Continuous Birth Support by Student Midwives and Labor Pain and Birth Satisfaction (MİDWİFERY)

The Effect of Continuous Birth Support Provided by Student Midwives on Labor Outcomes, Birth Perception, and Birth Satisfaction: A Randomized Controlled Trial

This randomized controlled study aimed to evaluate the effect of continuous birth support provided by senior student midwives on labor outcomes, birth perception, and birth satisfaction. Pregnant women admitted for spontaneous vaginal birth were randomly assigned to either a continuous birth support group or a routine care control group. The intervention consisted of continuous non-pharmacological support provided by trained student midwives under supervision throughout labor. Primary outcomes included perceived birth pain and birth satisfaction, while secondary outcomes included birth perception and obstetric interventions.

Study Overview

• Status: Completed
• Conditions: Labor Pain; Birth Satisfaction
• Intervention / Treatment: Behavioral: Continuous Birth Support; Other: Routine Care

Detailed Description

This randomized controlled trial is designed to evaluate the effect of continuous birth support provided by student midwives on labor pain intensity and birth satisfaction among women giving birth vaginally. The study will be conducted in a maternity hospital setting.

Eligible pregnant women who are admitted to the labor ward and meet the inclusion criteria will be informed about the study and asked to provide written informed consent before participation. After enrollment, participants will be randomly assigned to either an experimental group receiving continuous birth support or a control group receiving routine intrapartum care.

Participants in the experimental group will receive continuous birth support provided by trained student midwives in addition to routine intrapartum care. The intervention will consist of structured breathing exercises guided by student midwives, including slow-paced breathing, patterned breathing during contractions, and relaxation-focused breathing between contractions. The support will begin at admission to the labor ward and continue throughout labor until birth, following a standardized intervention protocol.

Participants in the control group will receive routine intrapartum care according to the standard clinical protocols of the maternity hospital, including regular maternal and fetal monitoring and clinical care by midwives and obstetric staff. No structured breathing exercise program will be provided.

The primary outcome of the study is labor pain intensity, assessed using the Visual Analog Scale (VAS). Pain will be measured at two time points: at admission to the labor ward (baseline) and at cervical dilatation of 6-7 cm.

The secondary outcome is birth satisfaction, assessed within 24 hours postpartum using the Birth Satisfaction Scale-Revised (BSS-R). he study aims to determine whether continuous birth support provided by student midwives is associated with reduced labor pain intensity and increased birth satisfaction compared to routine intrapartum care.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Döşemealti
    • Antalya, Döşemealti, Turkey (Türkiye), 07190
      • Antalya

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Pregnant women aged 18 years or older
• Singleton pregnancy
• Gestational age ≥ 37 completed weeks
• Low-risk pregnancy
• Planned vaginal birth
• Admitted to the labor ward in the latent or early active phase of labor
• No pharmacological analgesia before the first pain assessment
• Ability to communicate and provide written informed consent

Exclusion Criteria:

• High-risk pregnancy requiring continuous medical or obstetric intervention
• Planned cesarean section
• Multiple pregnancy
• Known fetal anomaly
• Use of pharmacological analgesia (e.g., epidural anesthesia, systemic opioids) before baseline pain assessment
• Obstetric complications requiring emergency intervention at admission (e.g., fetal distress, placental abruption, cord prolapse)
• Inability to cooperate with breathing exercises

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Continuous Birth Support by Student Midwives; Participants received continuous non-pharmacological birth support provided by trained senior student midwifery students under supervision throughout labor.	Behavioral: Continuous Birth Support; Continuous emotional, physical, informational, and advocacy support provided by senior student midwifery students under supervision during labor, including positioning, breathing techniques, massage, relaxation techniques, and psychological support.
Other: Routine Intrapartum Care; Participants received routine intrapartum care without continuous one-to-one birth support.	Other: Routine Care; Standard intrapartum care practices routinely provided in the study setting.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in labor pain intensity from baseline to active labor.	Labor pain intensity will be assessed using the Visual Analog Scale, a 10-centimeter horizontal line anchored with "no pain" and "worst pain imaginable." Scores range from 0 to 10. Higher scores indicate greater pain intensity. The outcome will be the change in participant-reported VAS score from baseline to active labor.	Baseline and during active labor, up to 24 hours
Birth satisfaction measured by the Birth Satisfaction Scale-Revised	Birth satisfaction will be assessed using the Birth Satisfaction Scale-Revised, a validated self-report questionnaire measuring women's satisfaction with the childbirth experience. The total score ranges from 0 to 40. Higher scores indicate greater birth satisfaction. The total scale score will be used as the outcome measure.	Up to 24 hours postpartum (Day 1)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Obstetric Interventions	Frequency of obstetric interventions during labor, including episiotomy, amniotomy, and labor augmentation.	During active labor (cervical dilation 4-10 cm, assessed continuously until delivery and at 1 hour postpartum

Collaborators and Investigators

• Sponsor: Antalya Bilim University
• Investigators: Principal Investigator: Seda Serhatlioglu, Doctorate, Antalya Bilim University

Publications and helpful links

General Publications

• Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. 2017;7:CD003766. doi:10.1002/14651858.CD003766.pub6
• Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. 2013;7:CD003766. doi:10.1002/14651858.CD003766.pub5

Study record dates

Study Major Dates

• Study Start (Actual): December 3, 2024
• Primary Completion (Actual): March 4, 2025
• Study Completion (Actual): March 4, 2025

Study Registration Dates

• First Submitted: December 31, 2025
• First Submitted That Met QC Criteria: April 29, 2026
• First Posted (Actual): May 4, 2026

Study Record Updates

• Last Update Posted (Actual): May 4, 2026
• Last Update Submitted That Met QC Criteria: April 29, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Birth Satisfaction; Midwifery Education; Student Midwives; Continuous Birth Support
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Labor Pain
• Other Study ID Numbers: 2025-SS; 1919B012325051 (Other Grant/Funding Number: TUBITAK 2209-A Undergraduate Research Support Program)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared.

Drug and device information, study documents

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