Maternal pushing during labour is crucial to the labour progress and the birth of newborn. Directing a woman’s pushing during labour is routine practice worldwide. Globally, professional organisations advocate for spontaneous pushing, a natural and woman‐led approach of pushing, to facilitate positive birth experience. However, maternal spontaneous pushing behaviours as well as its facilitating strategies remain comparatively unknown. This study aimed to identify and map the current evidence on spontaneous pushing, to inform education, clinical practice and policy. Six global databases as well as grey literature were searched from inception to September 2025. Data selection was carried out by two independent researchers. Twenty‐one studies were included and two themes emerged: (1) pushing behaviours: women’s natural behaviours during spontaneous pushing; (2) facilitating strategies: the strategies which are being used to support women’s spontaneous pushing during labour. This review highlights a significant discrepancy between women’s natural pushing behaviours and the instructions of routine practice. A step‐by‐step guideline should be synthesised and developed for clinical practice. These efforts would help to move clinical practice towards evidence‐based, respectful maternity care.
Yao et al. (Thu,) studied this question.