Vocalization and Spontaneous Pushing in the Second Stage of Labor

Enrolling by invitation · Not applicable

Conditions studied: Maternal Pushing Techniques, Perineal Trauma, Maternal Fatigue, Labor

In brief

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.

Key facts

Study ID

NCT07316348

Run by

Istanbul University - Cerrahpasa

People needed

112

Starts

2025-03-15

Expected to finish

2026-03-15

Last updated by the study team

2026-02-24

Who can join

Age: 18 and older. Sex: female. Healthy volunteers: accepted.

You may not qualify if…

• 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

Where it is running

• Istanbul University Cerrahpaşa — Istanbul, Ataşehir, Turkey (Türkiye)

Full record on ClinicalTrials.gov

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