Centre for Research in Evolutionary, Social and Inter-Disciplinary Anthropology, Department of Life Sciences, University of Roehampton, London SW15 4JD, UK.
Philos Trans R Soc Lond B Biol Sci. 2021 Jun 21;376(1827):20200024. doi: 10.1098/rstb.2020.0024. Epub 2021 May 3.
Regional variation in pelvic morphology and childbirth has long occurred alongside traditional labour support and an understanding of possible normal courses of childbirth for each population. The process of migration and globalization has broken down these links, while a European model of 'normal' labour has become widespread. The description of 'normal' childbirth provided within obstetrics and midwifery textbooks, in fact, is modelled on a specific pelvic morphology that is common in European women. There is mounting evidence, however, that this model is not representative of women's diversity, especially for women of non-white ethnicities. The human birth canal is very variable in shape, both within and among human populations, and differences in pelvic shapes have been associated with differences in the mechanism of labour. Normalizing a white-centred model of female anatomy and of childbirth can disadvantage women of non-European ancestry. Because they are less likely to fit within this model, pelvic shape and labour pattern in non-white women are more likely to be considered 'abnormal', potentially leading to increased rates of labour intervention. To ensure that maternal care is inclusive and as safe as possible for all women, obstetric and midwifery training need to incorporate women's diversity. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
盆腔形态和分娩的区域性差异长期以来一直伴随着传统的分娩支持和对每个人群可能的正常分娩过程的理解而存在。移民和全球化的过程打破了这些联系，而欧洲式的“正常”分娩模式已经变得广泛流行。事实上，在妇产科教科书中描述的“正常”分娩是基于一种在欧洲女性中常见的特定骨盆形态。然而，越来越多的证据表明，这种模式不能代表女性的多样性，尤其是对于非白种女性。人类的产道在形状上非常多样化，无论是在人群内部还是人群之间，骨盆形状的差异与分娩机制的差异有关。将以白人为中心的女性解剖学和分娩模式规范化可能会使非欧洲血统的女性处于不利地位。因为她们不太可能符合这个模式，所以非白人女性的骨盆形状和分娩模式更有可能被认为是“异常的”，这可能导致分娩干预率的增加。为了确保产妇护理对所有女性都是包容的和尽可能安全的，产科和助产培训需要纳入女性的多样性。本文是主题为“社会支持和母婴健康的多学科视角”的一部分。
