Lying on your back is one of the worst positions for giving birth.
Lithotomy is one of, if not THE most popular positions for laboring and giving birth in America. (It accounts for well over half of all births in America.) A close runner up is a reclined sitting position.
Research shows that women are able to labor more effectively and give birth more easily if they are allowed to choose their own positions and change them accordingly throughout labor and delivery. An upright position is often favored. (squatting, standing, kneeling) Updated medical textbooks detail that an upright position is beneficial to a birthing mom, especially a first time mom. Despite heaps of documented evidence against lithotomy, the majority of women are told that they should remain on their backs during labor and delivery.
Why is it a less than stellar position?
It can compress a large vein called the vena cava that can reduce blood flow to the placenta. It works against gravity and creates more work for mom and baby. The compression of the uterus while in this position can lower baby's oxygen supply. It can decrease the size of the birth canal by as much as 30%. There is a greater chance of the need for delivery "assistance" in the form of vacuums, forceps, and episiotomies.
Why is it so popular?
Basically, it makes it easier on the staff. Doctors and nurses can more easily assess/access a laboring woman in this position. Most hospitals will use fetal monitoring devices that are not movement friendly and require mom to remain in a lying position. (It also should be noted that continuous electronic fetal monitoring has not shown to have any effect on fetal outcome. It has, however, been related to an increased number of Cesareans.)
A few resources and references :
http://summaries.cochrane.org/CD002006/position-in-the-second-stage-of-labour-for-women-without-epidural-anaesthesia
http://www.scienceandsensibility.org/?tag=why-to-avoid-giving-birth-on-your-back
And pretty much any other book or website detailing birthing positions...
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