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When I was travelling in France, I encountered toilets without toilet seats. Essentially they require the user to squat. I was told that as a result, French women had fewer birth complications.

  • Is it true that regular use of squat-toilets makes giving birth easier?
  • If so, what is the mechanism by which this occurs?
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Humans (like other primates) have long squatted during childbirth. The use of a birthing stool to aid the upright birthing position was also common for centuries, and is still used today.

I couldn't find any sources linking the use of squatting toilets to childbirth. However, squatting to urinate/defecate isn't uncommon in undeveloped countries; these are also the countries most likely to utilize squatting for childbirth.

As far as the mechanism for utilizing a squatting position it's said that the pelvic outlet is larger in the squatting position - thus more room for the child to deliver. There's also less compression upon arteries while squatting as opposed to being supine. It is also suggested that gravity is a factor: the weight of the baby dropping onto the cervix to speed dialation: most reports I linked show that squatting births were in general faster but some studies report more tearing and bloodloss with the squatting position.

(http://www.amazon.com.br/gobe/Parto/Prote%E7%E3o%20Perineal/Artigos%20em%20ingl%EAs/perineal%20outcomes%20and%20position.pdf) - for whatever reason that link won't link for me today.

The basic conclusion from most reports: whatever position which makes Mom happy and comfortable while trying to squeeze a bowling ball out of a hole the size of a lemon is the best choice.

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This isn't intended to be a complete answer to your question, but my answer is a bit too long to fit into a comment, and I think this is so amusing (and informative) that it belongs here.

I'll let the title and abstract of this paper speak for itself:

Dov Sikirov. Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health. Digestive Diseases and Sciences, 48(7):1201–1205, July 2003.

The aim of the study was to compare the straining forces applied when sitting or squatting during defecation. Twenty-eight apparently healthy volunteers (ages 17–66 years) with normal bowel function were asked to use a digital timer to record the net time needed for sensation of satisfactory emptying while defecating in three alternative positions: sitting on a standard-sized toilet seat (41–42 cm high), sitting on a lower toilet seat (31–32 cm high), and squatting. They were also asked to note their subjective impression of the intensity of the defecation effort. Six consecutive bowel movements were recorded in each position. Both the time needed for sensation of satisfactory bowel emptying and the degree of subjectively assessed straining in the squatting position were reduced sharply in all volunteers compared with both sitting positions (P < 0.0001). In conclusion, the present study confirmed that sensation of satisfactory bowel emptying in sitting defecation posture necessitates excessive expulsive effort compared to the squatting. [Emphasis is mine.]

In summary, I haven't really answered your question at all, however, in the process I've found this relatively amusing scatological study. The study does conclude that squatting is better at least for defecation.

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As a french, I can tell you that there is no correlation between "squat toilet" and "birth complications" in France.

Squat toilets are only found in public area. At home or work, nobody would want a "squat toilet" (only some old houses have them).

The only reason there is "squat toilet" in France, is that it's easier to clean and less water use.

And of course, nowadays they tend to be rare.

  • +1 I rebelliously up-voted your answer, even though it contains no references: because, it's a new and simple (elegant) answer to the claim made in the OP. Some people will tell you that "the plural of 'anecdote' is not 'data'" and that all answers must be referenced. A more formal answer would need to prove your thesis (that squat toilets aren't significantly present in France), perhaps by referencing data for plumbing supply sales, or something like that. – ChrisW Sep 23 '13 at 10:18
  • @ChrisW, one could turn that one its head and require proof that squat toilets are significantly present. (I hate the things, so there will always be too many as far as I'm concerned!) – Benjol Sep 23 '13 at 12:03
  • Yes, I considered as being french, I may be the expert (at least to say that assumptions in the question are wrong). But I didn't prove it though. – Nikko Sep 23 '13 at 12:39
  • OP didn't provide any reference either. I'm not upvoting this, since I think it should have been a comment, but we should definitely question the relevance of the question itself. I am French as well, and I never heard about this. – Aeronth Sep 24 '13 at 13:06
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Humans were designed to squat for bodily functions (including childbirth). By abandoning squat toilets, we have lost the ability to squat (except momentarily). So, by returning to the daily habit of squatting to defecate, women can regain their ability to give birth in the most natural, ergonomic position. This study (http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1969.tb06185.x/abstract) shows that squatting opens the birth canal twenty to thirty percent more than the standard recumbent birth posture. Squatting has many other benefits, discussed at http://www.naturesplatform.com/health_benefits.html

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    Humans were not designed. Also, the website “Nature's Platform” is not an acceptable reference here. To paraphrase the Wikipedia discussion (before they purged any reference to this website): any website which claims that use of squat toilets is anticorrelated with cancer “has got some major explaining to do to prove their case”. – Konrad Rudolph Sep 22 '13 at 21:02
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    I don't think Jonathan's answer is bad. Evolution in a sense, "designs" us via natural selection as we adapt to our environment and for millions of years, we squatted to go #2 and the ladies, #1 and #2. A million years or evolution is usually right, so in a sense, yes, we were "designed" or at least, evolutionarilly pre-disposed, or . . . any way you say it, it sounds stupid, but the truth is, we've been built to squat and now we don't do it. – userLTK Oct 11 '15 at 0:23

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