The Evolution of Childbirth?

Sara Sklaroff’s review of Tina Cassidy’s book Birth: The Surprising History of How We Are Born for the Seattle Times, “The Evolution of Childbirth—A Horror Story,” reflects the secular worldview that says evolution “designed” the supposedly inferior process of human birth.

The statement “evolution found a balance” elicits a déjà vu to Jurassic Park’s declaration that evolution “found a way.” The unique features of the human birth process (when viewed from a biblical perspective), however, lose their superficial appearance of inferiority and instead reveal a marvelous design suited to the upright-walking human anatomy. Furthermore, a biblical perspective reveals our present groaning and travailing (a Romans 8:22 word choice particularly suited to the subject under discussion) to be the after-effects of the Curse incurred by Eve in Genesis 3.

Eve was a real woman designed by God with the ability to enjoy easy labors producing healthy babies to do her part in filling the earth. (In essence, Eve was the obstetrician’s dream patient, with a guaranteed good outcome without complications. Of course, had Eve remained in her original state she also would have been a guarantee of the obstetrician’s unemployment.)

But she (and her husband after her) made a terrible choice: they forsook God’s instructions for their lives in a failed search for godlike omniscience. God in His justice placed a curse on the whole of creation, reminding them and us of our spiritual death and need for God’s grace (see Why Does God’s Creation Include Death and Suffering?). Adam could have worked without thorny toil, instead tending the garden to obtain food, and Eve could have enjoyed at least relatively painlessly populating the earth. Instead, God told Eve that “in sorrow thou shalt bring forth children” (Genesis 3:16).

Cassidy’s book itself acknowledges the existence of a biblical curse on childbirth, pointing out the religious belief of some that women should be denied all forms of pain relief in labor. Those who may hold such a point of view might wish to consider the inconsistency of their position, inasmuch as all pain and suffering is a result of the curse upon sin. If we were to deny pain relief for laboring women on such a basis, we should also deny any pain relief and, in fact, all efforts to relieve the sick and suffering.

The human need for “help” in child delivery is not a product of evolution gone awry in the attempt to compensate for big brains and upright posture, but rather the result of the curse on an otherwise perfect creation. (By the way, veterinarians and those who breed domesticated animals might disagree with the assertion that “only” humans need help to deliver their offspring.)

According to the review, Cassidy’s book, which I am reading at the moment, deals with the “inferior” structure of the human pelvis and then presents graphic horror stories of human interference in the birth process throughout history. The book itself opens with a series of anecdotal accounts from the author as well as her relatives expressing disappointment with their own labor experiences. (Of course, anecdotal experiences make for interesting conversation but do not create actual expertise in a subject or add to the body of scientific knowledge.)

“Evolution and the Female Body”

The first chapter is entitled “Evolution and the Female Body” and, like so many introductory chapters of books purporting to convey scientific facts, it weaves a tale of speculations. This book opens with pronouncements about “Lucy,” though, incidentally, many evolutionists now consider “Lucy” to have been a male because of its pelvis [updated 2-27-2013: Lucy is now considered to be female after all.]. (See Dr. David Menton’s DVD Lucy—She’s No Lady! for further information about the true identity of Lucy.) Cassidy’s book contrasts the evolution of the human pelvis and birth experience with the anatomy and birth process of creatures that walk on four legs. The so-called “inferior structure” of the human pelvis is supposedly the evolutionary trade-off between bigger heads and problems created by upright posture. The most striking feature of the opening chapter is its lack of actual anatomical information about the human pelvis, substituting in its place nothing but evolutionary flag-waving.

In reality, the anatomy of the human pelvis is well-suited for walking upright.

In reality, the anatomy of the human pelvis is well-suited for walking upright. Unlike the pelvis of a four-footed animal, the human pelvis must tilt so as to allow for walking on two legs, and then compensate for the resultant effects of gravity on the internal organs. To keep these organs from falling down and out, the pelvic bones are linked by a complex system of rings and slings, many of which are attached to the all-important (and not at all vestigial) coccyx, commonly called the tailbone.

In later life, many women experience great inconveniences when these important pelvic structures begin to weaken. Such problems, like complications of childbirth, would be unheard-of in a perfect world not marred by sin and the Curse. Furthermore, pregnancy itself causes temporary modifications of the pelvic anatomy, such as a softening of the ligaments that bind the bones of the pelvis together, in preparation for childbirth.

The changing tilt of the human pelvic openings, from a wide open 10 degrees from the horizontal at the lower outlet while standing to a somewhat gravity-defying 60 degrees at the inlet (on top, while standing), presents additional challenges for the emerging baby. However, God’s design has provided features in both baby and mother to allow the infant to negotiate this path without any instructions or guidance in the normal, uncomplicated birth process.

The newborn’s skull is made of bones that are not yet fused, which allows the bones to overlap and reshape the skull to provide streamlining and moment-by-moment adjustment to the birth canal as the baby enters the outside world.

The anatomy of the pelvis, instead of making human labor difficult, provides an ideal route of exit. The shape of the bony pelvis and the positioning of the pelvic muscles are such that the baby being propelled through the birth canal tends to twist and turn in the directions most suited for a safe and successful exit. Multiple but limited options are often available, allowing for variation according to pelvic type and fetal size.

