Occurs because of two factors: Natural Increase when the birth rate is higher than the death rate, and Net Migration Gain when the number of migrants into a country exceeds the number leaving a country
Increases in the population level allow more effective exploitation of the resources available (food, energy, land etc) and lead to higher incomes per capita
MEDC pyramids tend to be narrow at the base (low birth rate) and remain a similar shape up to the ages of 65+ due to a low death rate through these ages
The pyramid is often tall due to long life expectancy