<![CDATA[Background: Perineal rupture is a common complication of vaginal delivery and may increase the risk of postpartum hemorrhage, pain, infection, delayed wound healing, and maternal morbidity. Appropriate maternal pushing guidance during the second stage of labor is a modifiable factor that may reduce perineal rupture by enabling effective pushing techniques and minimizing excessive pressure on perineal tissues. This study aimed to examine the relationship between maternal pushing guidance and perineal rupture among women undergoing normal vaginal delivery at Tepeleo Inpatient Primary Health Center, North Patani District, Central Halmahera Regency. Methods: This analytical observational study used a cross-sectional design and was conducted from March to May 2026. A total of 30 women undergoing normal vaginal delivery were selected using total sampling. Data were collected through observation checklists, medical records, and demographic characteristics and analyzed using descriptive statistics and the Chi-square test at a 95% confidence level. Results: Appropriate pushing guidance was received by 53.3% of respondents, while perineal rupture occurred in 50.0% of deliveries. Appropriate guidance was associated with a lower incidence of rupture (p < 0.001). Conclusion: Appropriate maternal pushing guidance was significantly associated with a lower incidence of perineal rupture. Strengthening midwives' competencies in effective pushing guidance is important to improve intrapartum care and maternal safety.]]>
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