Antique birthing chairs were designed around a simple principle: sit upright, let gravity help, and give the birth attendant clear access from below. Using one involves sitting with your back against the reclined backrest, gripping the armrests or handles, planting your feet on a footrest or the floor, and bearing down while the open seat allows the baby to be caught from underneath. The chair does much of the work by holding you in a position that opens the pelvis and recruits your body’s muscles more efficiently than lying flat.
How the Chair Is Designed to Work
The most distinctive feature of an antique birthing chair is the U-shaped or horseshoe cutout in the seat. This opening serves a direct functional purpose: it allows the midwife or birth attendant, seated or kneeling in front of or below the chair, to catch the baby as it emerges. Without that cutout, an upright seated position would block access entirely.
Beyond the seat opening, most antique chairs share a few key design elements. The backrest tilts slightly backward, letting the mother lean into it for support between contractions. Armrests or integrated handles give her something to grip and brace against while pushing. Many chairs also included a footrest, sometimes adjustable, so the mother could plant her feet firmly and engage her legs. One well-documented Italian chair from around 1701 featured a leather-covered seat, gripping handles, an adjustable footrest, and even a foot warmer built into the base.
Positioning Your Body in the Chair
The mother sits with her back supported by the backrest, hips positioned over the open section of the seat. Feet go flat on the footrest or floor, with knees apart. This creates a wide, stable base. The hands grip the armrests or handles on either side, which serves two purposes: it stabilizes the upper body and gives the abdominal and back muscles something to work against during contractions.
This seated, upright posture engages nearly every major muscle group involved in labor. Your abdominal muscles, back muscles, leg muscles, and the pelvic floor all work together more efficiently in this position than when lying down. The slight backward lean of the backrest keeps you balanced without requiring you to hold yourself upright through effort, so you can rest between contractions and then bear down with your full strength when needed.
Why the Upright Position Matters
Squatting, kneeling, and sitting on a birthing chair all produce the same core effect: they increase the pelvic outlet by about 28 percent compared to lying on your back. That extra space gives the baby more room to descend through the birth canal.
Gravity plays a significant role too. In an upright position, the baby’s head maintains steady pressure on the cervix between contractions, which helps dilation progress. When a mother lies on her back, the baby’s presenting part actually moves backward between contractions because of the angle of the pelvis, essentially sliding uphill. That back-and-forth slows things down. Sitting upright eliminates that problem. The second stage of labor tends to be shorter, and the urge to push arrives spontaneously at the right time rather than needing to be coached.
The Birth Attendant’s Position
Historically, the midwife sat or knelt directly in front of the birthing chair, low enough to reach through the seat opening. Sixteenth-century illustrations typically show at least one midwife seated at the front with additional attendants positioned behind or beside the chair. The attendants behind the mother sometimes provided physical support, pressing against her back or shoulders, while the midwife in front managed the delivery through the horseshoe opening.
This arrangement meant the mother and midwife were essentially face to face, with the midwife working from below. It’s a very different dynamic from modern hospital deliveries where the practitioner stands at the foot of a bed and the mother is reclined.
Portable and Folding Designs
Many antique birthing chairs were designed to travel. Midwives who served multiple families needed equipment they could carry to a home on short notice. Folding versions solved this problem: the leather-covered seat folded up and the arms folded inward, making the whole chair compact enough to transport. A collapsible version featured in a 1690 treatise by the German midwife Justine Siegemund included a full backrest, handles, footrest, and the signature open seat, all in a design that could be broken down and reassembled.
One Italian birthing chair in the collection of London’s Science Museum was passed through three generations of a midwife family from roughly 1701 to 1830, carried to births over more than a century. These weren’t fragile antiques in their time. They were working tools built to be hauled through streets and set up in bedrooms.
Risks of Prolonged Use
Sitting in a birthing chair for extended periods does carry a specific risk: swelling of the vulvar tissue after delivery. The sustained pressure of the body’s weight on the pelvic area, combined with the effort of pushing, can restrict blood flow and cause postpartum edema. This was documented even in clinical use of birthing chairs, not just antique versions. The practical takeaway is that changing positions periodically during labor, rather than remaining seated for the entire process, helps reduce this risk.
Antique Chairs vs. Modern Birthing Stools
Modern birthing stools available in hospitals and birth centers work on the same principles as their antique counterparts. They feature the same horseshoe-shaped seat opening, a low profile, and handles for gripping. The main differences are materials and adjustability. Modern versions use padded, cleanable surfaces and adjustable heights, while antique chairs were typically carved wood with leather padding.
Standard chairs without a seat cutout can also be used for upright labor and delivery, though they don’t provide the same access for the birth attendant. Some antique designs were essentially backless stools, while others were full chairs with tall backs, armrests, and footrests. The more elaborate the chair, the more support it offered for longer labors, but the core mechanics remained the same across all designs: upright posture, open pelvis, gravity doing its part.