why do women give birth on their backs

Women commonly give birth on their backs primarily due to historical, cultural, and medical convenience reasons rather than physiological benefits. Historically, women gave birth in upright positions such as squatting or sitting, which utilize gravity to aid delivery and allow pelvic flexibility. However, in the 17th and 18th centuries, lying on the back became the norm in Western cultures, partly because King Louis XIV preferred to watch births, and the reclining position gave him a better view. This royal preference influenced widespread adoption of the supine birth position. In modern hospitals, birth on the back (the lithotomy position) persists because it is more convenient for medical staff to monitor and assist during delivery, especially with the use of medical interventions and monitoring equipment. However, this position restricts pelvic movement, works against gravity making pushing more difficult, and may prolong labor. Women often have options to choose other positions that may be more comfortable and physiologically beneficial, such as squatting, hands-and-knees, or side-lying positions, which can facilitate labor progression and reduce pain. In summary, women traditionally give birth lying on their backs because of historical shifts influenced by royalty and the convenience of medical staff during delivery, not because it is the best or easiest for the birthing process itself. Upright and other alternative positions are generally more optimal for natural labor and birth.