The Effect of Pushing Techniques Used During Childbirth on Women's Labor Duration, Pain, and Fatigue Levels

April 2, 2026 updated by: Sukran Ertekin Pinar, Cumhuriyet University
The Effect of Pushing Techniques Used During Childbirth on Women's Labor Duration, Pain, and Fatigue Levels

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

This study will be conducted with women who have given birth. The research is designed as a randomized controlled experimental study. The sample will consist of women who apply to the maternity ward of a hospital in Turkey for normal delivery. A total of 128 women are planned to be included in the study, divided into two groups: 64 in the spontaneous pushing group and 64 in the Valsalva pushing group. Data will be collected using a Personal Information Form, a Visual Analog Scale, and a Visual Analog Scale for Fatigue. The pushing methods used during childbirth will be taught to the women by the researcher, and then they will be asked to practice them. The forms will be administered during the latent phase and the fourth stage of labor.

Study Type

Interventional

Enrollment (Estimated)

128

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being between 19-35 years old
  • Having had a normal vaginal delivery,
  • Being between 38-41 weeks pregnant,
  • Having a cervical dilation of 8 cm or more,
  • Being nulliparous,
  • Having a singleton pregnancy,
  • Not having a diagnosed physical health problem in the fetus or mother,
  • Not having a diagnosed mental health problem in the mother,
  • Not having hearing or perception problems,
  • Volunteering to participate in the study.

Exclusion Criteria:

  • Being under 19 or over 35 years of age,
  • Having undergone a planned cesarean section,
  • Being gestational age between 38 and 41 weeks,
  • Cervical dilation less than 8 cm,
  • Being multiparous,
  • Having a multiple pregnancy,
  • Having a diagnosed physical health problem in the fetus or mother,
  • Having a diagnosed mental health problem in the mother,
  • Having hearing and perception problems,
  • Not being a volunteer to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Spontaneous pushing group
This is the type of pushing that a pregnant woman does by making sounds and exhaling. The pregnant woman pushes spontaneously, and the intensity of the push is consistent with the contractions. Although contractions occur during spontaneous pushing, the pregnant woman does not push until she feels the urge to push. Pushing occurs with the urge to push. The pregnant woman begins to push with her resting breath.
Behavioral: Spontaneous straining

In this pushing method, pregnant women remain in a squatting position during the second stage of labor. The researcher provides the women with information about spontaneous pushing. The women will be supported in spontaneous pushing, and their urge to push will be taken into consideration. In spontaneous pushing:

Regular breathing until the urge to push is felt when contractions begin, inhaling and contracting the core muscles, pushing slowly, exhaling smoothly while contracting during pushing, pushing for 5-6 seconds while exhaling, pushing smoothly and regularly for 5-6 seconds while inhaling and exhaling, and regular breathing when contractions slow down.
Experimental: Valsalva straining group
This is the type of pushing performed by the pregnant woman while holding her breath. This type of pushing is generally considered by healthcare professionals as directed pushing. The researcher will guide the woman on when and how to push.
Behavioral: Valsalva type pushing
  • When contractions begin, take two regular breaths,
  • Then take a deep breath and hold it,
  • Tighten your diaphragm and abdominal muscles,
  • Push as hard and for as long as possible (10-15 seconds),
  • Continue holding your breath while pushing (glottis closed),
  • Exhale, take a deep breath, continue holding your breath,
  • Push hard again for 10-15 seconds,
  • Stop pushing when contractions ease,
  • Relax and try to rest until the next contraction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analogue Scale
Time Frame: Baseline
It is used to assess pain intensity. The scale is graded from 0 to 10 cm in length, where 0 represents no pain and 10 represents the most severe pain. It is applied by having the individual mark a point corresponding to the intensity of the pain they feel. The distance between the marked point and the lowest end of the line is measured in centimeters, and the resulting numerical value indicates the patient's pain intensity.
Baseline
Visual Similarity Scale for Fatigue
Time Frame: Baseline
The Visual Analogy Scale for Fatigue consists of 18 items. 13 items form the fatigue subscale, and five items form the energy subscale. The most positive and the most negative statements are located at opposite ends of the scale, and horizontal lines with 10 cm intervals are placed between the two statements. A high score on the fatigue subscale and a low score on the energy subscale indicate a higher intensity of fatigue. The minimum score for the fatigue subscale was 0, and the maximum score was 130; the minimum score for the energy subscale was 0, and the maximum score was 50.
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analogue Scale
Time Frame: In the fourth stage of labor
It is used to assess pain intensity. The scale is graded from 0 to 10 cm in length, where 0 represents no pain and 10 represents the most severe pain. It is applied by having the individual mark a point corresponding to the intensity of the pain they feel. The distance between the marked point and the lowest end of the line is measured in centimeters, and the resulting numerical value indicates the patient's pain intensity.
In the fourth stage of labor
Visual Analogy Scale for Fatigue
Time Frame: In the fourth stage of labor
The Visual Analogy Scale for Fatigue consists of 18 items. 13 items form the fatigue subscale, and five items form the energy subscale. The most positive and the most negative statements are located at opposite ends of the scale, and horizontal lines with 10 cm intervals are placed between the two statements. A high score on the fatigue subscale and a low score on the energy subscale indicate a higher intensity of fatigue. The minimum score for the fatigue subscale was 0, and the maximum score was 130; the minimum score for the energy subscale was 0, and the maximum score was 50.
In the fourth stage of labor

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cumhuriyet University

Investigators

  • Principal Investigator: Sukran Ertekin Pinar, Prof. Dr., Cumhuriyet University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2026

Primary Completion (Estimated)

July 30, 2026

Study Completion (Estimated)

July 30, 2026

Study Registration Dates

First Submitted

February 18, 2026

First Submitted That Met QC Criteria

February 25, 2026

First Posted (Actual)

March 3, 2026

Study Record Updates

Last Update Posted (Actual)

April 8, 2026

Last Update Submitted That Met QC Criteria

April 2, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TR SİVAS 09

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

There is not a plan to make IPD available.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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