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Clinical Trials in Turkey / NCT07316348
Enrolling by invitation Not applicable

Vocalization and Spontaneous Pushing in the Second Stage of Labor

NCT07316348 · tracked via the Priya Life Science Turkey tracker
Sponsor
Istanbul University - Cerrahpasa
Phase
Not applicable
Started
2025-03-15
Last updated
2026-02-24

Condition(s) studied

Maternal Pushing TechniquesPerineal TraumaMaternal FatigueLabor

Investigational drug(s) / intervention(s)

The vocalization straining technique will be used.

The vocalization straining technique will be used.: During the second stage of labor, vocalization pushing techniques (using the vowels A, O, and U to exhale in deep tones) will be encouraged, and the mother's pushing will be observed.

Study summary

The second stage of labor, defined as the period from full cervical dilatation to fetal birth, is a critical phase in which maternal pushing techniques may significantly affect maternal and neonatal outcomes (1-5). Evidence indicates that directed Valsalva pushing may be associated with maternal apnea, increased fatigue, pelvic floor injury, and adverse fetal effects, whereas spontaneous pushing with an open glottis supports physiological birth processes (2,5-11). The World Health Organization recommends encouraging women to follow their natural pushing urges and supports the use of open-glottis pushing techniques to promote a positive childbirth experience (12).

Vocalization pushing is an open-glottis maneuver involving intentional low-tone sound production during exhalation, which may facilitate pelvic floor relaxation, improve pain management, and enhance the birth experience (9-11). However, evidence regarding the effectiveness of vocalization pushing is limited, and data from Türkiye are lacking. This randomized controlled clinical trial aims to evaluate the effects of vocalization and spontaneous pushing techniques during the second stage of labor on labor duration, pain intensity, perineal trauma, maternal fatigue, and childbirth experience.

Eligibility

Sex
FEMALE
Min age
18 Years
Max age
—
Healthy volunteers
Accepted
Inclusion Criteria for the Study: * Being 18 years of age or older * Being nulliparous * Being at term (between 38 and 42 weeks of gestation) * Expecting a vaginal delivery * Having a singleton pregnancy * Presenting in vertex position * Estimated fetal weight between 2500-4000 g * Having had a complication-free pregnancy in terms of both mother and fetus * Not having any perinatal risks * Not having received any analgesia or anesthesia to relieve pain and fatigue during labor * Being able to read, understand, and write Turkish * Voluntarily agreeing to participate in the study Exclusion Criteria: * Being multiparous * Having a multiple pregnancy * Having dysphonia and hearing loss * Being a high-risk pregnant woman * Having any systemic, chronic, or neurological disease * Pregnant women with fetal risk (presentation anomaly, cephalopelvic disproportion, macrosomia, SGA, fetal death, fetus without gross pathology according to ultrasound) Endpoints for Cases Included in the Study: * Loss of the baby during labor or delivery * Delivery by cesarean section * Pharmacological intervention to relieve pain and fatigue during labor

Primary outcome measure(s)

  • Visuel Analog Scale -Pain — When cervical dilation is 8-9 cm and within the first 30 minutes after delivery
    Min: 0- Max:10
  • Birth Experience Scale — When cervical dilation is 8-9 cm and within the first 30 minutes after delivery
    Min: 42- Max:150
  • Visual Analogue Scale for Fatigue — When cervical dilation is 8-9 cm and within the first 30 minutes after delivery
    Min: 0- Max:10

Trial sites (1)

FacilityCityRegionStatus
Istanbul University Cerrahpaşa Istanbul Ataşehir

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Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT07316348 on ClinicalTrials.gov ↗ ← All trials in Turkey