The Evolution of Modern Childbirth
The evolution of childbirth through history is a reflection of humanity’s cultural shifts. From the intuitive, body-led births of indigenous cultures to the highly managed, medicalized systems of modern industrialized societies, and now to the family-centered skills-based movement emerging today, each shift has reshaped how families experience the profound journey of bringing life into the world.
The emerging skills-based paradigm that we will discuss today offers a unique opportunity to integrate our original physiological blueprint with modern life and understanding. It is a movement rooted in the concept that birth is an activity no matter the setting or outcome, and is therefore a journey that families can reflect back on positively based on what they did together along the way. It presents a vision for childbirth that emphasizes collaboration, preparation, and skillful engagement that can lead to empowered experiences far and wide.
Let us explore the evolution of childbirth and how it has set the stage for this exciting new frontier.
1. Indigenous Birth: Trust and Integration
For much of human history, childbirth occurred in harmony with natural rhythms. In indigenous cultures, women approached birth as an intuitive, physiological process—a natural part of life—trusting their bodies and the wisdom of their communities. Most importantly, life itself was an active, physical preparation for birth—walking long distances, lifting, squatting, moving, and engaging in daily survival activities kept women’s bodies balanced, adaptable, and attuned to nature’s intelligence.
Such activities laid the preparatory groundwork for a reliable trust and confidence in physiological births, and such activities were organically embedded within the necessities of everyday life. In The Farmer and the Obstetrician, Michel Odent explains how until recently, the preparation for birth was a byproduct of daily living. Physical work and mobility naturally contributed to the readiness of the maternal body.
Learning skills for childbirth, in the sense we discuss them today, were not as necessary back then because life itself prepared women for the challenges of labor. Birth had no need to be “medicalized,” nor was it viewed through the lens of good vs. bad choices or adequate guidance from the right kind of expert. It was simply a natural, lived experience, supported by cultural traditions and self-reliance, typical of most aspects of life.
2. Industrialization and the Medicalization of Birth
The first half of the twentieth century brought profound changes as societies industrialized. The standard of living changed considerably, bringing forward a markedly different, sedentary lifestyle largely detached from natural rhythms. This era marked the rise of medicalized childbirth, where someone else’s expertise emerged in place of women’s innate wisdom and ability, shifting the birth setting to hospitals and doctors. Birth became an event managed by specialists with highly trained skills, creating an expectation for external authorities to oversee this rite of passage—a common characteristic of much of modern life.
Generally speaking, the more comfortable a woman is living in her body, the more easily she gives birth. -Ina May Gaskin, Spiritual Midwifery
Women no longer relied on their own bodies, on their own adaptability, or on the connection with their extended family or community; instead, they became more and more isolated, instructed to “trust the science” of their institutions and culture.
3. The Counter- Cultural Philosophy: Freedom of Choice
By the 1960s and 70s, general dissatisfaction with the over-medicalization of birth sparked a resurgence of interest in natural and midwifery-led approaches. Families sought autonomy, reclaiming the right to choose where and with whom they would birth. Midwives became the leading champions of women’s choices, advocating for physiological birth environments and trust in women’s innate ability. As Michel Odent describes in The Birth Reborn, the countercultural movement reclaimed the idea that birth is a physiological process that belongs to women, not institutions.
By the early 2000s, the natural birth movement grew to worldwide recognition, and the New Zealand Midwifery Model became the foremost example of its principles and philosophy, organizing a system of informed choice and respect for women’s natural birth process. While this approach shifted the philosophy away from institutional control (overcoming the idea that birth is inherently a “medical emergency”), the movement did not directly address the physical disconnect and loss of preparation that had occurred due to modern lifestyles. Modernized, sedentary living, separation from nature’s rhythms, and growing reliance on technologies that make life easier, all come with important consequences, namely a loss of pragmatic self-reliance (skillfulness) and abilities. Even within the natural birth paradigm’s freedom to choose, many families remained unaware of the physical disconnect implicit in modern lifestyles or what they could “do” to prepare for birth, often without any knowledge of skills existing to remedy this gap.
In New Zealand, the cesarean rate followed steadily behind the growing worldwide average, currently situated around 30%. In the movement to apply their freedom of choice, many parents began by choosing a more natural setting with midwives to guide the process. But much like they may have relied on doctors in the medical model, they largely relied on the natural birth philosophy and midwives to “deliver” an alternative outcome.
While many experienced great success with their newfound choices—since birth is indeed innately designed to succeed automatically when allowed to happen—for so many others, and still today, the natural philosophy and the inclusion of informed choices didn’t lead to a “natural birth” upon which families could feel empowered. In fact, many women’s desire for a natural birth often led to the perception of having fallen short of one, representing a major source of emotional turmoil and upset.
