PIP: In 1992 at Vivekanand Hospital in Latur, Maharashtra State, India, researchers randomly allocated 326 pregnant women, 15-45 years old, at full term, to either the modified squatting position group (study group) or the normal lithotomy delivery position group (control group) to determine whether the modified squatting position using a birth cushion has any advantages over the normal delivery position. The U-shaped cushion is inexpensive, constructed with coir and foam, and has a washable cover. Its two handles provide the woman support as she pushes and delivers the newborn. There were 145 women in the study group and 181 in the control group. Women in the squatting position did not receive any episiotomies. They spent less time pushing (i.e., in second stage of labor) than those in the control group (median, 21.2 vs. 39.32 min; p 0.01), especially among gravidae 2 and above. The time required to perform vaginal operative delivery was much shorter for the squatting position than for the normal delivery position (11.6 vs. 28.86 min; p 0.01). Fetal stress was more common among newborns delivered by the normal delivery position than among those delivered by the squatting position (7.73% vs. 3.44%; p 0.05). Women in the squatting group were more likely to have an intact perineum after delivery than those in the control group. None of the women in the control group had postpartum vulval edema, while five in the study group did. The edema was mild, however, and resolved itself within 24 hours of delivery. Most women in the squatting position group were satisfied with this position. These findings suggest that the squatting position using a birth cushion has more benefits than the normal delivery position. It allows better coordination and more effective pushing. Traditional birth attendants and female health workers at subcenter and primary health center levels can be trained to use the birth cushion during labor.