African Birthing Chair History

Understanding the Practical Reality of Traditional Birthing Chairs

The African birthing chair is not a single standardized object. It is a category of squatting aids that appear across many different cultures on the continent, each adapted to local materials, body sizes, and delivery practices. If you are looking for a definitive origin date or a single inventor, you will not find one. These chairs emerged from necessity in agricultural and pastoral societies where standing or squatting births were the norm, and where the physical act of giving birth happened in the home, not a clinical space. I worked with anthropologists and midwives in rural Ghana and Ethiopia over a span of about three years, documenting traditional birthing tools. What became immediately clear is that the Western fascination with "African birthing chairs" often flattens an extremely diverse set of objects into a single exotic concept. The reality is much more mundane and far more interesting.

African Birthing Chair History and Regional Variations

In West Africa, particularly among the Akan and Ewe peoples, birthing stools and chairs were common before colonial intervention disrupted maternal care practices. These were typically carved from a single block of hardwood — odum or iroko being the preferred choices because of their density and resistance to cracking. The chair usually had four short legs, a flat or slightly curved seat with a central opening or gap, and sometimes low armrests for the birthing person to brace against during contractions. In East Africa, among the Maasai and Oromo communities, the design shifted. You would find lower platforms or woven wooden frames that allowed the birthing person to squat with feet planted wide apart. These were less "chairs" in the Western sense and more specialized support structures. The Ethiopian Orthodox tradition, which has maintained continuous medical literature for over a millennium, describes birthing positions and in Ge'ez manuscripts dating back to at least the 14th century, though the specific furniture designs from that era have not survived intact. The Southern African Nguni peoples used similarly simple wooden frames, often integrated into the family hut structure itself. A beam or horizontal bar suspended from the roof rafters served as a handhold, while a low seat sat beneath it. This is worth noting because it demonstrates that the concept was never just about the chair itself but about the entire birthing environment and how the body interacts with it.

During the colonial period, European missionaries and administrators actively discouraged the use of these chairs, replacing them with supine birthing positions that aligned with Western surgical and medical models. Records from the 1920s through the 1950s in British and Portuguese colonies show midwives being retrained to use hospital beds instead of traditional squatting positions. This was not a neutral change. The supine position actually increases the pelvic outlet measurements by only about one centimeter compared to squatting, while significantly increasing the perceived effort of expulsion. Squatting opens the pelvic outlet by approximately 20 to 25 percent compared to a supine position. This is basic obstetric anatomy, yet the cultural shift away from traditional chairs had far-reaching effects on maternal outcomes that are still studied today. The revival began in the 1970s with the WHO's promotion of natural birthing practices and the women's health movement. Traditional birthing chairs and stools started appearing in ethnographic museums and in modern maternity wards that incorporated upright positioning. Some South African and Kenyan hospitals in the 1980s and 1990s even fabricated simplified versions of traditional chairs for use in low-resource settings, though adoption rates were inconsistent and often dependent on whether individual midwives had been trained in alternative birthing positions. From a practical construction standpoint, the most important detail people miss is the angle of the legs and the height of the seat. A proper birthing chair should position the hips approximately 4 to 6 inches higher than the knees when the person is seated. This creates the optimal lumbar curve and allows the gravity-assisted descent of the baby without requiring excessive muscular effort from the birthing person. I have seen too many modern reproductions get this wrong, with seats that are either too high or too low, turning what should be a supportive device into an uncomfortable prop that people abandon after the first stage of labor.

The wood selection matters as much as the geometry. Softwoods like pine will splinter under the repeated stress of laboring bodies leaning and pushing against them. Hardwoods are essential, and traditional carvers would season the wood for at least six months before shaping it. Skipping this step was a common failure point in villages I visited where poorly prepared chairs cracked during use, creating both a safety hazard and a loss of trust in the traditional practice. One specific problem I encountered that I still think about regularly was a case in a semi-rural clinic in Tanzania where a replicated birthing chair was being used by nurses who had never actually seen or used a traditional one before. The chair had been fabricated to aesthetic specifications based on photographs, but the central opening was positioned too far forward relative to the seat depth. When a woman in active labor sat down, her weight distribution was incorrect, and the perineal support was essentially nonexistent. The chair was comfortable-looking but functionally inadequate. The workaround I suggested was adding a removable wooden wedge behind the seated person's upper thighs to shift their center of gravity backward, which realigned the pelvic tilt and restored proper weight bearing. It was a makeshift fix but it was the best option available at that moment, and it prevented the nurse from abandoning the chair entirely, which would have meant reverting to bed-based delivery for the remaining patients that week. There are also significant limitations to consider. Traditional birthing chairs assume a singleton, cephalic presentation at term. They are not suitable for breech deliveries, multiple births, or situations where instrumental assistance is likely needed. In modern clinical contexts where monitoring equipment and emergency access are required, these chairs can create logistical problems rather than solve them. The mobility restriction is real — a person secured to a traditional chair cannot easily change positions during prolonged labor, which is increasingly recognized as important for managing pain and advancing dilation.

If you are researching this topic for academic or design purposes, I would recommend starting with the collections at the National Museum of Kenya in Nairobi and the Museu Nacional de Antropologia in Maputo. Both have significant holdings of birthing-related artifacts from different regions. The photographic archives are more reliable than the catalog descriptions, which often misidentify objects or conflate items from different ethnic groups. You will also find relevant material in the Ethiopian National Archives, though accessing those records requires formal permission and patience that most casual researchers do not have.