Background: The women have been giving birth at health facilities without considering their preference of birth positions. Accordingly, they routinely positioned at lithotomy position as standard medical practices during normal vertex vaginal childbirths, which results in negative maternal and neonatal outcomes. Thus, this study aimed to understand women’s perception of birth positions.Objective: To explore perception of women toward child birthing positions among women on postnatal unit at Jimma Medical Center, Jimma town, Ethiopia 2020.Methods and Materials: A descriptive phenomenological approach was employed among women from postnatal and maternity care providers were selected purposively. The audio was transcribed, translated, coded, and categorized to respective identified themes. Then, thematized by Archive for Technology, Lifeworld and Everyday Language.text interpretation (ATLAS.ti version 8) software for thematic analysis in triangulation with the quantitative findings.Results: The women and health care providers were responded on factors affecting the use of alternative birth positions in the health facility. The women were positioned at common supine positions due to women’s lack of awareness about birth positions, women’s passivity to respect their decision-making on their position of preference, and health care professionals’ knowledge and skill gaps on alternative childbirth positions.Conclusion and recommendations: The women were coerced and adopted birth positions directed by health care providers. Therefore, health care providers’ practice should be intensified through the provision and implementation of evidence-based alternative birth positions.