Continuous Birth Support by Student Midwives and Labor Pain and Birth Satisfaction

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.

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