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Squatting, Pelvic Morphology, and a Reconsideration of Childbirth Difficulties

Gorman, John and Roberts, Charlotte A. and Newsham, Sally and Bentley, Gillian R. (2022) 'Squatting, Pelvic Morphology, and a Reconsideration of Childbirth Difficulties.', Evolution, Medicine, and Public Health, 10 (1). pp. 243-255.


Childbirth is commonly viewed as difficult in human females, encompassed by the “Obstetrical Dilemma” (OD) described by early palaeoanthropologists as an evolved trade-off between a narrow pelvis necessitated by bipedalism and a large-brained fetal head. The OD has been challenged on several grounds. We add to these challenges by suggesting humans likely squatted regularly during routine tasks prior to the advent of farming societies and use of seats. We suggest that habitual squatting, together with taller stature and better nutrition of ancestral hunter-gatherers compared with later Neolithic and industrial counterparts, obviated an OD. Instead, difficulties with parturition may have arisen much later in our history, accompanying permanent settlements, poorer nutrition, greater infectious disease loads and negligible squatting in daily life. We discuss bioarchaeological and contemporary data that support these viewpoints, suggest ways in which this hypothesis might be tested further, and consider its implications for obstetrical practice.

Item Type:Article
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Publisher statement:The Author(s) 2022. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited
Date accepted:19 April 2022
Date deposited:20 April 2022
Date of first online publication:26 April 2022
Date first made open access:06 July 2022

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