What is ‘physiological birth’? A scoping review of the perspectives of women and care providers

•Inconsistency in defining the term ‘physiological birth’ may result in a miscommunication of care, leading to unmet expectations and diminished satisfaction for women/persons experiencing labour and birth. ‘Normal’, ‘natural’ and ‘physiological birth’ are used interchangeably in the literature, however it is unclear what interventions (if any) are congruent with physiological birth.•There are challenges to advocating physiological birth in the hospital setting; a lack of exposure to physiological birth, medicalisation and insufficient support could contribute to a sense of uncertainty for care providers, hindering the provision of clinical care that adheres to a physiological approach. A physiological approach to labour and birth was important to women, regardless of the outcome.•If the term ‘physiological birth’ has become outdated, it is crucial to describe the birthing process without ambiguity and reshape midwifery standards to align with the values that women hold as important. Physiological birth was defined by the World Health Organization in 1997, however, clinical practices in childbirth have changed considerably since this time. Ambiguous terms in healthcare such as ‘physiological birth’ may cause confusion amongst care providers and consumers. To identify what is known about physiological birth, and how perceptions of physiological birth manifest in current literature. This review followed the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR checklist. Four databases were searched using keywords relating to physiological birth. Relevant studies were identified using agreed criteria, and data were extracted and synthesised. A total of 24 studies met the inclusion criteria for this review. Three connected factors were identified: (1) Physiological birth in a risk-averse system, (2) Dominant voices in birth, and (3) Lack of exposure to physiological birth. No unified universal definition of physiological birth was identified in the literature. ‘Physiological birth’ as a term lacks consistency. A risk-averse healthcare system could be a barrier to physiological birth. Dominant voices in the birthing space can dictate the way birth occurs. Lack of exposure to physiological birth may diminish the acquisition and maintenance of important skills and knowledge among care providers. Recognising the factors important to women could lead to a positive birth experience. Excluding a woman's subjective experience from health professi