Category: Academic Analysis

Source: The Conversation – UK – By Andrea Loux Jarman, Senior Lecturer in Law, Bournemouth University

The US Supreme Court told Donald Trump on February 20 that the tariffs he has used to try and bend the world to his will are unlawful. Tariffs are taxes and it is not for the president to impose them. According to the US constitution, Congress holds the power of the purse.

Trump relied on the terms of a 1977 law designed to address national emergencies, the International Emergency Economic Powers Act, to impose the majority of his tariffs. The court held that this law did not provide Trump with the legal authority to impose them.

In a post on social media following the court’s decision, Trump called the justices who ruled against him a “Disgrace to our Nation”. And he has subsequently announced that he will rely on another law, section 122 of the 1974 Trade Act, to impose worldwide tariffs of 15%.

But even if Trump’s use of that law survives legal challenge, these tariffs would be time limited. The act says that after 150 days the tariffs would continue only if Congress says so. Trump disagrees, saying in his State of the Union address on February 25 that “congressional action will not be necessary”.

Trump is a would-be “strongman” leader. Like all strongmen, his aim is to concentrate political power in himself and those closest to him. Since returning to the White House in January 2025, Trump has preferred to rule by way of executive order rather than through the legislative process. He has done so despite his Republican party controlling both houses of Congress.

Strongmen want to rule without the interference or oversight of legislatures and courts. But Trump has discovered that, in a constitutional democracy that is governed by the rule of law, the Supreme Court will not allow that to happen.

Resisting strongman rule

Trump is not the only western leader to experience push back from a top court when seeking to bypass the legislature. In 2019, Britain’s then-prime minister Boris Johnson wanted to fulfil his political promise to “get Brexit done” unfettered by parliament.

He advised the queen to suspend parliament for five weeks in the lead up to the UK’s “exit day” from the EU. The UK’s Supreme Court ruled unanimously that this advice was unlawful because, in the UK, parliament is sovereign. Parliament has two constitutional roles: to pass legislation and to hold the government to account.

The court held that Johnson and his ministers were constitutionally required to explain and justify their policies, decisions and actions to parliament and to answer parliament’s questions. Parliament must be free to exercise its constitutional functions, the court said, especially in times of great change.

The UK and the US have vastly different constitutions. But when faced with strongmen tactics, the supreme courts in both countries have stepped in to uphold the constitutional role of the legislature.

The function of legislatures in a democracy, US Supreme Court Justice Neil Gorsuch declared on February 21 after invalidating Trump’s tariffs, is “to tap the combined wisdom of the people’s elected representatives, not just that of one faction or man”.

In Israel, Prime Minister Benjamin Netanyahu (another would-be strongman leader) and his justice minister, Yariv Levin, have embarked on a programme of judicial reform in recent years to strengthen the power of the executive in relation to the judiciary.

The Israeli parliament passed amendments to the country’s quasi-constitutional Basic Laws in 2023, which aimed to limit the power of the courts to review ministerial decisions. These reforms have caused a constitutional crisis.

Protests were staged against the reforms across Israel in 2023, and military reservists threatened to not report for service. The protests ended abruptly with the October 7 terrorist attacks in southern Israel later that year.

Israel’s Supreme Court struck down one amendment to the Basic Laws in early 2024, with all 15 justices convening for the first time in Israeli history. The court held that it had the power to review the Basic Laws and declared an amendment – that would have limited the court’s ability to review ministerial decisions – unlawful.

However, the ruling has not derailed Netanyahu’s plans to reform the Israeli legal system. In 2025, the Israeli parliament passed a law that introduces more political control over judicial appointments. A case challenging this law will be heard by the full bench of the Israeli Supreme Court in summer 2026.

Meanwhile, Levin is refusing to cooperate with the president of the supreme court, Yitzhak Amit, to make judicial appointments. The Israeli government is also seeking to dismiss the independent attorney-general, Gali Baharav-Miara, who has argued against the reform.

In his response to the recent decision in the US to strike down Trump’s tariffs, French president Emmanuel Macron said: “It is not bad to have a supreme court and, therefore, the rule of law. It is good to have power and counterweights to power in democracies.”