4. The Silent Trend: The Rise of Skills-Based Birth for an Empowered Birthing Experience
In the 1980s, amidst the resurgence of midwifery, a quiet but significant movement emerged. Some families began developing and sharing their own birth skills, inspired by earlier pioneers like Lamaze, Bradley, Grantly Dick-Read, and others. These families added to and adapted new skills and methods within their own births, creating a more robust and personalized toolkit for navigating labor.
Unlike the passive approach of medicalized birth, or the approach that emphasized conscious choices within the natural birth model, these birth skills emphasized action: breathing through contractions, moving and softening the body to facilitate labor, and engaging pragmatically with the baby’s movements. This was a subtle yet important shift—an emergence of a new kind of autonomy and empowerment for parents through skills-based preparation.
As Fernand Lamaze describes in his book Painless Childbirth, labor is an activity, and preparation with physical and mental exercises allows a woman to actively participate and guide her own birth experience.
5. Larry Webster and the Neuro-Biomechanics of Birth
During this same period of a silent rise in birth skills in the 1980s, Larry Webster, a chiropractor dedicated to maternal and infant health, developed the Webster Technique. This method focuses on preparing the body and nervous system for the physiological activity of birth, addressing physical imbalances and tensions that can hinder pregnancy and labor. Webster’s work can be seen to parallel the family-led, skills-based movement, emphasizing the body’s ability to birth when supported through intentional and practical preparation. As Jeanne Ohm stated in Pathways Magazine, “Chiropractic care throughout pregnancy is a safe and effective way to balance pelvic misalignments. Doctors who are certified in the Webster technique use gentle and specific adjustments to realign the pelvis and restore function to the nerves, muscles, and ligaments associated with pregnancy and birth.”
The Emerging Skills-Based Approach: Bridging the Gap
Today, the “skills-based” approach has gained recognition as a universally applicable method of preparing for childbirth, transcending philosophical divides of “medical” versus “natural,” by focusing on the activity of labor itself, regardless of the birth setting. This focus allows families to bridge a major gap left in the wake of our modern lifestyles, to rediscover key body-awareness practices, movements, and conscious attunement to the labor process to achieve a sense of self-reliance. This approach proves to be a practical, adaptable, and important framework to achieve a positive sense of autonomy in birth, for all birthing families, of all walks of life.
If you want to change the world, change the way babies are born. -Michael Odent
The Autonomy and Ability to Birth Better
While the philosophy and practice of the midwifery model of care connects us with the wisdom to trust the natural birth process, the skills-based approach grows our engagement with our body, to trust in our ability to journey through the activity of birth.
The freedom to make birth choices, though vital for humanity, did not inherently restore a woman’s autonomy and ability to birth better. Such autonomy and birthing ability had been gradually lost through time —not merely taken away by institutions, but forgotten through the major cultural shift into modernity that rendered body-centered skillfulness and self-resourcefulness less necessary for survival.
Modern culture, even through the countercultural revolution, remained largely unaware of what we had lost that was so important for our autonomy in birth: community encouragement and physiological body preparation, each the “byproduct of daily living” within indigenous ways of life.
Today, we are on the cusp of a vital new development: a self or family-oriented skills-based paradigm in childbirth. This emerging approach helps recover the autonomy that was lost, by growing a skilled-birthing population, learning a greater awareness of how to work with one’s unique body and fully engage in the natural process of birth. Beyond the goal of a natural birth “delivery,” the expectation now spans toward a universal outcome: an empowering birth experience.
Birth skills, rooted in an understanding of the body’s natural design, allow families to work with the process of birth rather than feeling passive.
Each phase in the evolution of birth has refined the conversation, paving the way for meaningful advancements. The skills-based approach represents a next step, encouraging families not only to make informed choices but also to actively prepare for the physical activity. By focusing on how to birth, this approach places responsibility on our inner resourcefulness and strengthens the innate resilience and potential within the family, potentially helping to reverse our dependence on external authorities for generations to come.
Balancing the Partnership
There is a calling for renewed responsibility, for families and practitioners alike to explore this emerging conversation around birth. It is not a departure or negation from the past, but an evolution based on what has always been true: birth is an activity, and the conscious participation of the birthing family is essential to achieve a positive experience.
Regardless of one’s philosophical stance, it is vital to now ask: How can families support themselves in becoming active participants in their birth experiences? One answer lies in balancing the partnership between parents and practitioners, where practitioners encourage families to become skilled for birth—not just mentally, but physically.
When families are equipped with physical skills for the activity of birth, there is less expectation for an external provider to “deliver” a birth outcome. Instead, parents may join their providers on equal footing as teammates in the birthing process, where they themselves are sharing responsibility, capable of responding to the dynamics of labor in ways that are best for them.
