The aim of this study was to gain insight into the influences on women's use of birthing positions, and into the labor experiences of women in relation to the birthing positions they used. Quantitative studies have shown some medical advantages of non-supine birthing positions. They also suggested some psychological benefits but these are difficult to interpret. In this study in-depth interviews were conducted to gain a deeper understanding of the relationship between birthing positions and the labor experience. We found that the advice given by midwives was the most important factor influencing the choice of birthing positions. If medically possible, women benefited from having the autonomy to find the positions that were most useful to them. Their choices varied greatly, as did their experience of pain in relation to the type of position. Women, regardless of ethnicity, were most familiar with the supine position but valued practical information on other options. In conclusion, because the supine position is dominant in westernized societies, midwives have an important role to play in widening the range of women's choices. Midwives should empower women to find the positions that are most suitable for them, by giving practical advice during pregnancy and labor.