Picture this: for thousands of years, across regions from ancient Egypt to rural Asia, women gave birth squatting, kneeling or leaning forward. It was instinctive, effective and shaped by gravity itself. Then, somewhere along the way, that instinct was replaced. And, oddly enough, history traces part of the shift to a French king’s preference.
Accounts from 17th-century France suggest that King Louis XIV preferred observing births from a more convenient angle. Over time, the supine position gained traction in European medical practice and eventually became standard in modern hospital delivery rooms.
The problem is that the human body was never optimised for lying flat during labour.
Gravity is one of birth’s oldest allies. Upright positions such as squatting or leaning forward allow the pelvis to open more fully and assist the baby’s descent. Research from Oxford Academic suggests squatting can increase pelvic diameter by more than 2.5 centimetres, easing the mechanical process of birth.
Evidence supports this. A Cochrane Review (2013), analysing over 5,200 births, found that women in upright positions often experienced shorter labour, reduced need for epidurals, lower rates of caesarean sections and improved neonatal outcomes. In simple terms, positioning matters more than many realise.
Across South Asia, including Bangladesh, older birthing traditions often reflected this understanding. Squatting and vertical labour positions were once common, especially in home births attended by experienced midwives. As childbirth became increasingly hospitalised and medicalised, these practices were gradually replaced by the supine position.
This shift is not an argument against medical care. It is an argument for awareness. Modern obstetrics has saved countless lives, but it also means many women enter labour without knowing that movement and position can significantly influence the process.
Birth is not a passive event. The body is not simply something to be managed on a bed. It is active, responsive and designed to work with gravity, not against it.
The key is informed choice, understanding that lying on the back is not the only option, and in many cases not the most effective one.
