I only wear cloth diapers so I always lay down somewhere, a bed, the floor, a couch, back seat or rear of our car, or outside laying down on a changing pad. I've tried changing my diapers when standing or sitting on a toilet seat in emergencies and I can do it, but its a hassel and no telling how well I do. It's much easier to pin my diapers on properly when laying down. And it true whether my wife changes me or I have to do it myself. Fortunately my wife changes me most of the time now.