Inclusion Criteria:  Women between 18 -50 years of age presenting in labor or for induction of labor  Nulliparous (first delivery) 37 0/7- 41 6/7 weeks of gestation Singleton, Vertex presentation Plan to deliver with epidural anesthesia Has had at least one vaginal exam to determine the cervical dilatation prior to the proposed intervention Prescribed Oxytocin (Pitocin)  Exclusion Criteria:  Multi gravida women Admitted in second stage of labor Multiple gestations Non-vertex presentations Women receiving magnesium sulfate Preterm or post term labor (<37 weeks or >42 weeks) Women with hypertensive disorders of pregnancy Diabetes including gestational diabetes Muscular or skeletal limitations that does not allow for positioning Un-medicated labors ( delivery without epidural, about 5-20% ) Category III fetal heart rate tracings Suspected infections (e.g. STDs, viral/bacterial infections) Planned cesarean delivery