The Effect of Chocolate Consumption During Labor on Second Stage Duration

Childbirth is an energy-intensive physiological process, requiring sustained effort comparable in intensity to moderate physical activity. Studies suggest that providing an available energy source during labor, such as dextrose infusion or natural carbohydrate-rich foods such as dates, may shorten the duration of labor and improve cervical dilation without adversely affecting obstetric outcomes. The primary objective of the study is to examine whether giving chocolate during labor affects the duration of the second stage of labor, compared to a control group that will not receive a nutritional intervention. The study is a prospective, randomized, controlled trial that will be conducted in the delivery room of Hillel Yaffe Medical Center. Healthy pregnant women with a singleton pregnancy at ≥37 weeks gestational age, in spontaneous or induced labor, without diabetes (pre/gestational), will be recruited to participate. Participants in the intervention group will receive one serving of 50 grams of milk chocolate (cocoa content 25-30%, without filling or additives) at a cervical dilation of 6 cm or more (and not yet fully dilated). The mother will be asked to consume the serving gradually over 30 minutes. Milk chocolate was chosen because it is better tolerated compared to dark chocolate, has a more gentle profile of active ingredients (which can increase nausea and heartburn) and provides a source of available carbohydrates. The study will be conducted in accordance with the guidelines of the Ministry of Health's procedure for medical experiments on humans, and will be conducted after approval by the Institutional Helsinki Committee.

Study Overview

• Status: Not yet recruiting
• Conditions: Pregnancy; Labor; Second Stage of Labor
• Intervention / Treatment: Other: 50 g of milk chocolate cocoa content 25-30%

• Study Type: Interventional
• Enrollment (Estimated): 180
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Libby O Madar, M.D; Phone Number: +972-4-7744602; Email: NoaAl@hymc.gov.il
• Study Contact Backup: Name: Rinat Gabbay-Benziv, M.D; Phone Number: +972-4-7744514

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Gestational age ≥37 weeks
2. Single fetus in cephalic presentation
3. Spontaneous or induced labor in the active phase (dilation ≥ 5 cm).
4. Normal assessment of the mother and fetus upon admission to the delivery room (normal indices, normal monitoring and biophysical profile)
5. BMI 18-35 -

Exclusion Criteria:

1. Multiple pregnancies
2. Gestational age <37 weeks
3. Gestational or pre-gestational diabetes
4. Significant underlying diseases
5. Previous cesarean section/myomectomy
6. Known significant fetal malformation
7. Sensitivity to chocolate ingredients
8. Lack of documentation of necessary information -

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 50 g of milk chocolate cocoa content 25-30%; . Participants in the intervention group will receive one serving of 50 grams of milk chocolate (cocoa content 25-30%, without filling or additives) at a cervical dilation of 6 cm or more. The mother will be asked to consume the serving gradually over 30 minutes.	Other: 50 g of milk chocolate cocoa content 25-30%; Milk chocolate was chosen as it is better tolerated compared to dark chocolate, has a milder profile of active ingredients (which can increase nausea and heartburn) and provides a source of available carbohydrates. A dose of 50 grams was chosen that provides 25-30 grams of simple carbohydrates - sufficient for a significant increase in blood glucose but low enough to prevent a sudden sugar load or nausea. The intervention will be given at 6-9 cm dilation, towards the transition to the second phase - to allow the absorption of glucose and neurochemicals to be deafened at a time when the body needs increased energy and alertness. Giving it earlier may result in the effect of the chocolate wearing off before the second phase, and later - there will be no time for effective absorption.
No Intervention: control group - no intervention; Participants in the control group will receive routine care as is customary in the delivery room, without any proactive nutritional supplementation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of second stage of labor	The duration of the second stage of labor, defined as the time in minutes from full cervical dulation (10cm) to delivery of the neonate.	From full cervical dilation to delivery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mode of delivery	Mode of delivery categorized as spontanous vaginal delivery, operative vaginal delivery (vacuum), or cesarean delivery	At delivery
Maternal nausea or vomiting during labor	The occurrence of maternal nausea or vomiting during labor following the assigned intervention, as documented in the medical record	From intervention administration untill discharge from labor room
Umbilical cord blood glucose level	Umbilical cord blood glucose concentration measured from umbelical blood collected immediately after delivery (when a cord blood sample is obtained per routine practice	at delivery
Maternal heart rate	Maternal heart rate measured in beats per minute as recorded by continous intrapartum maternal monitorind	During the second stage of labor
Umbelical cord blood PH	Umbelical cord blood PH measures immediatley after delivery	At delivery
Neonatal Apgar score at 1 and 5 minutes	The Apgar score is assessed at 1 and 5 minutes after delivery. The total score ranges from 0 to 10, with higher scores indicating better neonatal condition.	1 and 5 minutes after delivery

Collaborators and Investigators

• Sponsor: Hillel Yaffe Medical Center

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): January 1, 2027

Study Registration Dates

• First Submitted: January 21, 2026
• First Submitted That Met QC Criteria: January 21, 2026
• First Posted (Actual): January 29, 2026

Study Record Updates

• Last Update Posted (Actual): February 4, 2026
• Last Update Submitted That Met QC Criteria: February 1, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Pregnancy; Randomized controlled trial; Labor; Second stage of labor; Non-pharmacologic intervention; Oral carbohydrate intake; Maternal exhaustion
• Other Study ID Numbers: 0200-25-HYMC

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No