{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:46:50Z","timestamp":1786632410516,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Maternal pushing during the second stage of labor plays a critical role to labor progression, with professional guidelines recommend supporting a natural, \u201cspontaneous\u201d 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study employed a descriptive qualitative approach using individual semi\u2010structured interviews. Data were analyzed using thematic analysis. Participants comprised of nine midwives involved in a feasibility study conducted in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Three themes were identified from the midwives' interviews. \u201cReturning to a physiological process of childbirth\u201d depicts midwives' positive involvement and experience in supporting spontaneous pushing, viewing it as a way going back to normal labor and birth. \u201cCreating a win\u2010win situation by spontaneous pushing\u201d highlights the benefits of this strategy for both midwives and women. \u201cReframing the approach to physiological labor and birth\u201d outlines the challenges and efforts it requires in reframing physiological childbirth by supporting spontaneous pushing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70060","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:24:29Z","timestamp":1774243469000},"page":"617-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Midwives' Perspectives on a Program Supporting Spontaneous Pushing During the Second Stage of Labor: A Qualitative Study"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4776-1037","authenticated-orcid":false,"given":"Jiasi","family":"Yao","sequence":"first","affiliation":[{"name":"School of Nursing Hebei Medical University  Shijiazhuang Hebei Province China"},{"name":"Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8752-4995","authenticated-orcid":false,"given":"Heike","family":"Roth","sequence":"additional","affiliation":[{"name":"Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"},{"name":"School of Nursing and Midwifery, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8996-9624","authenticated-orcid":false,"given":"Debra","family":"Anderson","sequence":"additional","affiliation":[{"name":"Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7267-0765","authenticated-orcid":false,"given":"Hong","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Nursing Peking University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0142-6962","authenticated-orcid":false,"given":"Kathleen","family":"Baird","sequence":"additional","affiliation":[{"name":"Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"},{"name":"School of Nursing and Midwifery, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Williams Obstetrics the 24th Edition","author":"Cunningham F. 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