The fourth season of The Gilded Age begins with Duchess Gladys Russell, portrayed by Taissa Farmiga, confronting severe challenges following her arranged marriage to Hector, the Duke of Buckingham. While the couple eventually found a genuine connection after moving to Sidmouth Castle in England, the premiere episode immediately plunges viewers into an intense situation as Gladys struggles through childbirth across the pond.
Farmiga described her reaction to reading the script for the first episode, noting that despite Gladys' privileged life, the character receives no respite. The actress recalled thinking about how difficult the experience would be for a woman who had already endured an emotional roller coaster throughout Season 3, forced into a marriage she initially feared would be a nightmare. Although Farmiga believed the season would start from a place of happiness and contentment given their true love match, the first moment viewers see Gladys is undeniably intense.
The episode depicts a critical medical crisis during labor where a breach birth threatens both mother and child. The attending doctor warns that the Duke may be forced to choose between saving his wife or his baby if complications arise. Fortunately, Bertha Russell, played by Carrie Coon, is present at the castle to witness the ordeal. However, it is Gladys' lady's maid, Adelheid Weber, who ultimately saves the Duchess's life by noticing continued bleeding after birth and summoning Mrs. Russell and Dr. Thomas.
The medical intervention comes with a drastic consequence: to stop the hemorrhage, doctors must remove Gladys' uterus, meaning she will never be able to give birth again. The doctor informs Hector of this outcome, advising him to let Gladys heal before sharing the news that her life was saved at the cost of her fertility. Bertha consoles the Duke as they process the situation, while also revealing to her daughter that Hector chose to save his wife over the baby when faced with the impossible decision.
Carrie Coon praised Farmiga's performance and stamina, noting how her ability to deliver such intense scenes makes the work easier for fellow actors. Coon reflected on the emotional weight of the episode for Bertha, who nearly lost her daughter and grandson within a year of almost losing her husband. According to Coon, these near-losses have made Bertha's priorities clearer than ever before.
Sources: Deadline.