32 Birth Chairs in the Middle Ages

Introduction

Birth chairs are labor assisting devices that can be found in nearly every culture through history. Some of the earliest recorded mentions of birth chairs or stools date back to ancient Babylon in 2000 BC. These chairs support women during the active and pushing stages of labor in an upright position. Current research suggests that upright labor position increase “uterine blood flow, contractility, and pelvic outlet diameters” which can shorten labor and increase the chances of an uncomplicated delivery. While the earliest examples of birth stools included stones set parallel to one another or giving birth on an assistant’s lap, medieval midwives developed the design and practice of safe delivery using birth chairs.

The Design of the Birth Chair

Birth chairs were specialized seats designed to support women during labor and delivery, offering a more comfortable and controlled position for both the mother and the attending midwives or physicians. Constructed primarily from wood, birth chairs typically featured a sturdy, often armless design with a seat that had a central hole or gap allowing the newborn to pass through easily. Birth stools were also used and were constructed on three legs with a horseshoe shaped or rectangular opening in the seat for the infant to pass through. The smaller and lighter design of the birth stool allowed it to be easily transported to the home of the laboring woman. Nonetheless, the seat of both birth chairs and stools were often set low to the ground, about ten inches, to allow the woman to brace herself during contractions. Additionally, these stools and chairs would either be backless, allowing an assistant to stand behind the laboring woman to support her or slightly inclined backwards. The designs were crafted to assist women in maintaining a semi-sitting or squatting position, which allowed gravity to aid in the birthing process. This posture was believed to facilitate labor by widening the pelvic opening, maximizing the use of abdominal muscles, and easing the delivery of the baby.

Medieval View of Childbirth

During the medieval period and through most of human history, childbirth was overseen by a female midwife or family member. Unlike today, childbirth was viewed as a natural and uncomplicated part of a woman’s life. Since cultural and religious stigma surrounded the woman’s body, physicians were often unwilling or forbidden from participating in the labor and delivery process. Consequently, Midwives and the simple tools she had available to her were considered the safest assistants for birth till around 1550. Midwifery texts from the medieval period advocate allowing labor to progress naturally with minimal intervention except in extreme cases. This was due both to a lack of material and skill and a trust in the ability of a woman’s body to give birth. Medieval depections of women in labor often show the mother surrounded by other women and children in either a supportive or celebratory state. Notably, all medieval texts recommend women labor in an upright position with the assistance of a birthing chair or stool. Although no physical chairs from before the 1600s remain, there are numerous depictions of both simple and elaborate designs to assist laboring women.

The Shift to Obstetric Care

The shift to women giving birth in bed began with a French Barber-Surgeon Jacques Gilemeau who suggested that women may have an easier time giving birth on their backs. Notably, this theory was not supported by any research. At the same time, King Louis XI Vs encouraged the practice through his fascination with women giving birth. Although physicians would often not participate in obstetric care, surgeons welcomed the chance to enter the field of medicine. These surgeons encouraged the supine position during labor because it allowed easier access to the child and new practices such as forceps delivery. Consequently, by the 17th century, nearly all women in France were giving birth on their backs. As medicine improved and physicians began to participate in obstetric care in the late 18th and 19th centuries, a more systematic approach to childbirth emerged. Obstetricians began to advocate for safer and more controlled environments for labor and delivery. This transition was accompanied by the introduction of new medical instruments, such as forceps, and the recognition of the importance of sanitation and hygiene during childbirth. These developments led to a gradual decline in the use of birth stools and other traditional birthing aids as the focus shifted toward hospital-based deliveries and medical interventions aimed at ensuring the safety of both the mother and the newborn and easier access for the physician.
The shift from birth stools to obstetric care also involved a cultural change in the perception of childbirth. While birth stools and similar devices were embedded in cultural practices and traditions, the emergence of obstetric care brought childbirth into medical settings, emphasizing the need for professional medical assistance and interventions during labor. This transition, while improving the safety and outcomes of childbirth, also altered the societal view of childbirth from a more communal and traditional affair to one that was increasingly seen as a medical event requiring specialized knowledge and expertise.

Connection to STS

Image of German Medieval birth stoolThe decline of birth chairs provides an example of path dependence theory. As new obstetric practices were developed, doctors encouraged women to give birth while lying on their back to make it easier to use the new obstetric technologies. As more women across generations continued giving birth while lying in bed, society accepted this position as the expected method of delivery. Even though research today has proven that labor progresses faster and easier when women stay upright, hospital equipment and women’s expectations lead the majority of women to deliver while lying on their backs.

AI Use Disclosure

I used ChatGPT to find additional sources and research studies for my chapter.

References

Banks, A, C. (1999). Birth Chairs, Midwives, and Medicine. Jackson: University Press of Mississippi.

De Jonge, A., Lagro-Janssen (2004).  Birthing positions. A qualitative study into the views of
women about various birthing positions, Journal of Psychosomatic Obstetrics & Gynecology, 25(1), 47-55.

Dundes, L., (1987). Evolution of Maternal Birthing Position. American Journal of Public Health, 77, 636-641.

Gaskin, I, M. (2003). Ina May’s Guide to Childbirth. Bantam Books.

Hacıvelioğlu, D., Tavşanlı, N. G., Şenyuva, İ., & Kosova, F. (2023). Delivery in a vertical birth chair supported by freedom of movement during labor: A randomized control trial. Open medicine, 18(1)

Miller, M., & Winick, A. (2022, April 28). Birthing Furniture: An Illustrated History. The MIT Press Reader. https://thereader.mitpress.mit.edu/birthing-furniture-an-illustrated-history/