At a time when strongman tactics appear to be on the rise, the courts are providing the last line of defence against authoritarian rule.

Andrea Loux Jarman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Trump tariff ruling shows top courts serve as last line of defence against strongman rule – https://theconversation.com/trump-tariff-ruling-shows-top-courts-serve-as-last-line-of-defence-against-strongman-rule-276571

Source: The Conversation – UK – By Fredrik NG Andersson, Associate Professor, Department of Economics, Lund University

Sweden has been part of the European Union for 30 years, yet it is one of the few EU countries that has kept its own currency, the krona. Legally, Sweden is expected to join the euro one day but in reality, that day keeps being pushed into the future.

This makes Sweden something of an outlier in Europe. In a referendum in 2003, 56% of voters said no to the euro, and no government since then has felt confident enough to revisit the question.

Now however, as Europe faces new economic and geopolitical pressures, there have been reports that the mood in Sweden is beginning to shift. The country’s central bank (Riksbank) recently acknowledged that the economic uncertainty caused by US president Donald Trump’s erratic tariff policies had “widened the range of potential outcomes”. But despite the headlines, any move would represent a major change in direction for Swedes.

Sweden’s relationship with European integration has always been pragmatic. Cooperation has been viewed primarily through an economic lens rather than as a political project.

During the cold war, the country’s policy of neutrality kept it outside the European Economic Community (the original European free trade area). When Sweden finally joined the EU in 1995, it did so largely because the creation of the single market in 1993 had reshaped trade across Europe. For a small, export-orientated economy, access to that market was essential.

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From the beginning, Swedish debate about EU membership centred on growth, jobs and stability rather than on questions of shared political identity. That economic focus would later shape attitudes towards the euro as well.

A second formative experience came from Sweden’s own financial and currency crisis in the early 1990s. After a period of currency turmoil, the Riksbank hiked interest rates to an astonishing 500% in a bid to prevent devaluation.

When this failed, the krona was allowed to float (meaning it could be traded on currency markets, which would determine its value) after being pegged to other currencies for more than half a century. Sweden then entered a deep recession.

The crisis marked a turning point. Sweden had moved to a floating exchange rate, the Riksbank was granted independence, and strict rules to prevent unsustainable budget deficits were introduced.

Over time these reforms restored credibility and stability. They also left a lasting imprint on public opinion: monetary independence and flexible exchange rates came to be seen by citizens as beneficial.

When the euro was being designed in the 1990s, Sweden was still recovering from its economic crisis. Public finances were strained and unemployment was high. A government-appointed commission concluded in 1996 that Sweden was not yet ready to join a monetary union. As a result, the country stayed out when the euro was launched in 1999.

Stronger on the outside?

When the 2003 referendum was called, memories of the 1990s crisis and the risks associated with fixed exchange rates were still vivid. So voters chose to remain outside.

Since then, Sweden’s economic performance has often been better than that of the euro area. Output has grown at a consistently faster pace, and the economy has weathered major shocks, including the global financial crisis, the European sovereign debt crisis and the COVID pandemic, with relative resilience.

Stronger growth has bolstered the public finances, and Sweden’s public debt ratio today stands at less than half the average level in the euro area.

As Swedish public opinion tends to evaluate European cooperation in economic terms, these comparisons matter. Support for the euro fell sharply during the euro debt crisis. Although it has recovered in recent years, roughly half of Swedes say they would vote no to joining while around one third would vote yes.

At the political level, the picture remains divided. Some parties continue to favour eventual membership, while others oppose it. The Social Democrats, Sweden’s largest party, are open to discussion but have made no commitment. The Moderate party is traditionally more pro-European and has signalled interest in reviewing the issue. The Sweden Democrats are firmly against adopting the euro.

But rising geopolitical tensions have nudged the tone of the debate. Sweden’s swift decision to join Nato in 2024 demonstrated that long-standing positions can change quickly. Some argue that deeper integration within the EU, including euro membership, would strengthen Sweden’s influence and reduce vulnerability in a more uncertain world.

