Just to add a footnote to PaganScribe's and Thalia's great explanations on evolution, and perhaps an unnecessary footnote on that - keep in mind that what we call "evolution" is the birds-eye view of a zillion things that happen to individuals. Over a whole lot of time, those things add up to shape the species. But as pointed out it's a continual process and one that isn't "over." So just because humans as a species have been evolving in a particular way doesn't mean that everyone who is alive today has the particular genes (whose expression is affected by environment - nutrition, disease, culture, etc.) that are more likely to lead to survival.
Also keep in mind that a physical trait may have deleterious consequences in one setting but beneficial consequences in another. So it won't necessarily be selected for 100% or against 100%. A good example is the set of genes that leads to sickle cell anemia. That set of genes confers some defense against malaria. So it makes sense that it wouldn't die out of a population that has evolved in the presence of malaria, even though it leads to disease.
So to take another example in the birthing context, just because in the past many women who were less fit for giving birth because of a disproportionate pelvis died, doesn't mean that the set of genes leading to a disproportionate pelvis would automatically be selected against 100% and that eventually we could anticipate that there would never be mamas with too-small pelvises giving birth to too-large babies. Because maybe certain mamas who had those genes lucked out and had great nutrition, a smaller baby who did survive, luck of the draw, whatever....and one of her offspring survived to pass those genes along. Maybe the set of genes was for a really big brain and the baby and her offspring grew up to be really smart, which was selected for. :LOL (Totally silly and inexact example obviously!)
All we can say about evolution and human birthing is that for most women most of the time birthing can go fine....because evolution works especially well on reproductive processes. But evolution works on individuals and not all individuals will be equally fit AND have equal luck in terms of culture, circumstances, etc. So one thing we should NOT do is imply that women should ALL have an equally grand birthing experience and that any failure to meet this standard must be their fault (or the system's) because evolution ensures that, left alone, all births turn out well. Even given all the problems with our birthing system in this culture, that just isn't true.



