Obstetrics at odds with evolution: The consequences of interrupting adaptive birthing consciousness

“Birthing consciousness” is a psycho-physical state of focus and retreat into which a woman sometimes enters during physiological birth. When this state is initiated and continues uninterrupted, the probability of a natural birthing process increases. Adversely, interruptions to the state of birthing consciousness slow down or even stop the birth from progressing. In this theoretical examination, I claim that birthing consciousness was a useful adaptation in human evolutionary time. However, in current hospital settings there are various interruptions to birthing consciousness. I offer a critical insight: obstetrics has neglected to exploit evolutionary advantages. Moreover, attention to evolutionary adaptation in the hospital generally, or obstetrics specifically, will advance best medical practices, thus public health in general. The suggested evolutionary approach offers a new perspective concerning the cascade of interventions in the birth process. It also suggests a path for future research concerning the reduction in the rate of unscheduled cesarean births, on the rise in current obstetrical care.