Abstract: Objective: To evaluate the effect of delayed pushing during second-stage of labor on birth outcomes among nulliparous women with epidural anesthesia. Methods: Four hundred nulliparous women with epidural anesthesia were randomized to the delayed pushing group and immediate pushing group. The measured variables included the length of second-stage of labor, duration of pushing, type of delivery, Apgar scores, neonatal weight, perineal injuries, postpartum hemorrhage (PPH) and maternal fatigue. Results: The second-stage of labor was significantly longer and the duration of pushing was shorter in delayed pushing group than those in the immediate pushing group (P<0.01). There were no differences in type of delivery, Apgar scores, neonatal weight, perineal injuries and episiotomy between groups (P>0.05).The PPH volume was significantly lower in the delayed pushing group than that in the immediate pushing group (P<0.01).The results showed comparatively lower fatigue scores in the delayed pushing group at both half an hour and two hour postpartum (P<0.01). Conclusion: The delayed pushing for nulliparous women with epidural anesthesia during the secondstage labor could shorten the duration of pushing, PPH volume and postpartum fatigue without adverse outcome for mother and neonate.