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It's not just "ethiopia-type" malnutrition that can cause bone deformation drastic enough to make a pelvis too small - anyone eating a highly processed diet is at risk for growing daughters with pelvic openings too narrow to birth properly.
This was substantiated when Dr. W. Price went & studied "primitive" peoples eating their native diets, and then people of the same culture eating "civilized" (white trader) diets. Birth problems, which were virtually nonexistent in the native diet population, cropped up with alarming regularity in the second generation of those eating the food of civilization. They were eating plenty, but it was all empty foods - white flour, white sugar, packaged & canned foods.
Our countries are slowly going back to a whole-foods ideal.....but if you look at the average shopping cart going through the store, you'll see that most people in the US are malnourished. With kids growing up on macaroni & cheese, white bread & margarine, and sugar cereals, is it no wonder that there are so many birth problems around here?
 

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All the specifics are in Nutrition & Physical Degeneration by Dr. Weston A Price. It was all done in the 1930's, so yes, that was before "enrichment" was common. But just looking at the pictures in the book is enough to convince you that whole, real foods are definitely the way to go!
 

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I've only heard of a couple cases of shoulder distocia that happened in a mother not in the "lamaze position" - propped up on the tailbone.
I know for me, my first baby got stuck at the shoulders, and that was the position I was in. All the others were born with me on hands & knees, and even though Davey was bigger in build that Ian was, he didn't get stuck.

FWIW, my body was telling me quite frantically to get off that table and on my hands & knees during my first birth, but I "couldn't" because I was in the hospital delivery room with an old-school OB attending. I feel that was why his shoulders got stuck.
 
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