As a birth position, it has been very popular in the past with obstetricians. It allows a good view of the birth process. However, advocates of natural birth believe that the position is not conducive to a smooth labor. They claim it constricts the birth canal, and that other positions, such as a squat, are preferable.

The origin of the position, and hence the name, was in the earliest method of lithotomy, the surgical removal of a bladder stone, in which an incision was made in the perineum. The patient was placed in this posture to afford the surgeon access.