The sacral preauricular extension (SPE) and sacral preauricular notch (SPN) are mor- phological changes at the ventral apex of the sacrum. We recently specified their shapes and appearances and suggested a scoring system based on prehistoric Austrian skeletal assemblages. We hypothesized that these specific pelvic changes relate to past pregnancies and parturitions, a hypothesis that we now tested on a subsample of individuals from the Simon Identified Skeletal collection in Geneva (n = 62) and the Christ Church, Spitalfields collection in London (n = 27) linked to historical information on deliveries. We found SPE and SPN in low frequencies and only in female individuals with at least two children in both collections, and a signifi- cant association between the emergence of SPE and first births by 25 years. SPN was found only in two females in the Simon collection, but both with a very high number of recorded parturitions including twin births. Based on these results, we are confident in our assumption that at least SPE, and possibly also SPN, result from increased compression forces at the sacroiliac joint, and especially at the ventrosuperior margin, in recurring (complicated) birth events, the interaction of enhanced pelvic joint mobility that is highest up to age 25, and postural changes related to weight gain during pregnancy. Pelvic shape, dimensions, body proportions, biomechanical issues and hormonal levels may also play a role in their emergence.