Representations of upright birthing positions are also frequently found in ancient art, as well as in 17th-19th century drawings. Birthing chairs of the 17th-19th century also indicate a preference for the upright or semi-reclining positions during birth. It therefore seems that the recumbent position for labor and delivery was only made popular by modern western Obstetrics during the 20th century.
Modern Obstetrics has brought many important advances to women’s health, particularly with the marked fall in maternal and perinatal mortality that have changed the way modern society looks upon labor. However, this does not necessarily mean that all introduced measures are beneficial, and some excessive medicalisation of labor appears to have occurred.
The rationale for the upright and mobile positions during labor and delivery, is that gravity aids the descent of the fetus, uterine contractions are intensified, there is less uterine compression of abdominal vessels, transverse pelvic diameters are increased with squatting and kneeling, and mobility usually provides increased distraction from pain and a greater sense of control. On the other hand, most western women prefer to lie down once they have reached 5-6 cm dilatation, and they cannot maintain squatting or kneeling positions for long periods of time.