures” that treat eggs, embryos and fetuses as separate persons are just as harmful for women planning to bring their pregnancies to term as they are for those seeking an abortion. Fetal personhood measures are “providing the basis for arresting [pregnant] women, locking them up, and forcing them to submit to medical interventions, including surgery.” For instance, a Washington, D.C., court ordered a critically ill woman “to undergo cesarean surgery over her objections”; both she and the baby died. In Wisconsin, a civil court ordered “protective custody” for the fetus of a woman who wanted to be delivered by a midwife, about whom a doctor had concerns:
The order authorized the sheriff’s department to take the woman into custody, transport her to a hospital and subject her to involuntary testing and medical treatment.
Poor women and African-American women are especially vulnerable. In several cases, African American women suspected of cocaine use have been “taken straight from their hospital beds and arrested shortly after delivery, [and] taken in handcuffs, sometimes shackled around the waist.” A separate article by Paltrow concludes,
Attacks on Roe threaten all pregnant women not only with the loss of their reproductive rights and physical liberty but also with the loss of their status as full constitutional persons.
Of course Sybil is not chained to her bed; she is not taken by a sheriff to the hospital, or forced to undergo a fatal cesarean (indeed, the doctor who wants to perform the cesarean is overruled). Nevertheless, Sybil’s powerlessness over her body and Lord Grantham and Sir Philip’s refusal to honor her mother’s choice—standing, as it does, for the closest approximation of what Sybil might want—are evocative of the current dangers facing women’s reproductive health. In the wake of Roe v. Wade’s 40th anniversary, Sybil’s death reminds American viewers of the tragedies accruing with each new assault on women’s rights.