The Evolutionary Origins of Obstructed Labor: Bipedalism, Encephalization, and the Human Obstetric Dilemma

  title={The Evolutionary Origins of Obstructed Labor: Bipedalism, Encephalization, and the Human Obstetric Dilemma},
  author={Anna Blackburn Wittman and L. Lewis Wall},
  journal={Obstetrical \& Gynecological Survey},
Obstructed labor is a common complication of human childbirth. In parts of the world where access to emergency obstetric services is limited, obstructed labor is a major cause of maternal mortality. Women who survive the ordeal of prolonged obstructed labor often end up suffering from an obstetric vesicovaginal fistula or another serious birth injury that leaves them crippled for life. Compared with the other higher primates (chimpanzees, bonobos, gorillas, and orangutans), these problems are… 

Developmental evidence for obstetric adaptation of the human female pelvis

The evidence that hormones mediate female pelvic development and morphology supports the view that solutions of the obstetrical dilemma depend not only on selection and adaptation but also on developmental plasticity as a response to ecological/nutritional factors during a female’s lifetime.

The obstetric dilemma: an ancient game of Russian roulette, or a variable dilemma sensitive to ecology?

The nature of the human obstetric dilemma is re-evaluate using updated hominin and primate literature, and the contribution of phenotypic plasticity to variability in its magnitude is considered.

Challenges to human uniqueness: bipedalism, birth and brains

This review paper highlights several recent challenges to key features that have been considered to be exclusive to hominins, testing three long-standing theories in evolutionary anthropology.

Reconstruction of Two Mother-Infant Dyads and Obstetrical Consequences of the Mesolithic-Neolithic Transition: A Case Study from Lepenski Vir and Vlasac (Serbia)

Results suggest that delivery was dystocic for the Mesolithic motherchild dyad and eutocics for the Neolithic mother-child dyads; obstetrically, the former is notably more efficient.

Human Variation in Pelvic Shape and the Effects of Climate and Past Population History

A lower magnitude of covariance between functionally important regions ensured that a wide range of morphological variation was available within populations, enabling natural selection to generate pelvic variation between populations living in different environments.

Covariation of fetal skull and maternal pelvis during the perinatal period in rhesus macaques and evolution of childbirth in primates

It is shown that forms of the fetal skull and maternal pelvis during the perinatal period covary in ways to relax the obstructions of childbirth in rhesus macaques, indicating that cephalopelvic covariation could have evolved not only in humans, but also in other primates in parallel, or it could be an example of a catarrhine synapomorphy.

Obstructed Labour: The Classic Obstetric Dilemma and Beyond

It is suggested that obstructed labour is not an inevitable character of the authors' species and that mediation of the environment and changes in birth posture can potentially reduce obstetric complications in the short and longer term.

Biocultural perspectives on maternal mortality and obstetrical death from the past to the present.

  • P. Stone
  • Medicine
    American journal of physical anthropology
  • 2016
This article reviews the research in pelvic architecture and cephalopelvic relationships from the subfields of evolutionary biology, paleoanthropology, bioarchaeology, medical anthropology, and medicine, juxtaposing it with historical, ethnographic, and global maternal health analyses to offer a biocultural examination of maternal mortality and reproductive risk management.

The Evolution of Difficult Childbirth and Helpless Hominin Infants

Because of the implications for behavioral, social, and cultural evolution, reconstructions of the evolutionary history of human parturition are driven by two main questions: First, when did



Encephalization and Obstetrics in Primates with Particular Reference to Human Evolution

Evidence of differences between primate species in the growth rate of the brain and/or in the length of development during ontogeny suggests that encephalization of adults cannot be expected to be proportionate to that of the neonate or of individuals at any particular developmental stage.

The evolution of modern human childbirth

This paper reviews the fossil and comparative evidence for when and how the modern pattern of birth evolved in a mosaic manner with some unique features appearing early in human evolution and others quite late.

The evolution of bipedalism and assisted birth.

It is suggested that the evolutionary transformation of a nonbipedal prehominid into a bipedal hominid first transformed birth from an individual to a social enterprise and set hominids on a trajectory toward the elaboration of cultural systems of authoritative knowl- tion.

Obstructed labor injury complex: obstetric fistula formation and the multifaceted morbidity of maternal birth trauma in the developing world.

Women who have experienced prolonged obstructed labor often develop serious social problems, including divorce, exclusion from religious activities, separation from their families, worsening poverty, malnutrition, and almost unendurable suffering.

The obstetric pelvis of A.L. 288-1 (Lucy)

Evolution of the ischial spine and of the pelvic floor in the Hominoidea.

  • M. Abitbol
  • Medicine
    American journal of physical anthropology
  • 1988
A theory is proposed to account for what appears to be an incongruous development and orientation of the ischial spines in humans.

The pelvis as a passageway. I. Evolution and adaptations

  • D. B. Stewart
  • Biology
    British journal of obstetrics and gynaecology
  • 1984
Man has an unusual pelvis, a large fetal head, and a complicated mechanism of labour. The evolution of the pelvic girdle, like that of the hind limb, is a story with some chapters still missing. In

Birth and Human Evolution: Anatomical and Obstetrical Mechanics in Primates

Foreword by Frank A. Chervenak and William J. Ledger Obstetrical Mechanics and Evolution Anatomy and Physiology of Parturition in Primates Factors Affecting the Different Pelvic Shapes Obstetrical