Before you read this post I recommend reading my literature review comparing supine and flexible sacrum birthing positions here. That paper was written in fall 2023 for a 300 level writing in the sciences course that I greatly enjoyed. I've never given birth but I was present at the home birth of my little sister, and grew up with lots of baby cousins and listened to their moms discussing motherhood frequently (note: in this post and in the birthing position literature review I use very cis oriented language referring to birthing persons as "mothers" and use she/her pronouns, obviously cis women are not the only people who give birth, but for simplicity and clarity's sake I will continue to use she/her pronouns and the term mother to refer to those who give birth). The idea for this literature review came from talking with my friend who wants to become a midwife about our general dislike of the traditional hospital birthing process. We are biased against traditional western childbirth practices, but if you research the topic it becomes clear that we are so right!!
The American healthcare system is totally wack (don't even get me started on the COST of giving birth at the hospital), but I find that our childbirth system is totally focused on the health of the baby at the detriment of the mother. I attribute the dominance of supine birth positions to many things
This is actually so crazy. For all of human history we did not have hospitals like we have for the past 100 years (Jimmy Carter was the first president to be born in a hospital in 1924 because his mother was a nurse), so pregnancy and childbirth did not involve the high level of medical monitoring and intervention we have now. The advent of modern medicine has changed the way we view pregnancy, childbirth, and babies because so many fewer women die in childbirth and babies die in general. However, this also means that a majority of pregnancy care and childbirth solely involves medical professionals and takes place at the hospital, as opposed to in the past when women and girls were often involved in the pregnancy and childbirth of their friends and relatives. If you lived in a village in 1300 it's pretty fuckin likely you saw someone give birth, but now hospitals are these monolithic buildings where pregnant women go in and then come out not pregnant + an infant. I think this lack of firsthand birth experience is a huge disservice to anyone giving birth because they go in blind relying on stories they've been told and information from their doctor. If I had seen ten babies delivered while their mother squatted to bear down, I'd be much more likely to strongly advocate to give birth in an upright position, but many women have never seen someone give birth, which makes it much easier for the supine position to continue to be dominant across the US (regardless of how shitty it is comparitively).
I don't blame them that is where the party's happening, but they are not the ones trying to push out a baby! The supine position has been so popular for so long that almost every portrayal of childbirth in media is of a woman sweating and screaming while laying down in bed, and almost every delivery room in america is arranged to encourage mothers to give birth laying down. By placing a hospital bed (like for sick people) in the center of the delivery room, the entire delivery environment is immediately supine centric. This is further encouraged by the cervix dilation checks done while the mother is laying down, and the commonly wired fetal heart rate monitors, literally tethering the mother to a supine or sitting position. The problem with spending your entire delivery in a bed is that your weight is continuously on your tailbone, shrinking the pelvic opening that the baby needs to pass through. So while the supine position makes monitoring the fetus and progress of the birth much easier for the medical staff, it makes the birth canal smaller and makes the second stage of labor (pushing out the baby) last longer and hurt more.
I have seen many penises on the big screen, but never in my life have I seen a vulva. There are so many cultural connotations with the vulva and vagina that it has hands down the largest nudity taboo, which is quite unfair for the birthing mother who is not only dealing with the physical pain of pregnancy and childbirth, but also the cultural shame we have attached to her genitals. Your vagina is rarely seen or touched by others consensually outside of sex, and when it is, that is usually at the doctor/gynecologist and it is not a pleasant experience (i hate you speculum). Then when you are pregnant there is a huge uptick in vaginal examinations, with a grand finale of pushing an entire human baby out of it while your vulva is out for everyone to examine and see at anytime. The supine position allows the legs to be closed to hide the vulva, and is the familiar position that vaginal exams are conducted in, as opposed to lateral or kneeling positions where your vulva is OUT for the world to see. I'm not saying that our cultural vagina modesty leads to embarassment during every childbirth, but I know if I saw more vulvas in my life I'd be much less scared for people to see mine
childbirth has been swept tidily into a little corner of our lives called The Delivery Ward and when weirdos escape (home birth? birthing retreat? natural birth? water birth?) they are often derided as stupid for risking the life of their child by not having them in a hospital, but having a baby at the hospital fucking sucks. Yes there are many women and newborns whose lives are saved from complicated births by modern medicine, but modern medicine needs to cater to the one giving birth because the current chilbirth system is not focused on reducing maternal pain and injury nearly as much as it is on convenience for medical staff. Also having a baby should be free not cost eighteen thousand dollars