Abstract The objectives of this mixed-methods study were: al to investigate midwives approaches to early pushing urge(EPUj: and bl to explore midwives perspectives and experiences of helping women cope with EPU. A quantitative observational methodology was adopted to investigate midwives approaches to EPU in 60 cases. A qualitative phenomenological approach was carried out in order to gain more in-depth understanding of midwives views and experiences of EPU management strategies. It was found that midwives mainly adopt approaches in the case of EPU: letting the woman do what she feels, and a stop-pushing technique. The findings are presented as four main domains: al midwives approaches to EPU: bl drivers guiding midwives approaches to EPU; c) influencing factors in helping women cope with EPU; dl variation of midwives approaches to EPU over time.