Ethical and clinical environment consideration disallowed this study from randomly assigning participants to experimental and control groups. Although the authors found no significant variation in either sociodemographic or obstetric variables caused by the nonrandom nature of distribution between the two. Further studies with randomized designs are needed. This study was limited to expectant mothers who did not receive epidural analgesia. In light of the fact that most women in labor in Taiwan receive epidural analgesia and that the exertion experience of women under such conditions differs from that of women not receiving epidural analgesia, the effects on delivery outcomes and postpartum fatigue of times spent in pushing exertion and pushing technique should be greatly magnified. Because no relevant research into this participant has been conducted in Taiwan, it is hoped that future research can examine the different outcomes realized by women in labor who received or did not receive epidural analgesia injections in terms of delayed pushing, postpartum fatigue, and delivery results.