Considering the way human beings are born, some people believe that there can be a "fault" in the design of human body. It is asserted that some normal births cause too much pain for women and cause certain disabilities. Accordingly, "there is no divine creation" which put us in the best possible form. Some even come up with the claim that it would be better if births had been through the belly. Let us consider such possibilities and question their likeliness.

How is uterus to be placed in the frontier abdomen?

In order for a baby to survive, a suitable space in which it will be fed and protected is necessary. Therefore, the uterus is in the best location as it is, and its equivalent cannot be maintained in the belly. Let us consider that births would really happen through the belly. If the uterus, where a baby develops in 40 weeks, were placed in the belly, then a set of problems would appear. The opening of the uterus would be turned toward the abdomen wall, and thus there would be no strong bonds to tie it up with the surrounding area. In this case we cannot place the intestines, mesenteric blood vessels, aorta, and the net of nerves in connection to them in any way. If the uterus were in the belly, it would unavoidably pressurize the stomach, liver, spleen, and other internal organs, as the mass inside a pregnant woman grew. This could obviously pose a lethal threat for both the mother and the baby.

How would the birth process begin?

If the uterus were anywhere else than its present position, it would contradict the physiology of birth. The fetus assumes three different positions along the developmental process: as it begins to be formed the head is up and the feet are down. At the sixth month, the baby assumes a horizontal position. When the birth draws near, feet and the hips are positioned on top and the head is turned downward, closer to the opening of the uterus. As the head gets closer to the opening, mechanical pressure increases. Thus, signals for the birth are sent to the brain so that the relevant hormone aid is sent in response. With the effect of the hormones, the uterus begins to contract in order to dispose of the being inside. As the opening of the uterus enlarges, the contractions increase. With its mechanical help, the sacro-coccigeal joint makes a 2-cm stretch to give way and with the support of the pubis bone in front, the birth is realized. If human birth was to occur through the belly, then how would the process—including the brain, pituitary gland, and adrenal glands—be triggered with mechanical pressure without the help of gravitation? If the uterus is placed inside the belly vertically, then a tube or similar opening is needed for a way out from between the legs. Even if there is mechanical pressure and the hormones to facilitate birth are secreted, then what way will the baby move? How can birth be realized through the soft-walled belly without any mechanical support at all? If human birth were possible through the belly without any support from the bones, the duration of birth would be much greater. In addition, as the size of the baby increased, a high positive pressure would be needed in order to balance the effect of gravity. However, the more a belly grows, the weaker its muscles become. If birth would ever be possible through the belly, then the mother would have to deliver her baby by lying prone in order to prevent the soft tissue to be torn. In addition certain flora (beneficial microorganisms) need to be placed to the birth channel in order to prevent relevant complications. Should the genital organ be transferred to the navel? For the best protection against complications, the baby's head need to be in horizontal position as if it were swimming. The effect of gravitation applies different pressures on the baby's head while the mother stands, sits, and lies in a supine position. In this case, by which force would the head be directed toward the opening in the frontal abdomen wall to start the birth process? The three different positions of a fetus along its development will never be possible in a uterus located in the belly. Then the fetus would dangle like a tree leaf under the effect of gravitation.

The easiness of normal physiological birth

A form of birth through the belly, a cesarean delivery is only realized in the face of certain anomalies. Although some women assume cesarean as a painless form of birth, findings adds to the cons of cesarean. Accordingly, rate of allergic asthma in cesarean-born children is found six times higher in comparison to others. It is thought that during normal birth, the baby receives some of the microorganisms on the mother's genital organ and the immune system forms antidote against them, which provides protection against asthma.

Strapping up the uterus?

As the baby develops in a period which lasts more than nine months, the uterus gradually grows. In the mean time, it is necessary to fix the uterus with sound bonds so that it becomes resistible to shakes. Counting in both sides, 14 pieces of bonds fixes the uterus to the bones (ilium, ischium, pubis, sacrum) around the hips. Were the uterus to be in the belly, how could we find such sound structure to support the bonds?

To conclude, God Almighty could have created our body in a different form, and He would have shaped our anatomy accordingly, which would then provide the best means for an ideal birth. Thus, it is nonsensical to seek errors in our present biological makeup in order to dishearten the faithful in their belief. Leaving aside such speculations, one cannot help but admire the perfect arrangement in human anatomy when considered from the perspective of wisdom.

Arslan Mayda is a medical doctor at Sifa Hospital, Izmir, Turkey.