If Sweden were to join, the formal process is relatively clear. It would need to participate in the EU’s exchange rate mechanism, align its legislation with euro area rules and meet the convergence criteria, such as limits on inflation and government deficits. It largely already satisfies these. In political terms, however, a new referendum would almost certainly be required.

For now, continuity appears more likely than change. Political parties remain divided. The updated review of the 1996 euro commission, chaired by the same economist, Lars Calmfors, did not agree on whether the benefits of adopting the euro would outweigh the costs.

Sweden’s approach to European integration has long been cautious and grounded in economic analysis. Unless Swedes become convinced that membership would clearly strengthen stability and long-term prosperity, the krona will probably remain as their national currency.

Fredrik NG Andersson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Could global tensions finally see Sweden warming towards the euro? – https://theconversation.com/could-global-tensions-finally-see-sweden-warming-towards-the-euro-276906

Source: The Conversation – UK – By Christopher Wiley, Head of Music and Media; School of Arts, Humanities and Creative Industries, University of Surrey

Like a voice from the grave, an important part of Surrey’s cultural heritage has sounded again. It is a short ceremonial brass fanfare by Dame Ethel Smyth (1858–1944).

Fanfares are short, rousing pieces for brass instruments. Late last year I was asked to find one to open the installation ceremony for the University of Surrey’s new vice chancellor, Professor Stephen Jarvis. As this was going to be a high-profile public event attended by hundreds of people in Guildford Cathedral, I knew I needed a unique piece of music.

Rather than commission a new work, I revived a forgotten piece instead: Smyth’s Hot Potatoes fanfare. I chose this composer because she had strong local ties and links to university research.

In 1930, eight of the most prominent British composers of the day were commissioned to write short fanfares for the Musicians’ Benevolent Fund. Each lasted about a minute.

The last of the set was written by Smyth. She based it on a military bugle call, formally titled the Men’s Meal (2nd call). The call signalled that the troops could collect their rations. It is colloquially known as Hot Potatoes. Soldiers added comic words to help remember its meaning: “Oh, pick ’em up, pick ’em up, hot potatoes …”

Three months ago, the university’s department of music and media presented a major orchestral concert for the annual nationwide Being Human Festival. Several of Smyth’s works received their modern UK premiere.

One year prior, the university installed a maquette of Smyth outside its main music performance space on campus. It is a smaller replica of the lifesize-plus statue unveiled in 2022 a few miles away in the centre of her home town, Woking. My research revealed it to be one of few statues to women composers in the world.

At the pinnacle of Smyth’s impressive musical output lies her six operas, several of which are available in modern recordings. Her other compositions include a Mass (a musical setting of the Christian liturgy), a concerto for violin and horn and a symphony-cum-oratorio. Smyth is widely known in Britain and internationally as one of the greatest women composers in classical music history. She was also an influential suffragette and a much-published author of autobiographical and other prose writings.

Yet little is known of her Hot Potatoes fanfare, possibly the last piece she ever wrote, other than its original instrumentation: four trumpets, four trombones and percussion. It is rarely even mentioned in literature on Smyth.

Composed when she was in her 70s, experiencing profound hearing difficulties and with the greatest achievements of her career behind her, its manuscript has long been lost and for many years it seems to have been generally assumed that it could never be performed again.

The piece would have held particular significance for Smyth. She was familiar with military fanfares from childhood, since her father had attained the rank of Major-General in the British Army. She quoted such bugle calls in her own music, Hot Potatoes having previously appeared in the overture to her final opera, Entente Cordiale, the centenary of the first performance of which fell last year.

While the use of Hot Potatoes is not explicitly identified in the opera’s published vocal score, an archival copy now held in the Beecham Collection at the University of Sheffield is annotated in Smyth’s own hand to indicate its origin.

Smyth’s fanfare from past to present

Smyth’s Hot Potatoes and the other fanfares in the set were first performed by students from the Royal Military School of Music (Kneller Hall Musicians) under Captain H.E. Adkins. The occasion was the Musicians’ Benevolent Fund Annual Dinner held in London’s Savoy Hotel on May 8 1930 (coincidentally the same date on which Smyth died 14 years later), from where the performance was relayed for broadcast on the BBC National Programme.

