Were women supposed to give birth against gravity? Expert explains

For thousands of years, women have given birth in positions that allow gravity to pull down the baby, however, these positions have become less popular with time.

Kneeling or crouching positions gave way to lying down flat on a bed and pushing the baby out of the pelvis without gravitational force which made the process easier.

Upright positions were generally recommended to shorten labour as it involved less physical effort by the mother, causing the baby to easily descend through the birth canal.

However, more women are opting for a supine position (resting position where a person lies flat on their back) with their face upwards.

The optimal position for birthing has remained disputed for a long time, some saying giving birth in a resting position could increase risk of extended labour, others finding it to significantly reduce the risk of neonatal mortality.

Instinct is to lean forward

Women post industrialisation are increasingly opting for recumbent positions, much of it could be to support the medical procedures, said a report published by the BBC, saying the position allows the physician to play an active role in childbirth and is convenient to monitor.

As per the report, if women in labour are left to their own devices, they would naturally lean forward on their hands and knees as opposed to lying on their back.

It brings the question of what made mothers change the instinctive method of birthing.

As per a study, there are several benefits of giving birth in an upright position, including less dependency on the epidural anesthesia and a small reduction in the duration of second-stage labour.

However, the same study cautioned against the increased risk of blood loss associated with standing positions.

As per another study quoted by the BBC, mothers who gave birth in centres that provided balls, bean bags were more likely to try out birthing in an upright position up to the second stage of labour.

However, those who gave birth in a ward with just a bed to lie on were more often giving birth by lying on their back.

Monitoring outweighs gravity

One reason prompting mothers to take an upright birthing position is gravity because it is beneficial to the process.

Sometimes, the benefits of gravity are not enough to ensure a safe childbirth.

Doctors are saying it can ease down the pull but is ineffective in cases of obstructed labour, blockage preventing the baby from getting pushed out of the pelvis.

Speaking to DH, Dr Vaishali Sharma, a senior gynecologist and fertility specialist (AIIMS) said: “Earlier, neonatal mortality was largely due to obstructed labor and infections, where gravity alone could not make a difference. With advancements, we began actively monitoring labor, tracking cervical progress, fetal head descent, and fetal heart rate and even allowing timely interventions when needed.”

"It ensures a sterile environment, and allows immediate medical or surgical intervention when needed. It also helps us to manually optimize pelvic dimensions in positions like knee-to-chest at 90 degrees, especially in complicated situations such as shoulder dystocia (obstructed labour)," added Dr Sharma.

The expert said though gravity plays a role in pulling the baby down, it is far less significant in comparison to the combination of uterine contractions, maternal pushing and a clear diagnostic view of the birth canal on an adjacent screen.

"With younger women having greater risk of diabetes, hypertension and liver disease, monitoring becomes an important part of childbirth," said Dr Sharma.