The lithotomy position is often used in Western cultures for childbirth – but what is it? The lithotomy position involves lying on your back with your legs elevated. The evolution of the maternal birthing position is explored further by Lauren Dundes, MHS in the AJPH May 1987, Vol. 77, No. 5.
In Europe until 1550, midwives were the only professional caregivers attending births. When looking at 16th Century depictions of birth, you can see many images of women birthing on chairs, squatting position or kneeling. So, why did this change? Francois Mauriceau (1637-1709), a French physician began as a pioneer for the reclining position in birth, he claimed this position would be both more comfortable for women and more convenient for those attending the birth. In his book 'The Diseases of Women with Child and in Child-Bed' 1668 he stated "the woman being ready to be delivered, should lie on her back upon it, having her body in a convenient figure".
King Louis XIV (1638-1715) further secured this change in birthing position as he 'reportedly enjoyed watching woman give birth' and became frustrated by the obscured view. This was a huge contributing factor to the change as royalty undoubtedly had a huge influence on the public and ultimately the fashion for giving birth.
The adoption of this birthing position was not based on sound scientific research but actually a position was implemented without any proven benefits except being more convenient for others - not the birthing person!
When giving birth you can actively participate - birth is not something that is done to you. When you explore the physiology of birth and the muscles of the uterus we can explore more effective birthing positions that make use of gravity to support child birth.
These positions include anything where the birthing person is upright, forward and open.
Leaning over a birth ball
There is a physiological and psychological benefit to giving birth in these positions where possible to allow for the use of gravity and making the most amount of space in the pelvis.