The fanfares were reprised at this annual event a couple more times, including on St Cecilia’s Day, November 22 1932. The previous June, it had also been recorded by the same ensemble for release by His Master’s Voice (HMV) toward the end of that year. But thereafter the trail runs cold.

However, the HMV recording of the fanfares yielded sufficient information for me to transcribe and arrange Smyth’s piece for students of the University of Surrey Brass Ensemble. I based this work on my wider knowledge of the composer’s output, which proved invaluable in identifying and replicating her musical idiosyncracies.

The idea came to me during research undertaken for my most recent journal article, which takes one of Smyth’s early piano pieces as a case study for exploring questions of performance and interpretation in the rediscovery of “lost” music by historically marginalised composers.

Instead of a faithful transcription, I changed the scoring (though in a nod to the original, I retained four separate trumpet parts) as well as the key of the piece. I even recomposed one bar in its entirety.

Certain details were simply too difficult to make out on the recording, while others naturally lent themselves to being enhanced (and I was convinced that there was at least one wrong note). Nonetheless, this project demonstrates the creative possibilities for bringing back music assumed to be lost to history, and for celebrating diversity by resurrecting works by neglected artists.

Fittingly, since Professor Jarvis’s installation ceremony was an official university event, I conducted the Brass Ensemble from the Cathedral’s South Balcony while wearing my doctoral robes, as had been Smyth’s own practice when wielding the baton. I hope this recovery of Smyth’s Hot Potatoes fanfare will now lead to repeat performances.

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Christopher Wiley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. How I brought a lost fanfare by Ethel Smyth back to life – https://theconversation.com/how-i-brought-a-lost-fanfare-by-ethel-smyth-back-to-life-276479

Source: The Conversation – UK – By Primrose Freestone, Senior Lecturer in Clinical Microbiology, University of Leicester

Sweat rarely smells on its own. Body odour develops when bacteria on the skin break down compounds in sweat and release volatile chemicals that evaporate into the air.

This interaction between sweat and microbes explains why some areas of the body smell more strongly than others, why odour varies between people and how deodorants and antiperspirants reduce it.

Sweat is a clear, salty liquid produced by glands across almost the entire surface of the skin. Its production is controlled by the autonomic nervous system, which regulates automatic bodily functions such as temperature and heart rate. The main function of sweat is cooling. When body temperature rises during exercise, stress or hot weather, sweat evaporates from the skin and carries heat away.

There are three main types of sweat gland, each producing slightly different fluids. Eccrine glands sit across most of the body and release a thin, watery sweat made mostly of water and salt. Apocrine glands, found mainly in the armpits and groin, produce a thicker fluid that contains fats, proteins and sugars. Apoeccrine glands, also concentrated in the armpits, produce sweat that is more similar to the watery type but in larger amounts.

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Anhidrosis: why some people – apparently like Prince Andrew – just can’t sweat

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Odour develops when bacteria on the skin break down the substances in sweat. The skin naturally hosts many kinds of bacteria. Groups with names such as Corynebacteriaceae, Staphylococcaceae and Propionibacteriaceae are commonly involved. As they feed on sweat, they break its ingredients into smaller chemicals that evaporate easily and reach the nose, creating smell.

Different bacteria produce different scents. Staphylococcus hominis, commonly found in the armpits, creates chemicals that smell similar to onions. Corynebacterium and Staphylococcus epidermidis break down a building block of proteins called leucine into isovaleric acid, a compound produced when bacteria break down sweat that has a strong, cheese-like smell.

Some Corynebacterium species produce compounds often described as goat-like. These smell-producing chemicals can stick to clothing, which absorbs both sweat and bacteria, allowing odours to linger. Research confirms that specific bacteria are linked to characteristic odours.

Armpits and feet tend to smell more strongly because they combine dense sweat glands with warmth and moisture, creating favourable conditions for bacterial growth.

