Moi teaching and referral hospital has the largest mother and baby hospital (Riley Mother and Baby hospital (RMBH) in the western region of Kenya. It has convenient labour-and-delivery rooms which are suitable for different labour and birth techniques and positions. Many women delivering in hospitals are not aware of their right to informed choice of birth position and often accept what is offered to them by midwives (Lugina et al, 2004). According to the International Confederation of Midwives (ICM) (2004), the role of the midwife Includes ensuring that the labouring woman is adequately informed of options that may facilitate a more informed choice and a less stressful birth experience. de Jonge et al (2008) assert that the ability of midwives to provide health information related to birth positioning and to support women in their preferred positions will depend largely on their knowledge and experience of various positions, attitudes towards evidence on birth positions, women's preferences and hospital protocols on midwifery care. This study researched midwives' practices and women's perceptions and preferences of birth positions and how these may influence a woman's view of the hospital birth experience or choice of birth place.