Although women can assume a variety of positions during childbirth, in the United States the majority of hospitals have a woman in the semireclined position with her feet up in stirrups. Some feminist health professionals claim that this position is easier for the

doctor rather than for the woman and that it is the most ineffective and dangerous po­sition for labor. Recently, women have been given more freedom in deciding how to po­sition themselves for childbirth in the United States. A woman on her hands and knees or in the squatting position allows her pelvis and cervix to be at its widest. In addition, the force of gravity can be used to help in the birth process.

In different areas of the world, positions for birth vary. Rope midwives in rural areas of the Sudan hang a rope from the ceiling and have the mother grasp the rope and bear down in a squatting position. In Bang Chan, Thailand, a husband cradles his pregnant wife between his legs and digs his toes into her thighs. This toe pressure is thought to provide relief from her pain (Dunham et al., 1992).

A recent controversial development in birthing is the underwater birth, which orig­inated in Russia. A woman is seated in a warm bath or Jacuzzi and is allowed to give birth underwater. It is thought that the warmth of the water makes labor less painful for the woman and less traumatic for infants. Because the baby gets its oxygen from the mother until the umbilical cord is cut, proponents claim there is little danger to the baby. One study from Italy reviewed 1,575 underwater births and found that water birthing pro­vided many advantages over traditional delivery, such as shorter first stage of labor, lower episiotomy rates, and reduced anesthesia use during labor (Thoni et al., 2005). However, other studies have not supported this research and have found that there are increased risks to both the baby and the mother (Pinette et al., 2004).