Washing removes sweat and reduces bacterial numbers, helping to limit odour. Changing clothes after heavy sweating is also important, as fabrics can trap sweat and microbes. Regular bathing and clean clothing reduce the build-up of odour-causing compounds.

Some people sweat excessively without heat or exercise. This condition, known as hyperhidrosis, affects around 2% of the population and often requires medical treatment rather than improved hygiene alone. Treatment options include prescription-strength antiperspirants, medications that reduce nerve signals to sweat glands, botulinum toxin injections, and iontophoresis, a treatment that uses a mild electrical current passed through water to temporarily reduce activity in sweat glands. In severe cases, surgery may be considered.

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Deodorants and antiperspirants tackle odour in different ways. Deodorants mainly target bacteria, using antimicrobial ingredients to slow their growth and fragrances to mask residual smells. Some plant-based products contain substances such as tea tree oil, potassium alum or pentagalloyl glucose, which also have antimicrobial effects.

Antiperspirants reduce the amount of sweat reaching the skin. Aluminium salts, such as aluminium chlorohydrate, form temporary plugs in eccrine sweat gland openings, limiting moisture and reducing the resources bacteria need to produce odour. Many products combine both approaches.

Body odour varies between people and can be influenced by genetics, age, diet, stress and health conditions. Food and drink can also play a role. Compounds from garlic, onions and some spices can circulate in the bloodstream and be released through sweat, altering its smell. Alcohol is partly excreted through breath and skin and can increase sweating, giving bacteria more material to break down.

Medications can affect body odour in similar ways. Some increase sweating, while others alter metabolism or change the balance of bacteria on the skin. Antibiotics, for example, can shift microbial communities, and certain antidepressants and diabetes medications may increase perspiration. These changes are usually temporary.

Men generally have larger sweat glands and tend to produce more sweat, which can support larger bacterial populations and higher levels of volatile fatty acids such as isovaleric acid, a compound produced when bacteria break down sweat that has a strong, cheese-like smell.

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Occasionally, changes in body odour signal an underlying condition. Trimethylaminuria is a rare inherited disorder in which the body cannot properly break down trimethylamine, resulting in a strong fish-like smell. There is no cure, but symptoms can often be managed through diet, specialised soaps, antibiotics that reduce certain gut bacteria and supplements that can help limit production of the chemical.

Other medical conditions can also alter body odour. Uncontrolled diabetes can produce a sweet or fruity smell on the breath, liver disease can cause a musty odour, and advanced kidney disease may lead to a urine-like smell. Certain infections and metabolic disorders can also change how the body smells.

For example, researchers have investigated whether analysing volatile chemicals released from the body could help detect infections such as malaria. One study examined whether odour profiles might assist diagnosis through chemical signatures in breath and skin emissions.

Sweat remains essential for regulating body temperature. It does not meaningfully remove toxins, despite common claims. Detoxification is carried out primarily by the liver and kidneys. This means you cannot “sweat off” a hangover or “sweat out” a cold. Alcohol is broken down by the liver, and viral infections are cleared by the immune system, not through sweat.

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However, prolonged sweating during intense exercise or hot weather can lead to fluid and electrolyte loss. To prevent dehydration, it is important to drink enough fluids, and during sustained exertion drinks containing electrolytes may help replace what has been lost.

Body odour is not simply a matter of cleanliness. It reflects the complex interaction between sweat glands, skin bacteria, clothing, diet, medication and individual biology. For most people it is manageable and normal. In some cases, persistent or unusual changes in smell may warrant medical advice.

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Strange Health is hosted by Katie Edwards and Dan Baumgardt. The executive producer is Gemma Ware, with video and sound editing for this episode by Anouk Millet. Artwork by Alice Mason.

In this episode, Dan and Katie talk about a social media clip via YouTube from Alexandrasgirly.

Listen to Strange Health via any of the apps listed above, download it directly via our RSS feed or find out how else to listen here. A transcript is available via the Apple Podcasts or Spotify apps.

