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Cumulative evidence supports the use of upright positions during labour and childbirth, which has benefits for both mothers and babies. Despite good evidence to support upright birthing positions and the restrictive use of episiotomy, birthing in some part of Africa continues to use the lithotomy/semi-recumbent birthing position and episiotomies. These practices may reflect challenges in adopting and supporting evidence-based practices. Hence, it became important that research be undertaken to explore mothers', midwives' and obstetricians' perceptions and experiences of birthing positions and perineal trauma with this research question: What are the perceptions and experiences of mothers, midwives and obstetricians regarding birthing positions and perineal trauma? The aim of exploring the perceptions and experiences is to identify why birthing positions and perineal care are not based on evidence. Therefore, the findings gathered from this study will play an important role in understanding mothers, midwives and obstetricians views and experiences regarding birthing position and perineal trauma.