UC proponents have responded to these criticisms by emphasizing that childbirth is not a disease, but rather a natural, physiological process requiring proper nutrition, hygiene, prenatal self-care, and psychological preparation. They claim that both throughout history and in the impoverished regions of today's world it has not been the lack of medical assistance, but rather conditions of poverty and nutritional ignorance which cause maternal mortality to be a major health issue. Rickets, for example, is prevalent in daughters of malnourished women, resulting in deformation of the pelvis and an increased chance of hemorrhage in scenarios of anemia. Proponents assert that the women who plan unassisted childbirth today (many of whom are giving birth to their second or third child, with a 'proven' pelvis), do so with a wealth of information and self-care, and are better prepared than most women who depend on care providers to deliver their child.