Primrose Freestone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The biology of body odour, from sweat glands to skin bacteria – https://theconversation.com/the-biology-of-body-odour-from-sweat-glands-to-skin-bacteria-275491

Source: The Conversation – UK – By Eugene Malthouse, Research Fellow, Centre for Decision Research and Experimental Economics, University of Nottingham

Some buildings leave such an impression when you visit them that they can be forever summoned to the mind’s eye. For us, these include the soaring dome of St Paul’s cathedral in London, the Georgian grandeur of Royal Crescent in Bath, and the ascending towers and pinnacles of King’s College Chapel in Cambridge.

As psychologists with a particular focus on wellbeing, we are fascinated by the feelings these buildings instil in us – a sense of being grounded, of momentary stillness, even of awe.

But while the effects of experiencing beautiful surroundings on people’s wellbeing has been extensively researched, these studies have mainly focused on natural landscapes and settings.

We wanted to understand how people value different urban settings – and which types of building they view most positively. In England, 83 out of every 100 people now live in towns and cities, so variations in these urban landscapes can hold important consequences for wellbeing.

Our study, published in Frontiers in Psychology, found a particularly powerful effect when people viewed older buildings, particularly those classified as being of special historic or architectural interest. Indeed, we found these listed buildings are comparable with forests and lakes in terms of how people rated their scenic quality.

How we tested urban scenicness

Our study combined two large datasets – the first from Scenic-Or-Not, a website where people rate the scenicness of photographs taken throughout Britain on a scale from 1 (“not scenic”) to 10 (“very scenic”). For our analysis, we used only photographs taken within English urban areas, giving us 28,547 ratings of 3,843 images.

We combined this with Historic England’s dataset of more than 370,000 listed buildings throughout England and Wales, plus their grade – I (of exceptional interest), II* (particularly important) or II (special interest) – and the century in which the building was constructed.

This enabled us to compare the ratings of views with and without listed buildings, and to explore other questions such as how the grade or century of construction influences the scenicness rating. Sometimes these buildings featured prominently in the photographs, other times only marginally – we counted them all the same.

We also used Google’s Vision AI tool to detect other features in photographs that might influence scenicness. This allowed us to rule out the possibility that photographs containing historic buildings were judged more scenic because they also tended to contain trees, for example.

In our study, the average scenicness of English urban areas was 2.43 out of 10 – significantly lower than how people rate the scenicness of natural environments. In another study that used the same platform to rate British rural scenes, these averaged 4.16.

But we also found that when a listed building was present in the photograph, this score was on average 0.61 points higher – a 25% increase. As shown in this table, this “historic building effect” was comparable to that of forests and lakes.

Impact of different features on scenicness rating:

Photographs in which the most prominent listed building was either grade I or grade II* listed were perceived more scenic than those featuring slightly less historically or architecturally significant (grade II) buildings. Images featuring buildings constructed in earlier centuries were also judged more scenic.

What makes historic buildings so valued?

The scenic quality of urban areas has previously been linked with variations in happiness and health. Our study shows old buildings in particular make important contributions to urban scenicness. This suggests that historic buildings may be worth preserving not only for their architectural significance but for their effect on people’s wellbeing.

But it also raises the question of whether the sheer age of these buildings makes them so impactful – or is it also the nature of their design?

Experts in architecture have speculated on the reasons old buildings continue to be valued so highly. For example, the apparent timeless popularity of certain historic styles, such as the symmetry of Georgian architecture in Bath’s Royal Crescent, has been contrasted with modern architecture that disregards or rejects traditional proportional guidelines.

But there are also psychological reasons why many people value historic buildings so much. These might include their reassuring sense of permanence; their weathered and imperfect nature; the stories of past lives they hold; or their ability to conjure feelings of nostalgia within us.

We hope to learn more about why people feel so strongly about historic buildings, and the effects such buildings can have on their wellbeing, in our future research. In the meantime, please share your thoughts and experiences in the comments below.

Eugene Malthouse received funding from the European Research Council.

Sidney Sherborne received funding from the European Research Council.

