Birthing humans in the past, the present, and future: how birth can be approached holistically through an evolutionary medicine lens

Abstract

Birth is a key biocultural event for humans. It can be examined from multiple research perspectives and represents an important part of clinical medicine. Research on childbirth may be locked into disciplinary silos that do not acknowledge birth in a holistic manner. This chapter unites research on childbirth in bioarchaeology and biological anthropology with midwifery practice, providing a platform for a deeper understanding of childbirth in theory and in practice. The chapter is organised around three central questions that broadly address the value of a holistic perspective on birth, and how this may be deepened through an evolutionary medicine lens. This discussion outlines the importance of archaeological human remains in developing hypotheses and theories on the evolution of birth, as well as integrating themes in ecology and energetics to address birth from a holistic perspective. The chapter opens with a review of birth today, then outlines relevant information on the evolution of the human pelvis, before moving to examine studies of childbirth in the past (and associated challenges with these investigations) before closing with calls for the integration of evolutionary and clinical research considerations within analyses of human childbirth.