A reversible orthopedic seat cushion can include a right leg support channel, a left leg support channel, a rear cutout, and a front contoured protuberance, which can allow a person sitting in the cushion to experience reduced pressure on the persons coccyx, while having support and guidance to the position of the legs. The seat cushion can also be used in a reversed position. The features of the cushion may promote a healthy sitting posture, and proper spine alignment, and may reduce or prevent back pain. Also disclosed is a method for configuring a support contour of a cushion.