Why do we give birth on our backs? Do you know why? No it’s not because it’s the best or easiest position (it’s not!). Throughout history, women have given birth in upright positions. Being in an upright position allows the sacrum and coccyx to move and flex, creating space in the pelvis for baby to be born. Lying flat on your back restricts this freedom of movement, not to mention baby having to fight uphill against gravity. So WHY do we give birth lying down?
It wasn’t the norm to give birth on our backs until the 1700’s. For thousands of years women have used instinct to get in to the best position for labour... upright, squatting, forward positions. In the 18th century, women would give birth sat on birthing stools. Midwives in attendance would be near the floor to watch the baby being born. French King Louis XIV, who fathered 22 children in his lifetime, had a perverse desire to watch his wives and mistresses give birth, but kings did not bow and scrape. He became frustrated with his inability to watch his mistresses birth his children, his view obscured by birthing stools, so he insisted they were born with their mothers lain on their backs, legs apart, so he could have a better view.
And of course, because royalty gave birth like this, everyone copied them, and giving birth on your back became the fashion. This position became the norm across Western Europe and the rest of the western world. Combine that with what modern media shows us of birth, predominantly women in a hospital setting on their backs, and the increase in medical interventions and monitoring requiring us to lay on a bed, and the reclining lithotomy birth position has become “normal”.
But it’s important to know that just because there’s a bed, we don’t have to get on it, and there is a multitude of other positions we can use throughout labour both for comfort and to facilitate the progression of labour. Upright, forward and open positions are the most optimal.
So in answer, why do we give birth on our backs? It’s NOT for the benefit of the person giving birth. It’s for the benefit of everyone who wants a good view!