 The investigators designed a pilot randomized controlled trial to assess the feasibility and acceptability of repeated hands-and-knees positioning during labour. The objectives were 1 to provide an estimate of enrollment rates, 2 to assess compliance with the study protocol by participants and care providers, 3 to obtain womens views about their experiences using the hands-and-knees position, and 4 to provide estimates of treatment effects to inform the sample size calculation for a large trial. 