Aim: Review aims to throw light on the historical evolution of various birthing positions used, scientific relevance of alternate birthing positions, the circumstances that led to a shift in birthing position to horizontal ones and the factors currently existing nowadays that hinders the adoption of alternate birthing positions.

Background: Evidence-based knowledge suggests that the positions taken by women during labour have a tremendous effect on the maternal and neonatal birth outcomes. Women in birth should be permitted to select the position of their choice to birth, preferably alternative birthing positions (including upright, kneeling, squatting and lateral positions) during labour. Now a days, most parturients deliver in a semi-recumbent, lithotomy or dorsal, positions. Hospital admission of laboring women leads to disruptive practices that restrains spontaneous and instinctive attitude of laboring women and the focus is strictly only on intrapartum fetal wellbeing and maternal co morbidities. Respect to women’s choice of birthing position and comfort is mostly underrated.

Clinical Significance: Traditionally, laboring women used physiologically appropriate labor positions such as sitting up right, squatting, and even standing in the birthing process. A pregnant woman delivered her infant in more natural physical positions that allowed for flexing of the hips, straightening the pelvis and facilitating the use of gravity, all of which facilitated the fetus moving through the birth canal. Birthing positions can serve as a nonmedical intervention to improve birth outcomes.

Understanding of scientific relevance of alternate birthing positions, the circumstances that led to a shift in birthing position to horizontal ones and the factors currently existing nowadays that hinders the adoption of alternate birthing positions can help in adopting policies and practices that can promote position changes during labour process that suits the choice, satisfaction and comfort of mother also leading to a positive child birth experience.