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@nana87: I was under the impression that the slip & fall caused it & that lye = soap. It's not like she ingested it.m

Tbh, I thought it was just lazy writing/contrived plot point. I also thought she was way earlier in her pregnancy than 25 weeks ?

I thought it was slipping on the bar of soap that obrien put there too. And yeah I really wondered about how a little fall would make her lose the baby- but it also makes me really carefully getting in and out of the shower.

Btw - the miscarriage was season 1

So now I'm intrigued! Found this site: http://trmbaby.com/fertility-medicine-and-downton-abbey/

Cora Crawley’s Pregnancy and Miscarriage

Background: Despite what must have been at least 15 years of unprotected intercourse, Cora Crawley had not conceived a child after her daughter, Sybil was born. In fact, she was transitioning to menopause, when she was discovered to be pregnant! This is just what Lord Grantham had been hoping for, another chance at a male heir of his own.

Dr. Clarkson explained how all of this happened to the astonished Lord and his wife, saying that age associated menstrual changes can bring about a sudden “surge” in fertility. He also said their was no reason to believe that the baby would not be healthy.

Then tragedy strikes. O’Brien, Cora’s maid, misinterprets several conversations and wrongly believes that she is going to be fired. In a moment of spite, O’Brien hands Cora the wrong bar of soap during Cora’s bath… and within minutes Cora has lost the baby. We learn that it was a healthy boy.

Medical Reality: By all accounts, Cora would be in her 40s when this child was conceived. Since the 1950s, it has been well known that natural fertility actually declines with age. However, it is easy to understand why Dr. Clarkson might say some women have a sudden “surge” in fertility.

Due to elevations in FSH, some women who did not ovulate frequently on their own, may start to ovulate when this occurs. Elevations in FSH can also increase the chance of twins. So Dr. Clarkson is not completely wrong about this “surge.” His statement was consistent with what was generally known at that time.

Also, during this time, it was not widely recognized that older women had more “dyskyesis” or recurrent miscarriage – probably in part because pregnancies were actually more rare in this age group. So Dr. Clarkson’s assumption that the baby should be healthy was based on general medical knowledge and possibly by the tendency of the time to not alarm patients.

So what about soap and miscarriage?

The soap in question is almost certainly lye soap, which is harsh by today’s standards and thus not used much today. It is true that lye injected into the uterus was used as an agent to induce abortions, but soaping up with lye (even in a tub) would not be the cause of her abortion.

The likely cause of the miscarriage was either genetic abnormality of the baby, or perhaps Cora had developed an incompetent cervix or a uterine fibroid that made her more prone to miscarriage.

O’Brien did not cause Cora’s miscarriage, but certainly her foul heart justifies her horror and guilt over the whole affair.