Women have described birth as an intense powerful life experience that affects their whole life and being, making childbirth the most significant events in their life1 . Earliest records of maternal birth positions show the parturient in an upright posture, but over centuries delivering women in upright position has become a lost art2 . Current evidence-based practices for management of the second stage of labor supports the practices of delayed pushing, spontaneous pushing, and maternal choice of positions3,4.About 19,340 deliveries are conducted in our tertiary care center of mothers with traditional values and receptive to adopting various birthing positions. Thus, this study is conducted at our tertiary care institute to compare the various alternative birthing positions and their effects on maternal and perinatal outcome. Objectives1.To study duration of labor in upright and dorsal position.2.To study maternal outcome in upright and dorsal position.3.To study fetal outcome with respect to APGAR score and need for neonatal resuscitation.4.To study mothers experience and acceptability by visual analogue scale. Material and Methods-A prospective observational study was conducted after ethical clearance in a tertiary care center among 800 mothers admitted to labor room, who were fitting into inclusion criteria and who gave their consent for participation. The data was maintained, compiled and analyzed. Result- Upright position is associated with significant reduction in the duration of second stage of labor in primipara as well as multipara. The rate of episiotomy, LSCS and instrumental delivery is significantly reduced in mothers opting for upright birthing position. When given a choice, mothers readily adopted the upright position as it had an advantage of “being in control” of the birthing process and is associated with decreased pain perception.