– ref. What makes a city beautiful? Here’s what ratings of thousands of urban landscapes reveal – https://theconversation.com/what-makes-a-city-beautiful-heres-what-ratings-of-thousands-of-urban-landscapes-reveal-276319

Source: The Conversation – UK – By Anastasia Topalidou, Associate Professor in Perinatal Biomechanics and Health Technologies, University of Lancashire

For years, debates about maternity care have centred on how women give birth. But the more important question has always been safety.

Vaginal birth, assisted birth and caesarean section are different clinical routes, not measures of success. The outcome that matters is the wellbeing of both mother and baby, guided by individual risk and informed decision making.

In the wake of maternity investigations, public debate has focused on staffing levels, organisational culture and accountability. These are essential concerns. But there is another, less visible issue. We still do not fully measure or understand what physically happens during childbirth itself.

Labour is one of the most physically demanding processes the human body experiences. It involves coordinated muscle activity, shifting pressure through the pelvis and spine, and joints adapting under intense physiological stress. Yet there are currently no studies directly measuring how labour positions, movement, hands-on techniques and physical forces affect the mother and baby in real time during active labour.

As a result, many positioning strategies are based largely on tradition and accumulated clinical experience rather than direct measurement.

Guidance sometimes suggests certain positions are better than others. But bodies do not behave in one-size-fits-all ways. Research examining upright birthing positions shows there is no single ideal mechanical pattern. The same position can distribute strain differently depending on flexibility, spinal curvature, previous injury and joint mobility.

Despite this complexity, active labour is still not measured biomechanically in real time, while other demanding physical activities have been studied in great detail. Marathon running, for example, has been analysed extensively. Researchers have mapped muscle activity, joint forces and how the body interacts with the ground. Birth has not received the same level of mechanical study.

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This gap reflects long-standing research priorities. Women were historically excluded from large areas of clinical research, and funding for women’s health remains comparatively limited. In England, a dedicated Women’s Health Strategy was introduced only in 2022.

Foetal movement

One of the most common reasons women seek urgent maternity assessment is reduced or absent foetal movement. Yet foetal movement itself is not directly measured.

The main monitoring tool used in pregnancy and labour is cardiotocography, often called CTG. It tracks the baby’s heart rate and the mother’s contractions. It does not capture how the baby moves, such as limb activity, rotation or developing movement patterns. In practice, assessment still relies largely on what the pregnant woman feels and reports.

When someone says, “My baby is not moving normally,” she is describing a change we cannot objectively measure in real time. If detecting change early is central to safe care, this gap matters. When reassurance is given, it is based on the measurements we currently have, but not always the ones we need.

The education gap

Midwives, obstetricians and maternity teams support one of the most physically demanding processes the human body undergoes. Yet formal education in biomechanics is limited. Biomechanics is the study of how forces move through the body, how joints interact and how changing one angle affects another.

Understanding how altering hip position affects the pelvis and spine is not abstract theory. It can influence comfort, pressure on tissues and potentially safety.

Embedding biomechanics into maternity education is not about criticising clinicians. It is about giving them more precise tools and knowledge to support decision making.

Improving maternity safety requires care to be guided by evidence rather than shaped mainly by tradition.

The NHS spends substantial sums each year on maternity-related negligence payments. Investing even a fraction of this in rigorous childbirth research, alongside improvements to staffing and systems, could strengthen the scientific foundation of care and support safer, more personalised decisions.

Behind every statistic is a family living with loss, trauma or unanswered questions. Improving maternity safety is not only about accountability or workforce pressures. It is also about understanding what happens during labour, equipping clinicians with better knowledge and ensuring women’s concerns are supported by reliable tools.

Birth is one of the most significant physical events in human life. It deserves to be studied and understood with the same scientific rigour applied to any other complex medical process.

Anastasia Topalidou received funding from the NIHR Applied Research Collaboration North West Coast (NIHR ARC NWC) for the completion of the scoping review referenced in this article.

– ref. Good maternity care needs good science – but there’s more research on marathon running than giving birth – https://theconversation.com/good-maternity-care-needs-good-science-but-theres-more-research-on-marathon-running-than-giving-birth-276093