The objectives of this mixed-methods study were: a) to investigate midwives' approaches to early pushing urge; b) to explore midwives' perspectives and experiences of helping women cope with EPU. A quantitative observational methodology was adopted to investigate midwives' approaches to early pushing urge in 60 EPU cases. A qualitative phenomenological approach was carried out in order to gain more in-depth understanding of midwives' views and experiences of EPU  Independently from the undertaken approach, 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 strongly struggle to cope with EPU; provide women with explanations and information on EPU; empower mothers; offer individualised woman-centred 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.3