CONCLUSION A simple elevation of the back of the laboring women with the easily available, low cost resources of backrest that maximizes the important benefits of the gravity offers greater advantages to the low 2012 73 risk mothers in terms of enhanced comfort, shorter duration of second, third stages of labor, insignificant amount of blood loss and safe birthing experiences. In our country the cost-effective interventions are must to deal with the normal process that would work with the natural physiological principles in terms of acceptability, affordability, feasibility and availability to all women. Skilled birth attendants have an important responsibility to promote comfort during labor and birth and should strive to bring a paradigm shift from the routine supine/lithotomy position that works against gravity to women centered, gravity-oriented supported sitting upright position by educating the women and their family before delivery, about the benefits and conducting normal vaginal deliveries in simple upright position to promote maternal and perinatal outcome of labor.