Birth: The Surprising History Of How We Are Born


If you ever find yourself saying – “(Sigh) I wish I lived during such-and-such time instead of now” – read the book, Birth: The Surprising History Of How We Are Born, by Tina Cassidy. I think I read half of it with one eye open, the other not wanting to know all the details of what I was reading. Never have I had such a simultaneous appreciation of what our bodies are capable of and how amazing modern medicine can be.

It’s also a great book for anyone that is considering being a parent, or is just interested in the topic. Ms. Cassidy pulls back the veil on what used to be, and in many ways still is, the mysterious and miraculous process of bringing a new life into the world. Until recently, in many societies, pregnant women were supposed to stay out of sight, and in some cultures – like the !Kung of the Kalahari Desert in northeastern Namibia – women were even supposed to give birth alone. My 92 year-old grandmother was commenting the other day that when she was growing up, once a woman got pregnant you didn’t see her because until she gave birth, she would hardly leave the house. Women being able to just go about their business as usual while pregnant is actually a relatively new idea.

Birth also covers the tensions and occasional all-out battles between midwives and doctors over the last few hundred years. Most of the time midwives were supported and respected for their services by their communities. At some points they were even revered, attending to royalty during their births, but at other times they were burned at the stake as supposed witches.

Below are some more highlights from the book:

Babies are born helpless and wailing because our pelvises have “hit a wall” with their size and shape. Because we are a species that walks upright, our pelvises need to be a certain way. One of our fellow primates, the howler monkey, is in labor for just 2 minutes and their babies come out already understanding how to feed and cling to their mothers. Humans, on the other hand, can be in labor many hours – even days – and human babies have little knowledge about how to do anything. Human babies are born with underdeveloped brains, but that is because if their heads were any bigger they would not be able to fit through the birth canal. Some scientists have suggested there is a “fourth trimester” of development after the typical 38 week gestational period inside the womb because of how rapidly baby’s brains and bodies develop after birth.

It’s not the size of a woman’s hips that suggest she will have an easier birth, it’s the size of her pelvic opening. Apparently child-bearing hips are a myth; some very small women with narrower hips have had healthy births and some larger women with wider hips have had difficulty giving birth. There is a condition called cephalopelvic disproportion (CPD) where a woman’s pelvic opening is too small for her baby’s head to fit through, in which case she would need a C-section. But CPD is rare. The reason why doctors cannot predict in advance whether a woman will be able to have a healthy vaginal birth is because every woman’s pelvis stretches differently and every baby’s head adjusts shape as it comes through the birth canal. Only when the labor process has kicked off will anyone have a better sense of what to do.

There are more C-sections than there need to be. The author noted that the fewest births take place on Sunday and most births take place during normal business hours, and it’s not just a coincidence. If you thought the U.S. had the highest rates of C-sections you’d be wrong. About 90% of wealthy women in Rio de Janiero opt for C-sections, but not necessarily for safety reasons – they don’t want to put their vaginas at risk. The documentary Business of Being Born goes into the topic in-depth, if you are curious to learn more.

– Men might not enjoy seeing the birth as much as they say they do. Most societies throughout most of history banned men from the birthing space. Now they are practically expected to be there. In one survey conducted in the 1960s by Dr. George Davidson, men that were present in the room where their partner’s were giving birth were interviewed with their partners a couple months afterwards and every single one of them unhesitatingly said they were happy they were there. When he interviewed them separately and asked the men again, many said it’s something they could have missed, didn’t feel it improved their relationship, and others admitted they were having trouble putting the images of birth out of their minds during sex. Interestingly, many women find they are able to “relax” and give birth soon after their male partner had to leave their side for one reason or another. Another doctor though, found that women required less anesthesia when their husbands were coaching them through their birth.

A few women have orgasms during birth and 2-3% of women report no pain. What?? Yep, no pain. There was a famous doctor, Fernand Lamaze, that suggested the less a woman believes that birth will be painful, the less pain she will feel. He set up centers in France where no anesthesia was given and even the cleaning staff were trained in how to calm and relax a woman in labor. His centers reached rates of 18% of women reporting no pain, not the rate he was hoping to achieve, but still impressive. Some women have even reported orgasms during birth, sometimes along with pain. Apparently because of how the baby pushes against its mother as it is exiting, it can cause a woman to have a vaginal orgasm. There is a documentary about this very topic, called Orgasmic Birth, which is definitely worth checking out.

– Nikita