A contemporary theme in maternity care is the provision of alternatives for childbirth. This paper focuses on alternative positions during the first stage of labor. The variation in positions used through history are examined. Empirical observations of the influence of positions on labor and various physiological considerations are also discussed. The paper includes recent research findings of the effect of specific positions on labor. Maternal position is viewed as a feature in the conduct of labor that must be considered within the context of a variety of factors influencing both a safe and satisfying labor outcome.