Abstract

Human populations across the world tend to have different pelvic shapes, and this geographic pattern of variation can be partially explained by the cumulative effects of genetic drift during the early expansion of our species across the globe. Climatic adaptation to very different latitudes has also contributed to shape the pelvis across large geographic areas. Despite increasing understanding of this variation and its evolutionary history, it is often the case that geographic diversity is ignored and modern White Europeans are used as the model for human pelvic anatomy. We can see this in several studies of human evolution, especially of the evolution of childbirth, but also in more applied disciplines such as midwifery and obstetrics. The description of ‘normal’ childbirth provided within obstetrics and midwifery textbooks is still usually modelled on a specific pelvic morphology that is common in White European women, the ‘gynaecoid’ pelvis. There is clear evidence, however, that this pelvic shape is not representative of women’s diversity. 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. Preliminary results of NHS maternal data from London confirms differences in labour and in the rate of interventions in women of different ethnicities. Normalising a White-centred model of female anatomy and of childbirth can disadvantage women of non-European ancestry. To ensure that maternal care is inclusive and as safe as possible for all women, obstetric and midwifery training need to incorporate women diversity.