Midwives' Perspectives on a Program Supporting Spontaneous Pushing During the Second Stage of Labor: A Qualitative...

Maternal pushing during the second stage of labor plays a critical role to labor progression, with professional guidelines recommend supporting a natural, "spontaneous" approach to pushing. Midwives are key to facilitating this practice; however, there is limited of evidence regarding their perceptions of spontaneous pushing. This study was designed to explore midwives' perceptions of a program that supported a woman's spontaneous pushing during labor.

This study employed a descriptive qualitative approach using individual semi-structured interviews. Data were analyzed using thematic analysis. Participants comprised of nine midwives involved in a feasibility study conducted in China.

Three themes were identified from the midwives' interviews. "Returning to a physiological process of childbirth" depicts midwives' positive involvement and experience in supporting spontaneous pushing, viewing it as a way going back to normal labor and birth. "Creating a win-win situation by spontaneous pushing" highlights the benefits of this strategy for both midwives and women. "Reframing the approach to physiological labor and birth" outlines the challenges and efforts it requires in reframing physiological childbirth by supporting spontaneous pushing.

Midwives identified a gap between current evidence and routine midwifery practice. Prenatal education for women and professional training for maternity staff would help to enhance the implementation of spontaneous pushing during labor.