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The double S shape of the vertebral column is one of the most important evolutionary adaptations to human bipedal locomotion, providing an optimal compromise between stability and mobility. It is commonly believed that a six element long lumbar spine facilitated the critical adoption of lumbar lordosis in early hominins, which contrasts with five lumbars in modern humans and four in chimpanzees and gorillas. This is mainly based on the juvenile Homo erectus skeleton KNM-WT 15000 from Nariokotome, Kenya. Yet, the biomechanical advantage of a long lumbar spine is speculative. Here we present new vertebral and rib fragments of KNM-WT 15000. They demonstrate that the sixth to the last presacral vertebra possesses rib facets and therefore indicate the presence of only five lumbar and twelve thoracic segments, as is characteristic of modern humans. Moreover, they show that no additional element was located between the sixth to the last presacral vertebra and Th11 as suggested in the original description. The transition from thoracic to lumbar type orientation of the facet joints that takes place at Th11 is thus at the same segment as in over 40% of modern humans, suggesting an identical lumbar mobility and capacity for lordosis. Taken together, KNM-WT 15000 had one vertebra less than previously thought irrespective of whether rib-free lumbar vertebrae or vertebrae that bear lumbar-like articular processes are counted. Furthermore, the new rib fragments imply a rearrangement of the ribs that results in a symmetrical rib cage. This challenges previous claims for idiopathic or congenital scoliosis. We conclude that the bauplan of the hominin axial skeleton is more conservative than previously thought.

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The term 'obstetrical dilemma' was coined by Washburn in 1960 to describe the trade-off between selection for a larger birth canal, permitting successful passage of a big-brained human neonate, and the smaller pelvic dimensions required for bipedal locomotion. His suggested solution to these antagonistic pressures was to give birth prematurely, explaining the unusual degree of neurological and physical immaturity, or secondary altriciality, observed in human infants. This proposed trade-off has traditionally been offered as the predominant evolutionary explanation for why human childbirth is so challenging, and inherently risky, compared to that of other primates. This perceived difficulty is likely due to the tight fit of fetal to maternal pelvic dimensions along with the convoluted shape of the birth canal and a comparatively low degree of ligamentous flexibility. Although the ideas combined under the obstetrical dilemma hypothesis originated almost a century ago, they have received renewed attention and empirical scrutiny in the last decade, with some researchers advocating complete rejection of the hypothesis and its assumptions. However, the hypothesis is complex because it presently captures several, mutually non-exclusive ideas: (i) there is an evolutionary trade-off resulting from opposing selection pressures on the pelvis; (ii) selection favouring a narrow pelvis specifically derives from bipedalism; (iii) human neonates are secondarily altricial because they are born relatively immature to ensure that they fit through the maternal bony pelvis; (iv) as a corollary to the asymmetric selection pressure for a spacious birth canal in females, humans evolved pronounced sexual dimorphism of pelvic shape. Recently, the hypothesis has been challenged on both empirical and theoretical grounds. Here, we appraise the original ideas captured under the 'obstetrical dilemma' and their subsequent evolution. We also evaluate complementary and alternative explanations for a tight fetopelvic fit and obstructed labour, including ecological factors related to nutrition and thermoregulation, constraints imposed by the stability of the pelvic floor or by maternal and fetal metabolism, the energetics of bipedalism, and variability in pelvic shape. This reveals that human childbirth is affected by a complex combination of evolutionary, ecological, and biocultural factors, which variably constrain maternal pelvic form and fetal growth. Our review demonstrates that it is unwarranted to reject the obstetrical dilemma hypothesis entirely because several of its fundamental assumptions have not been successfully discounted despite claims to the contrary. As such, the obstetrical dilemma remains a tenable hypothesis that can be used productively to guide evolutionary research.