I’ve attended childbirth in a rural India. These ladies spend their lives in the fields.
Let me tell you, they were in every bit of as much pain as the Irish women I’ve attended, their labours were just as long, and just as high an incidence of complications, although they did have smaller, less healthy babies. The difference was that the Indian women expected the pain, and thought it was normal, that’s all.
Yes, in India they didn’t practice managed labour, like they do in Dublin, but Ireland is one of the safest (safer than the USA for example) places to have a baby in the world, and there are almost no home birth.
Some women in developing countries have pelvises that are misshapen because of genetic causes, TB or malnutrition- these women have great difficulty in giving birth, no matter what position they are in or how relaxed they are.
In places like Ethiopia and rural parts of India, where people may live 24 hours walk from the road, and at least 48 hours from medical care, a lot of these women (and almost all of their babies) die because of their obstructed labours, which can last for several days.
My classmates, who spent a month in a more remote hospital in Northern India, saw 11 women present to hospital in seriously obstructed labour, only 5 of the women and 1 of the babies survived. 5 more women and their babies died on the way to the hospital. That’s one month in one hospital in one country.
In Ethiopia, the Addis Ababa Fistula Hospital was set up to deal with another devestating consequence of obstructed labour- obstetric fistula.