The article on spontaneous pushing is in JOGNN Nov/Dec 2005, Vol 34, Number 6, 695-702 and is titled Provider Support of Spontaneous Pushing During the Second Stage and the authors are Carolyn Sampsellem Janis Miller, Yuwadee Luecha, Kathryn Fischer and Lisabeth Rosten Conclusion: The proportion of spontaneous pushig by the birthing woman was positively and significantly associated with the proportion of caregiver communication supporting and encouraging spontaneous pushig. Importantly, spontaneous pushig did not significantly lengthen the duration of second-stage labor or totlal time spent pushing.