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Background: The choice of positions during labor and birth has a huge impact on a mother's comfort levels during the birth process and how quickly and effectively her labor does or does not progress. The aim of this study is to explore health care providers’ perceptions on birthing positions and the possibility to improve evidence-based variety in birthing positions in 2 busy hospitals in Afghanistan. Methods: An exploratory study using focus group discussions (FGDs) asked 30 physicians and midwives in Malalai Maternity Hospital, Kabul, and Badakhshan Provincial Hospital in which positions women can labor and give birth. Convenience sampling technique was utilized to select health workers from 1 urban and 1 rural setting. Data collectors were midwives trained in conducting FGDs. Ethical approval was taken from Institution Review Board. Results: Providers’ perceptions include that some positions have disadvantages such as standing position is difficult to manage and may cause lacerations. They prefer that patients do not give birth in standing position regardless of the woman's wishes. They also think it is unhygienic to give birth in a “sitting/squatting position”. Conclusion: Health care provider perceptions significantly impact women's choices of position during birth and this may contribute to the decision to give birth at home. Researchers recommend educating health care providers and advocating that facilities offer alternative birthing positions and resources in hospitals. Hospital management should ensure that women are supported to adopt the position of their choice.