This partnership lightens the load for midwives, who are often stretched thin managing hundreds of births per year, and fosters a collaborative environment for an empowered family to emerge from each birth.
The General Outline of Skills-Based Preparation
Skills-based childbirth preparation teaches families how to engage with the physiological processes of labor. This approach is adaptable and universal, supporting any birth setting or desired birth plan, even non-laboring cesareans. It emphasizes:
Breathing Through Contractions: Families learn how to use breath to remain soft, focused, and physically aligned with the natural rhythms of labor. This helps manage pain if present, and also steadies the surreal experience of medical procedures such as planned and unplanned cesareans.
Body Positioning and Movement: Understanding how to move and align the body helps facilitate the baby’s descent which can profoundly influence the ease and progression of labor. Such skills can be utilized even before labor begins.
Softening and Balancing Tissues: Practical techniques help reduce tension, create balance and openness, and prepare for the work of birth with less strain.
Active Engagement with the Baby’s Position: Families learn to interpret and respond to the baby’s movements, fostering a sense of connection and cooperation during labor.
Birth skills, rooted in an understanding of the body’s natural design, allow families to work with the process of birth rather than feeling passive or devoid of internal control. They dissolve the gap between “natural” and “medical” paradigms, offering a pragmatic way forward for everyone.
“Even in the case of an unexpected cesarean, your baby’s birth is still your baby’s birth, so it’s important to use skills to stay on top of and feel in control during the process.” (Wintergreen, Birthing Better)
Chiropractic Care: A Foundational Support for a Birth Skills Approach
Let’s now talk about how chiropractors trained in methods like the Webster Technique play a crucial role in this new paradigm. By aligning the pelvis and reducing physiological and mechanical stressors, perinatal chiropractic care supports the preparation needed for a skills-based birth. These adjustments create a foundation of balance and ease in the body, enabling birthing parents to apply their skills more effectively.
Chiropractic care is an ideal complement to all birth settings, choices, and plans. It aligns with the principles of supporting the body’s physiology while facilitating greater adaptability, both of which are essential for every activity of birth. Today, more and more chiropractors are helping families establish their skills-based birth plan empowering their approach to birth with confidence.
All of us, families, birth providers, and chiropractors are being called to integrate a new chapter within the birth conversation:
Families: Recognize your vital role in birth. Equip yourselves with skills to actively engage in the process, working with your body and your baby as a team. Create a skills-based birth plan that you can use to guide your actions for the beginning stages of labor, contractions, transition, and birth.
OBs and Midwives: Continue to foster partnership models that encourage families to take an active role in their births. Offering guidance as well as encouraging families to learn and practice skills will lead to many more positive birth experiences.
Chiropractors: Continue your essential work in preparing the body and nervous system for birth. Your expertise in physical alignment and physiological balance is a cornerstone of this emerging paradigm!
Empowered Birth Experiences
Every birth is an activity, the majority of which require conscious effort and labor. This means birth is not only about the desired outcome; it is about the journey—how we prepare, how we act, and how we move through the incredible process of bringing life into the world.
This concept stands at the frontier of childbirth in the 21st century: a return to resourcefulness, a celebration of the universal truths that can bring people together, and a skillful integration with the innate wisdom in every fiber of our body. Let us embrace this frontier with open hearts and minds.
Fathers and the Skills-Based Approach to Birth
In The Birth Partner by Penny Simkin, we learn that when a partner learns to support the birthing woman with skills and confidence, it not only strengthens the birth experience but also deepens the bond within the family.
Families who embrace a skills-based approach identify that this is one of its most cherished gifts—strengthened partnerships between mothers and fathers during childbirth. Birth need not be hard work for the mother and infant alone. If partners are invited to be skillfully involved, the labor becomes shared in a unique dynamic that can elevate the birthing experience for everyone. This collaboration is particularly powerful when it is built upon preparation, clear communication, and skill sets that are learned and practiced by families themselves.
Fathers as Partners in Birth
Historically, the role of fathers in birth has ranged from passive observers to excluded parties, depending on cultural norms or institutional settings. The skills-based approach, however, transforms this dynamic by offering the option to invite fathers into the process as active, valued participants. Fathers can now gain the knowledge and confidence to contribute meaningfully to the birthing journey.
“Many dads I know felt powerless at the births of their children, and hated seeing their partners in pain and unable to do anything to help. They felt totally unconnected to the birthing experience. If you learn the skills together with your partner, it’s a shared experience.” (Dan, Birthing Better)
A partner’s skillful support does not mean intervening but rather “interweaving” with the mother’s experience of labor, creating a sense of stability and reassurance. Fathers learn to engage in a collaborative effort, offering their presence, strength, and skillfulness to guide and sustain the process, holding space and protecting the mother’s inner experience.
