This is the type of pushing that a pregnant woman does by making sounds and exhaling. The pregnant woman pushes spontaneously, and the intensity of the push is consistent with the contractions. Although contractions occur during spontaneous pushing, the pregnant woman does not push until she feels the urge to push. Pushing occurs with the urge to push. The pregnant woman begins to push with her resting breath.

This is the type of pushing performed by the pregnant woman while holding her breath. This type of pushing is generally considered by healthcare professionals as directed pushing. The researcher will guide the woman on when and how to push.

In this pushing method, pregnant women remain in a squatting position during the second stage of labor. The researcher provides the women with information about spontaneous pushing. The women will be supported in spontaneous pushing, and their urge to push will be taken into consideration. In spontaneous pushing:

Regular breathing until the urge to push is felt when contractions begin, inhaling and contracting the core muscles, pushing slowly, exhaling smoothly while contracting during pushing, pushing for 5-6 seconds while exhaling, pushing smoothly and regularly for 5-6 seconds while inhaling and exhaling, and regular breathing when contractions slow down.

It is used to assess pain intensity. The scale is graded from 0 to 10 cm in length, where 0 represents no pain and 10 represents the most severe pain. It is applied by having the individual mark a point corresponding to the intensity of the pain they feel. The distance between the marked point and the lowest end of the line is measured in centimeters, and the resulting numerical value indicates the patient's pain intensity.

The Visual Analogy Scale for Fatigue consists of 18 items. 13 items form the fatigue subscale, and five items form the energy subscale. The most positive and the most negative statements are located at opposite ends of the scale, and horizontal lines with 10 cm intervals are placed between the two statements. A high score on the fatigue subscale and a low score on the energy subscale indicate a higher intensity of fatigue. The minimum score for the fatigue subscale was 0, and the maximum score was 130; the minimum score for the energy subscale was 0, and the maximum score was 50.

It is used to assess pain intensity. The scale is graded from 0 to 10 cm in length, where 0 represents no pain and 10 represents the most severe pain. It is applied by having the individual mark a point corresponding to the intensity of the pain they feel. The distance between the marked point and the lowest end of the line is measured in centimeters, and the resulting numerical value indicates the patient's pain intensity.