• Although there is no evidence determining the optimum response to EPU, midwives mainly adopt two approaches in the case of an EPU: letting the woman do what she feels and a stop-pushing technique
• Independently from the approach undertaken, it is recommended that midwives need to work with each individual woman in the context of each labour to determine the best approach in the specific case
• Midwives should acknowledge that women often struggle to cope with EPU. Midwives should provide women with explanations and information on EPU; empower mothers; offer individualised womancentred care and emotional support
• Factors that may facilitate midwives in helping women cope with EPU are: models of care considering one-to-one care and continuity of carer; supportive working environments promoting normality of labour and birth; observing a number of women experiencing EPU in labour; good team working and peer support