“My husband was my rock; the men have to be involved! He kept my breathing focused and overall contributed to our wonderful experience.” (Christie B., Birthing Better)
The Difference It Can Make
The skills-based approach equips fathers and partners with practical tools to support mothers effectively. This goes beyond the affirmation of “being there” and provides actionable ways to engage in the physical and emotional demands of labor. Some of the key elements include:
• Enhanced ability to communicate, both verbally and non-verbally.
• Synchronized support with the rhythm of contractions.
• Confidence in applying counter-pressure, assisting with positioning, or facilitating softening and relaxation.
• Navigating unforeseen challenges by maintaining coherence and focus on the activity at hand.
• Remaining grounded and calm amid any circumstantial changes in the birth plan.
Coherence and Empowerment Through Skills
One of the most important aspects of this approach is the sense of coherence it fosters early on in the family’s life. When parents work together using skills, external circumstances no longer define what a “successful” birth means. Instead, their success is measured by how they engage with the process itself—how they respond to contractions, support the baby’s efforts to be born, and adapt to each moment of labor.
“I felt empowered and in control (most of the time), and when I lost it a little, I was able to refocus. I put this down to the skills my husband, Matt, and I learned.” (Girlie, Birthing Better)
In the field of Salutogenesis, which explores the nature of health and well-being, we learn how internal resources grow our adaptability. We learn how adaptability is what leads to a “sense of coherence,” which is essential to every positive life experience. And we learn how positive experiences are the building blocks for generating biological and social health.
The key to healing birth exists with fathers. -Jeanne Ohm
Fathers and mothers can find coherence in their shared skills and are able to stay present, regardless of the twists and turns that labor may take. This translates into resilience, health, and an empowered attitude when parenting in the beginning stages of life.
Even in the most medicalized births, the fundamental recognition remains intact: Every birth is a physiological activity that we are immersed within, and every birth experience can be traversed with a sense of coherence.
When mothers desire their partners to be present, their skillful inclusion enriches the experience for everyone involved. Drawing from those who have walked this path, we can help create opportunities for other families to integrate this approach to birth, by normalizing and encouraging skills-based childbirth preparation. We can recognize that the intimacy of bringing life into the world can and should be honored and protected by a mother’s partner, a rite of passage for the family to own, together.
“The key to healing birth exists with fathers.” (Jeanne Ohm, D.C., Pathways Magazine)
The Role of Chiropractors in Supporting Partners
In the context of a skills-based approach, chiropractors trained in perinatal care can play a significant role in preparing fathers for birth. Chiropractic education reinforces his understanding of the body’s biomechanics, giving him additional insights and hands-on skills to support his partner during labor. Understanding the importance of alignment and biomechanics enhance the couple’s ability to approach birth with internal resources and confidence.
This approach aligns with the hope for birth to become a cooperative, family-centered journey. By inviting fathers to embrace their roles as skilled and supportive partners, we honor the profound capacity of families to work together in bringing new life into the world. This is not merely a new method of childbirth but a movement—a call to honor birth as a shared, family-centered, human experience that recognizes each family to be the heart and home of our human potential.
The H.A. Brant Study (1961) and Continuing Research Proposals
The H.A. Brant study (1961) involved 126 women who received four 30-minute classes focused on birth skills. During labor, these women were coached by birth professionals, ensuring they had the necessary support to integrate their learned skills. The study revealed significant outcomes: improved maternal coping during labor, higher Apgar scores for newborns, and positive feedback from healthcare providers working with skilled mothers, as compared to control groups. Brant’s findings emphasized the benefits of equipping women with birth skills. It highlighted the transformative potential of skills-based approaches to childbirth, even in structured or medicalized settings, suggesting that the active preparation and application of skills empower women and improve birth outcomes.
The ICPA (International Chiropractic Pediatric Association) research initiatives aim to explore the effectiveness of birth skills and the Webster Technique in enhancing childbirth outcomes and experiences. Such studies propose a dual-path approach: one path encouraging families to self-learn and use any birth skills of their choice during pregnancy, and another path combining these self-learned skills with the Webster Technique. The research would track variables such as labor duration, fetal positioning, and maternal satisfaction to understand how these methods impact both the physical and emotional aspects of birth.
The impetus for this research stems from the growing recognition that childbirth is not just about outcomes but also about the activity of labor itself. When families are equipped with skills, they are more likely to find coherence and empowerment during birth, regardless of challenges or deviations from their birth plan. This aligns with the ICPA’s mission of promoting salutogenesis—a focus on well-being through coherence and adaptability.
If successful, this study could validate the complementary roles of chiropractic care and self-learned birth skills, evolving the childbirth conversation to include not only informed choices but also practical preparation. It represents an opportunity to highlight the universal relevance of chiropractic care and advance a more integrative, family-centered approach to childbirth.