Each option available for a baby’s journey turns the baby’s head so that its smallest dimension enters the curvy birth canal at each level. The infant’s head, having entered the pelvis looking sideways, must spin 90 degrees as the neck flexes and the head descends. This rotation must then reverse while extending the neck backwards as the baby descends farther into the pelvis. The pelvic shape forces the baby to finally twist as the head emerges to allow the roomiest possibility for the delivery of the shoulders.

Pain and Process

The importance of these steps becomes more evident when they don’t occur normally. The whole process would be an engineering nightmare to design due to the changing shape and other dynamic features of the component parts, yet in the majority of births for about six thousand years, the mechanism provided by the Lord has functioned nicely, albeit with the pain incurred in Genesis chapter three.

An old family doctor once told me that he liked obstetrics because it was the only area of medicine wherein he could admit one healthy patient to the hospital and send two healthy patients home. Unfortunately, we know this is not always the case. The pain attending the birth process and the fact that, sadly, the outcome is not always good has led to a myriad of medical interventions in an effort to diminish pain—certainly a humane idea—and to achieve the desired goal of a healthy mother and a healthy baby.

The desire to relieve pain and to increase the likelihood of healthy outcomes, both laudable goals, have in obstetrical history created undesirable situations. Strong drugs, the only available way to relieve pain in the past, have at times rendered laboring mothers quite incapable of cooperating with their caregivers. The fact that these women were then unable to assist with their own deliveries contributed to the rise in the need for the now-unpopular forceps delivery.

The rise in the rate of Cesarean section deliveries over the past century has many causes. The trend has been in part attributable to the increasing popularity of various forms of regional anesthesia. Epidural and spinal anesthesia may interfere with the natural progress of labor. Medications are often used to induce labor in order to avoid possible complications from other conditions, but such induced labor may be unsuccessful. Furthermore, fetal monitoring may actually increase the likelihood of a Cesarean section. The goal of monitoring is to detect problems before damage occurs, but, as with all medical tests, false alarms are possible. The effort to get more healthy babies into the world has resulted in an increased level of medical and operative intervention in the natural process of labor.

History and Evolution of Midwifery and Obstetrics

As suggested by the review, the actual book spends most of its ink describing the “evolution” of the practice of midwifery and obstetrics. The author ignores the progress that has brought forth decreased maternal and infant mortality and saved many “miracle babies,” and the book focuses instead on grisly tales that transform the historical birthing room into a chamber of horrors. Like most areas of medicine, obstetrics in all its forms suffers from a checkered past—only gradually replacing dogma borne of anecdotal experiences and superstitions with actual scientific advances (which, like all scientific discoveries, are incomplete and subject to change). Unfortunately, in medicine—the ultimate living laboratory—unforeseen side effects, incorrect presumptions, and even the misapplication of good ideas can have painful or deadly consequences.

Tragically, careful reading and application of the biblical record could have spared countless lives, even before Pasteur and Koch’s discovery. As detailed in David Wise’s article “Modern Medicine,” the Bible already contained a great deal of information regarding infection control procedures such as quarantine, disposal of infectious material, sanitation and waste disposal, hand-washing, and handling of the dead. The latter two are particularly applicable to the tragedy of the late 19th century maternity wards, for medical practitioners generally ignored the admonitions to wash their hands after handling bodies at autopsies and subsequently infected maternity patients.

The medical community’s rejection of Pasteur and Koch’s discoveries was rooted in evolutionary presuppositions that long predated Darwin, reaching back to the Greek philosophy of spontaneous generation. To have accepted Pasteur’s clear demonstration that life only comes from life would have been to reject the preconceived notions on which their practices were based. Evolutionary thought was the enemy, not the benefactor, of human society. This belief in spontaneous generation of disease-producing organisms led to the needless death of many at the hands of medical practitioners who ignored Pasteur and Koch’s advice with the same vigor they had ignored the Levitical guidelines from preceding centuries.

God’s Plan

Evolutionary thinking still keeps many people ignorant of the true origin of death and suffering in this world, and does not recognize death as a curse for sin and a reminder of the eternal destiny of all who ignore God’s offer of grace. Death is the friend of evolution, the agent of its presumed advances. The Bible announces the truth that everyone who has lost a loved one knows from experience: death is our enemy. In fact, 1 Corinthians 15:26 assures us that the last enemy Christ will destroy is death.

While God in His justice had to impose the Curse upon sinful mankind, including the curse upon Eve and all of her daughters in childbirth, in His grace He ordained that the very process He had cursed would be the route He would utilize to bring His only begotten Son into the world! He promised the seed of the woman would someday crush the serpent’s head (Genesis 3:15), a woman would compass a man (Jeremiah 31:22), and a virgin would conceive (Isaiah 7:14).

And even as human marriage—though universally marred—is designed to paint a picture of Christ and His Church, so the human birth process typifies the great plan of grace Christ Himself executed by His death on the cross. John 16:21 states, “A woman when she is in travail hath sorrow, because her hour is come: but as soon as she is delivered of the child, she remembereth no more the anguish, for joy that a man is born into the world.” By these words our Lord Jesus assured the sorrowing disciples of His Resurrection and the joy they would have because of His victory over death. Christ’s victory was not just for Himself but for all who would accept His death on the cross as payment for their sins. Likewise, when we look at the human birth process, marveling at its design and groaning at its curse, delighting at every good outcome and weeping at every tragedy, we should also be reminded of the joy available in eternity, in a place with no tears or death, for all who accept God’s gift of grace in Christ Jesus.