Maybe the more difficult occur in areas where death in childbirth is normalized. Any birth canal works if you are ok with mom deaths. Plausible.
Women who have 1 child go extinct - death in childbirth is only behind infertility in being selected against The child only has half her genes and she doesn't have any more after she's dead
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You could select for death in childbirth with selective breeding and c-sections, if you wanted to. You'd have an active breeding population of dead mom kiddos. Stuff like this happens all the time w/farmed animals.
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