Introduction: Women are at high risk for perineal injuries during vaginal birth. This can occur due to spontaneous tissue rupture or performance of episiotomy. The most common problem that women with perineal injury face is perineal pain. Due to the frequent occurrence of these problems in women in the postpartum period, experts have begun to look for methods that would help reduce the incidence of perineal injuries. One of the methods that has been proven successful through research is the use of birthing positions during labour. Purpose: The purpose of this diploma was to determine, through a review of the professional literature, how can the use of birth positions in the second stage of labour help reduce the incidence of episiotomies and severe perineal ruptures. Methods: For the research part of the diploma, we performed a systematic review of Slovenian and foreign literature. The literature was selected with the help of the library of the University of Ljubljana at the Faculty of Medicine and searches in various databases: COBISS, DiKUL, PubMed, Wiley Online Library and Google Schoolar. Search keywords were: »positions for labour«, »alternative birth positions«, »episiotomy in birthing positions«, »birthing positions during second stage of labour«. Results: With the help of the PRISMA diagram, we presented a schematic presentation of the found literature, and with the use of keywords, restrictive criteria and elimination we came to 28 texts suitable for the final analysis. We analyzed the literature according to the author and year of publication, research design, purpose of the research, sample and country of research, and key research findings, after which we divided the literature by codes and categories. Discussion and conclusion: Through this review, we discovered a number of positive effects that the use of alternative delivery positions can have on the mother’s body. By using childbirth positions, we can reduce the need for episiotomy, instrumental assisted labor, reduce the possibility of severe ruptures of the perineum, shorten the second stage of labour, enable less painful childbirth and pleasant recovery after childbirth and also give women a greater satisfaction with their birth experience. According to many global recommendations, midwives should have a lot of knowledge about birthing positions their purpose and benefits, as we are experts in midwifery practice, and should be able to give advise and guide woman during labour according to their wishes and expectations.