Duration of LaborLabor PainFear of ChildbirthControl (Internet Only)Support
Investigational drug(s) / intervention(s)
Midwife-Guided Birth Affirmation Cards
Midwife-Guided Birth Affirmation Cards: The intervention consists of the application of structured affirmation (positive statement) cards integrated into standard midwifery care during the active phase of labor. A standardized set of 24 culturally appropriate affirmation cards, developed based on literature and expert opinion, will be used. Each participant in the intervention group will be invited to select or be guided to use a subset of these cards (e.g., 4-6 cards) according to personal preference.
During uterine contractions, participants will be encouraged to focus on the selected affirmation statements and repeat them silently or aloud in synchronization with breathing techniques. The midwife will support the process by presenting the cards in a visible area, reading them aloud when needed, and providing verbal encouragement. The intervention will be applied in short cycles (approximately 10-15 minutes) depending on the participant's tolerance and can be repeated throughout the active phase of labor.
Study summary
The aim of this study is to evaluate the effects of midwife-guided birth affirmation cards on labor duration, pain level, fear of childbirth, perceived control, and perceived support in primigravidas. The study seeks to determine whether this non-pharmacological approach used during labor improves the childbirth experience. Accordingly, the research aims to answer the question: "Do midwife-guided birth affirmation cards affect labor duration and the childbirth experience, including pain, fear, perceived control, and perceived support, in primigravidas?"
Eligibility
Sex
FEMALE
Min age
18 Years
Max age
40 Years
Healthy volunteers
Accepted
Inclusion Criteria:
* Having a singleton pregnancy between 37-42 weeks of gestation
* Being between 18-40 years of age
* Being a primigravida
* Having a cephalic presentation with vertex position
* Being in the active phase of labor (cervical dilatation ≥4 cm)
* Accepting non-invasive interventions
* Having no mental or physical disability
* Being able to understand and speak Turkish
* Willingness to participate in the study
Exclusion Criteria:
* High-risk pregnancies
* Pregnant women at risk of intrapartum complications (e.g., oligohydramnios, polyhydramnios, intrauterine fetal demise, placenta previa, placental abruption, acute fetal distress, preeclampsia, fetal dystocia, macrosomia, etc.)
* Pregnant women with a history of medical or obstetric complications
* Women who have attended antenatal education classes (pregnancy school)
* Women using epidural analgesia or other pharmacological pain management methods
* Women experiencing communication difficulties
* Women who are unwilling to participate in the study Exclusion Criteria from the Study
* Experiencing dizziness, shortness of breath, or other discomfort,
* Difficult and prolonged labor, instrumental delivery, placental retention, postpartum hemorrhage, need for neonatal intensive care,
* Situations requiring emergency cesarean section during labor,
* The woman will be excluded from the study if she ceases to cooperate during labor.
Primary outcome measure(s)
Labor Duration — Labor/delivery durations: - Stage 1 active phase (≥4 cm to full dilation), - The duration of Stage 2 (from full dilation to the baby's birth) is given in hours and minutes. The researcher will monitor the duration of labor and interventions through the Birth Care Guide. The Birth Care Guide provides a structured monitoring framework aimed at conducting clinical monitoring systematically, based on evidence, and in a woman-centered manner throughout all stages of labor, from the moment the pregnant woman is admitted to the delivery unit. The guide is based on the World Health Organization's (WHO) positive birth experience and intrapartum care model, and includes the regular recording of clinical parameters related to the progress of labor (cervical dilation, uterine contractions, fetal and maternal monitoring findings), as well as principles of respectful maternal care such as continuous midwifery support, informed consent, effective communication, protection of privacy, supportive care practices, and joint decision-making.
labor pains — Pain (VAS, 0-10 cm): - Applied once at 4 cm, 6 cm, 8 cm, - Full dilation is reached, - Stage 2. The researcher will monitor labor pain using a VAS (Visual Analog Scale). The VAS will be used to measure the pain perceived by the individual. This scale was developed by Price et al. (1983) (Price et al., 1983). In this study, a 10 cm long Visual Analog Scale (VAS) will be used for pain assessment. The left end of the scale will be labeled '0 = no pain', and the right end will be labeled '10 = unbearable pain'.
Fear of Childbirth — Fear (W-DEQ): - W-DEQ-A is administered during the early active phase (4-5 cm) - W-DEQ-B is administered within 2 hours after birth (when the mother is stable). The researcher will monitor fear of childbirth using the W-DEQ A and B version. The scale consists of 33 items. Each item is a 6-point Likert scale with scores from 1 to 6, where 1 means "completely" and 6 means "not at all". The minimum possible score on the scale is 33, while the maximum score is 198. Higher scores indicate a higher level of fear of childbirth experienced by women.
Perception of Control and Support During Childbirth — Sense of Control and Support (SCS): - Applied during the early active phase (4-5 cm) - within 2 hours after birth (when the mother is stable). The Perception of Control and Support During Childbirth Scale will be used by the researcher. It is administered to assess women's perceptions of control and support during childbirth in the postpartum period. The Perception of Control and Support During Childbirth Scale consists of 33 items in total, comprising sub-dimensions of internal control, external control, and perceived support. The scale is a five-point Likert-type scale, where 1 means "strongly disagree" and 5 means "strongly agree". The lowest possible score is 33, and the highest is 165. A higher score indicates a higher perception of support and control during childbirth.
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.
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